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Inspection Summary


Overall summary & rating

Requires improvement

Updated 6 December 2017

The inspection took place on 27 and 28 September 2017. Surround Care provides assistance to people who require support with daily tasks and personal care in their own homes. The service was supporting about 170 people when the inspection took place.

There was a registered manager in place. A registered manager is a person who has registered with the CQC 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 2008 and associated Regulations about how the service is run.

We found five breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.

Some people did not have robust risk assessments, which identified and explored all the risks which they faced. Staff recruitment checks were not fully completed to ensure staff were suitable to work in the care sector.

There was a lack of systems to prompt office staff about how to consistently and routinely respond to accidents and incidents involving people who used the service. There was a lack of recording systems in place to evidence action taken when this happened.

Staff received regular training and an induction to their roles when they started working at Surround Care. However, the methods used to check staff’s competency following staff’s induction and during their time at the service were not robust. Staff were not always provided with training specific to people’s needs.

People were supported by staff to make choices with their daily care needs. However, the service did not assess if people had capacity to make certain decisions. Staff were not trained about the Mental Capacity Act 2005. People had not fully given their consent to share information to other agencies.

Staff were kind towards people. However, some staff did not engage with people or treat them and their homes in a respectful way.

People’s care assessments were centred on them as individuals. However, people’s reviews did not demonstrate that people had been fully involved and asked about their views of the care they received, in a meaningful way.

The provider and manager were not completing audits to assess the quality of the care provided, and putting plans in place to make timely improvements. Quality audits which did take place were not being checked by the manager. There was a lack of systems in place to ensure the service was monitored in a meaningful way. We found issues with elements of the governance of the service which the manager and provider were not aware of until we inspected Surround Care.

People were protected from experiencing harm and abuse by staff who were knowledgeable about how to do this. Staff were aware of the potential signs of abuse. The service had systems in place for staff to respond to concerns.

Inspection areas

Safe

Requires improvement

Updated 6 December 2017

The service was not always safe.

People’s risk assessments did not always explore all the risks people faced, with a plan of action for staff to follow.

When concerns were raised about people’s safety, these were not always acted upon.

Staff recruitment checks were not fully completed.

Effective

Requires improvement

Updated 6 December 2017

The service was not always effective.

Staff knowledge, skills and competency was not routinely monitored.

Staff ensured people had choice and were consenting to their care.

Records did not confirm if people were adequately supported to have enough to eat and drink.

Caring

Requires improvement

Updated 6 December 2017

The service was not always caring.

People and their homes were not always treated with respect.

People’s confidential information was not fully protected.

Most people found staff were kind in their interactions with them.

Responsive

Requires improvement

Updated 6 December 2017

The service was not always responsive.

People did not have person centred reviews.

The service did not involve and ask people’s views about the service in a meaningful way.

People did not always receive support when they wanted it.

Staff did not always engage with people.

Well-led

Requires improvement

Updated 6 December 2017

The service was not always well led.

There was no quality monitoring of the service completed by the provider and the manager.

Internal audits were not robust and were not checked by the manager.

There was a lack of action taken to consistently respond to concerns. Systems were not always in place to ensure appropriate action was always taken.

Staff found the manager approachable.