Background to this inspection
Updated
7 December 2022
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.
Inspection team
The inspection team consisted of two inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats and specialist housing.
Registered Manager
This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.
At the time of our inspection there was a registered manager in post.
Notice of inspection
We gave the service 48 hours’ notice of the inspection, as we needed to be sure that the provider or registered manager would be in the office to support the inspection.
Inspection activity started on 10 October 2022 and ended on 25 October 2022. We visited the location’s office on 12 October 2022.
What we did before the inspection
We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We asked the registered manager to provide us with their most recent call, visit data to people. We reviewed all the information we held about the service. We used all this information to plan our inspection.
During the inspection
We spoke with the registered manager and nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We spoke to 1 member of staff who was visiting the office. We reviewed a range of records. This included 7 people’s care records, associated risk assessments and Medication Administration Records [MAR] where appropriate. We looked at 3 staff files in relation to recruitment, training, supervisions and spot checks. We looked at a sample of the service’s quality assurance systems including safeguarding and complaints management records. The Expert by Experience spoke with 16 people who used the service or their relative about their experience of the care provided.
Following the inspection to the domiciliary care office, we continued to seek clarification from the registered manager to validate evidence found. We spoke to a further 4 members of staff by telephone.
Updated
7 December 2022
About the service
SureCare Southend is a domiciliary care agency providing personal care to people living in their own homes. At the time of our inspection there were 54 people using the service.
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
People had experienced missed and late care visits and staff did not always stay for the length of the scheduled call time. People were not always informed about delays.
Staff had been safely recruited and relevant checks were completed, however, we were not satisfied staffing levels and deployment of staff ensured all people’s care needs were met in a timely way.
Staff knew how to keep people safe from harm. Risks to people had been identified, assessed and reviewed. However, we found the provider did not have robust processes in place to analyse incidents and share learning with staff in order to minimise the risk of reoccurrence.
We have made a recommendation about staff supervision.
People and their relatives told us they felt able to raise concerns; however, they were not confident they were being listened and responded to. We received mixed feedback around the effectiveness of the leadership of the service.
People told us, not all staff wore Personal Protective Equipment (PPE) when providing care and support.
The providers governance arrangements did not provide assurance the service was well led, and regulatory requirements were not being met.
People’s medicines were being managed safely; we saw PRN protocols in place for people who needed their medicines as required.
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 and update
The last rating for the service under the previous provider was requires improvement (published April 2021). The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found the provider remained in breach of regulations.
Why we inspected
The inspection was prompted in part due to concerns received from the local authority about missed and late calls, complaints and communication. A decision was made for us to inspect and examine those risks.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for SureCare Southend 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 systems and processes and the monitoring of the overall quality of the service, which had not been established to do all that is reasonably practical to assess, monitor and mitigate risk to provide safe care and treatment to people using the service at this inspection.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.