Date of Assessment: 17 June 2024 to 31 July 2024 This was a planned assessment. Care Relief Team Limited Derbyshire (CRT) is a care agency, providing care and support to people living in their own homes. The assessment looked at the homecare service. The report for the most recent inspection was published 4 August 2022. The overall rating for the service was requires improvement. We assessed 17 quality statements, including Learning culture; Safe systems, pathways and transitions; Safeguarding; Involving people to manage risks; Safe environments; Safe and effective staffing; Infection prevention and control; medicines optimisation; Independence, choice and control; Equity in experiences and outcomes; Shared direction and culture; Capable, compassionate and inclusive leaders; Freedom to speak up; Workforce equity, diversity and inclusion; Governance, management and sustainability; Partnerships and communities; Learning, improvements and innovation. We assessed these quality statements and the overall rating for the service is now good.
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Focused inspection downgraded the service from Good to Requires improvement due to medicines not always administered as prescribed, late calls from insufficient staffing, and weak governance oversight including outdated safeguarding logs. The provider took immediate mitigating action and engaged with stakeholders, but improvements need to be embedded to be effective.
Concerns (8)
criticalMedication management: “People did not always receive their medicines as prescribed. Some people were prescribed medicine in a patch format to treat pain. We found on several occasions this medicine had not been administered as prescribed.”
criticalSafeguarding: “the safeguarding log was not kept up to date as per policy. There was a risk of concerns not being reviewed, resulting in the risk of ongoing harm to people.”
criticalGovernance: “The provider lacked oversight to identify and address areas for improvement in a timely way... The compliance audit procedure in place did not identify or address issues until a month after the incident.”
moderateMissed or late visits: “People did not always receive their care calls at the agreed time due to insufficient staff deployed by the service.”
moderateStaffing levels: “Staff felt more staff were needed to ensure all calls were made on time and for staff rotas to be managed well to make sure staff absence such as leave or sickness was adequately covered.”
moderateComplaints handling: “complaint outcomes were not always communicated effectively or in a timely manner. People told us they were not happy with how their concerns and complaints were processed.”
moderateLeadership: “Temporary management support arrangements put into place by the provider were not always effective.”
minorCommunication with families: “Not everyone received their calls on time or were informed by the office staff if their call was going to be late.”
Strengths
· Staff were safely recruited with criminal record checks and references obtained
· Staff completed safeguarding training and were competent to identify and report concerns
· Infection prevention and control practices were good, with staff using PPE appropriately
· Risk assessments identified people's needs and reflected their preferences
· Incidents were reviewed monthly with themes and trends considered
Quality-Statement breakdown (10)
safe: Using medicines safelyNot rated
safe: Systems and processes to safeguard people from the risk of abuseNot rated
safe: Learning lessons when things go wrongNot rated
safe: Staffing and recruitmentNot rated
safe: Assessing risk, safety monitoring and managementNot rated
safe: Preventing and controlling infectionNot rated
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsNot rated
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringNot rated
well-led: Engaging and involving people using the service, the public and staffNot rated
well-led: Working in partnership with others; Continuous learning and improving careNot rated