We carried out a review of the data available to us about Supportive SRC Ltd on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Supportive SRC Ltd, you can give feedback on this service.
Supportive SRC Ltd is a domiciliary care agency providing personal care to people living in their own houses and flats in the community. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is to 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 125, mainly older people received personal care.
People's experience of using this service and what we found
People confirmed they received their medicines safely as prescribed from suitably skilled staff. Medicines records were maintained, and associated checks completed. An action plan was in place to review the medicine audits to ensure any required actions were clearly documented.
Staff told us they felt well supported in their roles and understood when to escalate any concerns or to seek support and guidance. Records evidenced staff received supervisions, observations and competency checks which ensured they worked to high standards; following best practice. Where any concerns were recorded, further training and support was provided. Action plans were in place to ensure planned annual staff appraisals were completed following the company policy.
People, their relatives and staff provided very positive feedback about the care and support they received. Improvements had been made under the new registered manager since the last inspection. Further provider oversight was discussed and planned. An associated action plan remained in place to ensure the service continued to maintain, and where required, improve standards of care.
People received a safe service. Staff had access to clear information to provide people with safe care and support. Care records had been reviewed and updated with clear guidance to support all areas of risk.
There were enough staff to ensure people received a safe, consistent service to support their assessed needs. Staff had received training to safeguard people from abuse. Systems and processes were clear and easy for staff to follow to report any concerns. Records confirmed any concerns were effectively managed with actions implemented to improve the service.
Staff training was managed electronically. A review of training, due to recent restrictions on providing group practical training sessions had ensured staff remained up to date with their skills and knowledge.
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 ensured care was based upon good practice guidance to help ensure people received a safe, person centred and effective service.
Promoting independence was encouraged and people were offered choices. The registered manager and staff team worked closely with external healthcare professionals to ensure
people's health and wellbeing was maintained.
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 (published 17 December 2019) and there were multiple 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 carried out an announced comprehensive inspection of this service on 3 and 4 December 2019. 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 in 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 safe, effective, responsive and well-led which contain those requirements.
The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. 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 Supportive SRC Ltd on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
Supportive SRC is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to children, younger and older adults. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is to 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 they were 136 people receiving personal care.
People’s experience of using this service and what we found
Overall the feedback we received from people and relatives was complimentary. However, we found continued concerns about the aspects of managing risks, medicines, records and the governance of the service. Although there had been some improvements, legal requirements were still not consistently met.
There were enough staff to ensure people were safe. Staff had received training to safeguard people from abuse and knew how to report concerns. The management team sought to learn from any accidents or incidents involving people.
Staff had received training to understand how to support people well. Care records provided information in relation to people's backgrounds, interests and care needs. Staff felt supported in their role, however records showed a lack of supervisions were taking place.
We have made a recommendation about supervisions.
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; systems supported this practice. The registered manager ensured care was based upon good practice guidance to help ensure people received an effective service.
Promoting independence was encouraged and people were offered choices.
The registered manager and staff team worked closely with external healthcare professionals to ensure people's health and wellbeing was maintained.
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 (published 28 December 2018).
The provider completed an action plan after the last inspection to show what they would do and by when to improve.
At this inspection enough improvements had not been made and the provider was still in breach of regulations.
The last rating for this service was requires improvement (published 28 December 2018). The service remains rated requires improvement. This services has been rated requires improvement for the last two consecutive inspections.
Why we inspected
This was a planned inspection based on the previous rating.
Enforcement
We have identified two breaches in relation to the management of risk, records and governance.
We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
People’s experience of using this service:
People's risk assessments did not consistently cover all potential areas of risk, such as a risk of choking or falls. We looked at the systems in place for medicines management and found records did not support keeping people safe. People felt safe in the care of staff members and were happy with staffing levels. The provider had appropriate systems in place to support staff to raise any safeguarding concerns. Staff had access to appropriate personal protective equipment (PPE) to help prevent the spread of infection.
People told us they received effective support. Systems were in place to ensure that staff received
appropriate supervision to support them in their roles. Staff felt they were trained to the right level to effectively work with people.
Checks were made on the ongoing competency of staff and staff felt they could ask for extra training and support at any time. People told us that staff sought their consent prior to carrying out care and made people aware of the actions they were to take. People were supported to eat meals of their choosing and were assisted to access health professionals when necessary.
People told us care staff were very caring, kind and compassionate. Staff enabled people to be independent and to make choices where possible. People's privacy and dignity needs were maintained by staff members caring for them.
People told us they were provided with a responsive service. People received care and support to meet their individual needs. People and families spoke about being involved in the process of writing and reviewing their care plans. People knew how to make complaints and we saw evidence to show complaints had been fully investigated.
The provider’s systems and processes in place to monitor and audit the service required improvement. Records management needed improvements regarding medicines, risk assessments and quality monitoring of the service.
More information is in detailed findings below. We identified two breaches of the Health and Social Care Act (Regulated Activities) Regulations 2014 around safe care and treatment and governance. Details of action we have asked the provider to take can be found at the end of this report.
Rating at last inspection: Good (report published December 2016)
Why we inspected: This was a planned inspection based on the rating at the last inspection. The service now required improvement.
Follow up: We will speak with the provider following this report being published to discuss how they will make changes to ensure the provider improves the rating of the service to at least Good. We will revisit the service in the future to check if improvements have been made.
At our last inspection of Supportive SRC Limited, published on 6 July 2016, we reported that the registered provider was in breach of Regulation 19; Fit and proper persons employed. This was because the registered provider did not operate recruitment procedures which were robust enough to protect people using the service from unsuitable staff.
The provider had not undertaken thorough background checks for staff before they started working with vulnerable people. We issued a requirement notice to the registered manager to send us a report (action plan), within 28 days, on how they intended to mitigate and address the breach of Regulation 19.
The registered manager sent this report to us promptly and we were satisfied with how they intended to address the issues we found. At this inspection we found improvements had been made to meet this regulation.
Supportive SRC Limited is registered with the Care Quality Commission to provide personal care to people who wish to remain independent in their own homes. The agency provides services throughout areas of County Durham and provides a range of home care and support. At the time of our visit there were approximately 300 people using this service who were supported by 151 staff.
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 2008 and associated Regulations about how the service is run.
The registered manager showed us how the recruitment procedure had been changed since the last inspection. This included checks to ensure people could demonstrate their previous employment history including other previous posts involving children or vulnerable people. The registered manager and other senior staff responsible for overseeing the recruitment of staff at the service demonstrated that they knew the importance of ensuring that recruiting checks were robust. Systems in place at the service ensured staff could not work with vulnerable people until full background checks had been carried out. We saw that people using the service were protected from applicants who were unsuitable to work with vulnerable people.
Supportive SRC Limited is registered with the Care Quality Commission to provide personal care to people who wish to remain independent in their own homes. The agency provides services throughout areas of County Durham and provides a range of home care and support.
At the time of our visit there were approximately 300 people using this service who were supported by 151 staff.
There was a manager in place who had recently been assessed by CQC as having the skills, qualifications and experience to be the registered manager. The registered manager had also worked in a key leadership role for the organisation for over ten years and was continuing in this role. A registered manager is a person who has registered with the Care Quality Commission (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. There was also a ‘homecare manager’ appointed by the provider to manage the day to day operation of the service.
Everyone who was using the service had a care plan which described how their individual care and support needs were to be met. This meant that everyone was clear about how people were to be supported. These were evaluated, reviewed and updated as required. People who used the service and those who were important to them were actively involved in deciding how they wanted their care, treatment and support to be delivered. The registered provider had detailed plans in place to improve how care plans were written and had started to make these changes.
The registered provider had an effective system in place to identify, assess and manage risks to the health, safety and welfare of people who used the service. We saw risk assessments were carried out and these were updated if new situations or needs arose.
We found the registered provider did not operate recruitment procedures which were robust enough to protect people using the service from unsuitable staff. The provider had not undertaken thorough background checks for staff before they started working with vulnerable people.
Feedback from people who used the service showed that staff and the registered manager were friendly, open, caring and diligent; people who used the service trusted them and valued the support they provided. People told us they were happy with the support from this agency and felt they were in control of the support they received.
The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The Act requires that as far as possible people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible. People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the MCA.
We found the registered manager had a good understanding about how the service was required to uphold the principles of the MCA, people’s capacity and ensure decisions about their best interests were robust and their legal rights protected.
The registered manager and staff that we spoke with promoted peoples’ wellbeing and it was evident that staff knew people who used the service well. This included their personal preferences, likes and dislikes. Staff had used this knowledge to form caring and therapeutic relationships. These relationships improved the agency’s effectiveness and helped them make changes in response to people’s needs or in response to emergency situations.
People were supported by staff who had received appropriate training. The registered provider made sure that staff were provided with training that matched the needs of the people they were supporting. This was particularly important where staff were supporting people with complex conditions which required staff to have and maintain specific skills. Where staff undertook specialised training, their work was overseen and monitored by suitably qualified staff from the registered provider and other organisations.
People were protected from the risk of abuse. Staff, the registered manager and the homecare manager understood the procedures they needed to follow to ensure that people were safe. They had undertaken training and were able to describe the different ways that people might experience abuse. When asked they were able to describe what actions they would take if they witnessed or suspected abuse was taking place and what they expected of service colleagues and statutory agencies. Staff were aware of their role in protecting people from harm and were diligent in checking for signs of abuse.
We saw the registered provider had policies and procedures for dealing with medicines and these were followed by all staff. Staff had detailed training about how treatments were to be given. Some of these were personalised and dependant on people’s needs and varying condition. Safeguards were in place where people required support with treatments. Medicines were securely stored and there were checks in place to make sure people received the correct treatment.
The service had a complaints policy which provided people who used the service and their representatives with clear information about how to raise any concerns and how they would be managed. Staff we spoke with understood how important it was to act upon people’s concerns and complaints and would report any issues that were raised, to the registered manager. People who used the service and those who were important to them knew about the complaints process and had confidence that these would be handled appropriately by the registered provider.
We found that the registered manager and registered provider had systems in place to monitoring the quality and ensure that the aims and objectives of the service were met. This included audits of key aspects of the service, such as medication and learning and development, which were used to critically review the service. We also saw the views of the people who used the service and those who were important to them, were sought. The registered manager produced action plans, which showed when developments were planned or had taken place. The services operations were also subject to oversight by a board of trustees who provided an additional level of decision making in line with the registered providers aims and objectives.
We saw people were fully involved in decisions about their care. One person said 'A senior member of staff and a carer recently came out to visit me to discuss my care plan.'
People described how their care and welfare needs were met. Comments included 'They make sure I have biscuits to hand when they leave and help me with my eye drops'. Another person described how, with the support of agency staff, they were able to enjoy shopping trips out in the community.
Relatives described how the agency had increased their family member's number of calls in response to their changing needs.
We saw appropriate procedures were in place so staff were clear about the support each person needed with their medicines.
We found staff were recruited appropriately. This helped to make sure only people with the right skills and knowledge were employed to work for the agency.
We saw the provider had a system to regularly assess and monitor the quality of the service people received. We found there was also an effective complaints procedure.
As part of this review, we visited four people in their own homes and spoke with them about their experiences of the support they had received from this service. Relatives were present during two of the visits. At the time of our visit to the office, we spoke with the manager and three care workers, two senior care workers, two home care managers and the out of hours on call member of staff. We spoke over the telephone with a further 19 people who used the service and a further five care staff during our visits to people.
People we spoke with were positive about the care and support they received. Comments included 'They are all good carers', 'I'm 100 percent happy, we have got to know each other over time and have a good working relationship', and 'They are brilliant, like Angels', 'It's a good care company. It's excellent,' and 'The lasses are just like friends.' Everyone without exception we spoke with told us staff treated them with respect. One person said 'They respect me and I respect them. ' A relative who was present during one visit said 'They wouldn't be in if they did not treat (X) with dignity and respect.' Another relative said 'They (the agency) have their good points, they just need the odd tweak here and there.'
When we visited we also had the opportunity of watching staff practices as they supported people. We heard staff address people respectfully and explain to people the support they were providing. Staff were friendly and very polite and understood the support and communication needs of people in their care. Staff waited for people to make decisions about how they wanted
their care to be provided.
People told us they never had a missed call and staff normally stayed for the length of time they had agreed to in their care plan. People told us they felt safe and would feel comfortable about contacting the manager if they were unhappy.