Background to this inspection
Updated
20 May 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
This inspection was carried out by one inspector and an Expert by Experience (ExE). An ExE 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 homes.
Registered Manager
This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
At the time of our inspection there was a registered manager in post, who was also the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider.
Notice of inspection
This inspection was announced. We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.
Inspection activity started on 27 April 2022 and ended on 6 May 2022. We visited the location’s office on 29 April 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 used all this information to plan our inspection. We reviewed other information we had received about the service, including notifications received from the provider. The law requires providers to send us notifications about certain events that happen during the running of a service. We sought feedback from the local authority, community professionals who work with the service and Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We also reviewed the provider’s social media sites to confirm they had published our last inspection ratings.
During the inspection
We contacted 20 people who use the service and their representatives and spoke with four people who use the service and eight relatives about their experience of the care provided. We spoke with the registered person, a care coordinator, a team leader and newly appointed staff member. We reviewed a range of records, including five people’s care records, medication records and daily notes. We looked at five staff files in relation to recruitment and six staff supervision records. A variety of records relating to the management of the service were reviewed, including the provider’s policies, procedures and quality assurance audits.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We spoke with two other people who use the service and 12 staff members. We looked at staff rotas, training data and quality assurance records. We spoke with three community professionals who worked in partnership with the service, supporting people living in their own homes.
Updated
20 May 2022
About the service
SureCare Reading and East Berkshire is a domiciliary care agency. It provides personal care to people living in their own homes. The service supports older people, younger adults, people living with dementia, physical disabilities, mental health needs and sensory impairments. Not everyone who uses the service may receive personal care. The Care Quality Commission (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. At the time of the inspection the service was providing personal care to 31 people in the Reading and East Berkshire area with 28 staff.
People’s experience of using this service and what we found
People were supported safely by staff, who understood how to safeguard people from discrimination, neglect, and abuse. There were enough staff deployed, with the right mix of skills to deliver care and support to meet people’s needs. Staff effectively assessed risks to people’s health and well-being, which were managed safely. People experienced good continuity and consistency of care from regular staff who knew them well and how they wished their care to be delivered. The provider recruited staff safely in accordance with regulations. People received their prescribed medicines safely, from staff who had their competency to administer medicines assessed regularly. Staff raised concerns and reported incidents, which ensured action was taken to protect people from similar events in the future. We were assured that staff followed good infection control and safe food hygiene practices.
Staff assessed all aspects of people’s physical, emotional and social needs and delivered support to ensure these were met to consistently achieve good outcomes for them. The registered manager effectively operated a system of spot checks, supervision, appraisal and staff meetings, which supported staff to deliver care based on best practice. Staff were supported to access training, develop and maintain skills relevant to their role. Staff supported people to eat and drink to maintain a healthy balanced diet. Staff worked in partnership with healthcare professionals to make sure care and treatment effectively met people’s changing 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.
The registered manager had developed the care coordinators and team leaders into an effective management team that worked well together. The management team effectively operated systems to review the quality and safety of the service. The registered manager encouraged critical feedback from people and staff to drive continuous improvement in the service. Staff had developed positive relationships, effective communication and information sharing with community health care professionals.
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 this service was requires improvement (report published 21 June 2021) and there were breaches of regulation. 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 improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
We had received concerns in relation to staffing, staff training, unsafe care relating to moving and
positioning people and infection prevention and control. As a result, we undertook a focused inspection on 28 April 2021 to review the key questions of safe, effective and well-led only. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment and good governance.
We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions of Safe, Effective and Well-led which contain those requirements. For those key questions not inspected, we used the ratings awarded at the inspection before the last inspection to calculate the overall rating. The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for SureCare Reading and East Berkshire on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.