SentriCare

About the service

Sentricare is a domiciliary care service providing personal care to people living in their own homes. At the time of our inspection there were 72 people using the service.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

People’s experience of using this service and what we found

The provider's oversight of the service had not identified some of the shortfalls we found during the inspection process as part of their audits and checks.

There were systems in place for managing complaints, safeguarding concerns, accidents and incidents. However, feedback from people and relatives on how the provider dealt with complaints and concerns was mixed. The main complaint raised by people and their family members were late calls, the consistency of staff attending people’s homes and poor communication with the office staff.

Most risks to people had been assessed. However, risk assessments were generic and had not always contained person-centred information to support staff with people’s individual medical conditions.

People were protected from abuse because systems were in place to keep people safe. Staff were aware of their responsibilities to keep people safe.

There were enough staff members available to support people. People were supported by staff to take their medicines. Generally, staff followed infection control guidance and had access to personal protective equipment.

There were appropriate pre-employment checks in place to make sure newly recruited staff were suitable to carry out their role.

People’s care and support was planned in partnership with them and persons close to them. Care plans were in place and had been reviewed. Staff received training and people told us they felt supported by the staff and considered they had the skills and knowledge to support them safely. Staff sought people's consent and encouraged people to make their own decisions. Where appropriate, staff supported people with nutritional and hydration needs.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was requires improvement (published 18 September 2020). The service remains rated requires improvement. This service has been rated requires improvement for the last two consecutive inspections.

Why we inspected

The inspection was prompted in part due to concerns received about missed and late calls, staff not staying the correct length of time, client confidentiality and infection control practices. A decision was made for us to inspect and examine those risks.

We have found evidence that the provider needs to make some improvements. Please see the safe, responsive and well-led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Sentricare on our website at www.cqc.org.uk.

Enforcement and Recommendations

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to the provider’s governance and monitoring processes at this inspection.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

SentriCare is a domiciliary care agency providing personal care to people in their own homes. The service was supporting 39 people from the Walsall location and 74 at the Birmingham location, with personal care in their own homes at the time of our inspection. The Birmingham location is not currently registered, but an application has been submitted. We looked at and considered information about both locations as regulated activities are delivered from Walsall and Birmingham locations at the time of this inspection.

People’s experience of using this service and what we found

We were not supported by the provider in carrying out this inspection due to records not being available when requested. This was due to the lack of organisation of stored documents.

There was a lack of provider oversight which meant risks to people’s safety had not been responded to appropriately. Systems to monitor the quality and safety of the service were ineffective and placed people at the risk of harm. The systems in place had failed to identify the areas for improvement found at this inspection including the monitoring of the missed, short and late calls .

Risk assessments were not in place for all health conditions, or for people’s known risks to enable staff to have the information they needed to meet their needs.

People we spoke to said they felt safe however, two people told us that they had to teach staff how to support them correctly, to meet their needs in the way they wished.

Staff we spoke to told us they had received some training to meet people’s needs. However, we saw from records that staff had not completed training on all of the health conditions of service users, to give them the knowledge and skills to support them effectively and safely.

Accidents and incidents audits did not provide a full and clear picture of frequency of accidents or incidents or of actions taken to reduce further occurrences.

We were unable to ascertain if medication recording had improved as MAR charts could not be located and were not provided for us to review. This will be reviewed at the next inspection.

Spot checks of staff visits in people’s homes were completed to monitor that people received the support they needed.

Audits need to be improved to provide clear and robust information and evidence of outcomes for people.

Systems and process which were in place were not robust to protect people from potential harm.

We were not provided with evidence of any lessons learnt following incidents or accidents.

Staff we spoke to told us they understood their roles and responsibilities, had received some training and felt supported by the management.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was Good with requires improvement in Safe (26 March 2019). At this inspection we found that the rating had deteriorated to Requires improvement.

Why we inspected

We received concerns in relation to missed, short and late calls and the standard of care and support received. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has changed from Good to Requires Improvement. This is based on the findings at this inspection.

We have found evidence that the provider needs to make improvement. Please see the safe and well-led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

People’s experience of using this service:

Records relating to medication administration required improvement. We spoke with the management team about this and they told us they would address this without delay. By the end of our inspection, they had already commenced this work.

The provider’s complaints policy required review but everyone we spoke with was happy with the care they received. No-one we spoke with had any complaint about the service. Records showed that any complaints that had been received were minor and had been responded to in a timely and appropriate way.

Staff had person centred information on people’s needs and risks and the support provided was personalised to them and their individual requirements.

People told us they received good care and felt safe with staff. They said staff members were kind, caring and respectful.

People and their relatives confirmed that staff usually turned up on time and provided the support they needed in accordance with the people’s needs and wishes. Records showed that the support people received was consistent and reliable.

Records showed and people told us that where their needs or choices changed, the management team tried their best to accommodate these changes. People and their relatives said that the support provided was regularly reviewed with them by the management team and that their views were regularly sought by the provider on the quality of the care provided.

From the records we viewed and the feedback we received it was obvious that people’s care was planned and well organised.

Staff were recruited appropriately with the required pre-employment checks undertaken prior to employment to ensure staff members were safe and suitable to work with vulnerable people.

Call monitoring records showed that people’s visits were rarely missed and that the majority of visits were made on time. This showed that staffing levels were sufficient to ensure each person’s visit was completed in accordance with their requirements.

Staff were sufficiently trained to do their job role well and supported by their line manager. Staff morale was good. Staff told us they were supported by the management team and the provided. Staff felt they provided a good service to people. The people and relatives we spoke with agreed with this.

The systems and processes in place to monitor the quality and safety of the service were effective in identifying and driving up improvements in the service. The provider and management team demonstrated a good knowledge of their regulatory responsibilities with regards to people’s care and managed the service well.

Rating at last inspection and why we inspected: This was a scheduled inspection. At the last inspection the service was good. At this inspection, the service was rated good again.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme.

This inspection took place on 16 June 2016 and was announced.

SentriCare provides personal care for people in their own home. There were 52 people using the service when we inspected and there was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run.

People told us they felt safe when staff came into their home and were protected from the risk of potential abuse. People had their individual risks looked at and had discussed how these could be reduce with plans in place to manage them. There were enough staff to ensure that people had their calls at the agreed time and the required number of staff. People who required support with their medicines were confident that the staff helped them in receiving the medicines when required.

Staff received regular training so their skills and knowledge reflected the needs of the people they cared for. Staff were supported with regular supervisions with the management team to reflect and discuss how their role and responsibilities were being met. Where people needed support with their meals they told us they were happy that staff came them a choice or provided the assistance needed to enjoy their meal.

Care plans were in place detailing how people wished to be supported and people were involved in making decisions about their care. People’s consent was appropriately obtained by staff when caring for them and people who could not make decisions for themselves were supported by representatives or family members. People told us they got healthcare appointments as required to meet their needs.

People knew the staff and felt they provided a personalised service where time was spent chatting while providing care and getting to know them. People felt the care they had received met their needs. They were also supported in maintaining their dignity and encouraged to be involved in their care needs where able.

People’s views and decisions they had made when planning or making changes to their care were listened to and recorded in care plans. People knew how to make a complaint and felt comfortable to do this should they needed to. People were provided with the information they needed should they wish to raise a complaint. People told us they felt that if they had raised any concerns they would be dealt with.

The registered manager was accessible and approachable. People, their family members and staff felt able to speak with the management team and provide feedback on the service. The management team had kept their knowledge current and they led by example. The provider ensured regular checks were completed to monitor the quality of the care that people received and looked at where improvements may be needed.

In the office we met and spoke with the registered manager, deputy manager, care co-ordinator and four care staff employed by the agency. We made telephone contact with two people that used the service and spoke with them about their experiences. We also spoke with two relatives/friends. People praised the staff that provided care. One person said: "They are friendly, polite, nice girls".

During the inspection we looked at four people's care plans and risk assessments. We saw that the care records were in order and updated to ensure that care was delivered correctly.

We spoke with care staff about how they were supervised and trained to meet people's needs. We reviewed the training and support mechanisms in place for staff. We saw that the agency provided sufficient training to ensure that staff were competent to fulfil their role. A member of staff that we spoke with said: "I am in and out of the office all of the time. They are very helpful, you can phone or pop into the office to have a chat. There is on call as well to help you when the office is closed". Another staff member said: "The management talk to you, they make sure the staff are happy".

We looked at medication administration and safe handling processes and saw that they were well managed by the agency.

After the inspection we contacted people who used the service, their relatives and care staff.

People we spoke with told us that they were happy with the standard of care they received and were involved in giving feedback to the service.

One person told us, 'The staff are excellent. They are very caring and they do what I ask of them. They respect my preferences and choices'.

Another person told us, 'I am very happy. I always have the same carer and have never had any missed calls. If you have a problem they sort it out for you'.

We spoke with a relative who told us, 'The staff are wonderful. They know my relative's care needs. I would recommend this agency'.

Staff we spoke with told us they had appropriate training to undertake their work competently and to keep people safe.

We found that appropriate recruitment and selection procedures had been undertaken by the service.

We found that there was a system for ensuring the ongoing quality assurance within the service.

We found that SentriCare was compliant in the five outcome areas.