You are here

Evergreen Care Requires improvement

Reports


Inspection carried out on 15 September 2020

During an inspection looking at part of the service

About the service

Surecare Barnet is a domiciliary care provider based in Barnet, North London and provides personal care to adults and older people in their own homes. At the time of this inspection the service was supporting 40 people.

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

Most people and their families were positive about the level of care and support they received from the service. Most praised the caring nature of care staff.

Care planning had improved. We found that the processes for assessing risks and medicines management had also improved, however further improvements were needed.

Despite the overall positive feedback received and improvements seen, we found concerns with the governance and management oversight of accidents, incidents and complaints. We were not assured that concerns raised were appropriately investigated and used to improve the service people received.

Most people and families told us they received their care visits in a timely manner. However, we found some concerns with rota management with lack of travel time scheduled in for some care staff between visits. We made a recommendation around staff working hours.

There were gaps in the providers recruitment process with regards to obtaining appropriate employment references and exploring gaps in employment.

There were concerns with staff morale and a culture of some staff not feeling able to raise concerns in an open way with the management team.

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 19 November 2019). 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 improvement had not been made and the provider was still in breach of regulations.

Why we inspected

This was a planned inspection based on the previous rating. However, the inspection was prompted in part due to concerns received. A decision was made for us to inspect and examine those risks.

We have found evidence that the provider needs to make improvements. We received concerns in relation to staffing, the management of accidents and incidents and overall care delivery. As a result, we undertook a focused inspection to review the key questions of safe, responsive 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 remained as 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.

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

Enforcement

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 to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to safe staff recruitment and overall go

Inspection carried out on 2 October 2019

During a routine inspection

About the service

SureCare Barnet is a domiciliary care agency providing support with personal care to people in their own homes. Fifty-five people were using the service at the time of the inspection.

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

Not all risks to people's health and safety had been identified and assessed. Risk assessments did not always contain guidelines for staff about how to reduce risk and support people to remain safe.

Medicines management and administration processes were not safe. There was a lack of clear information, guidance and records to ensure people were receiving their medicines safely and as prescribed.

Care plans were also not comprehensive and not always person-centred. They did not always contain enough information for staff to know people's individual needs and choices.

The provider had systems in place to monitor the quality of the service and make improvements where needed. However, they had had failed to identify some of the areas for improvement we found.

People who used the service and their relatives were happy with the service they received. People said the staff were kind, caring and respectful and they had developed good relationships with them.

Staff received the training, support and information they needed to provide effective care. The provider had procedures for recruiting staff to help ensure only suitable staff were employed.

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 good (published 10 November 2017).

Why we inspected

The inspection was prompted in part due to concerns received about timeliness of care calls and the providers response to complaints raised. A decision was made for us to inspect and examine those risks.

We have found evidence that the provider needs to make improvements. Please see the Safe, Responsive and Well led sections of this full report.

The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection.

Enforcement

We have identified breaches in relation to assessing risk, medicines management and overall governance at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We have asked the provider to send us an action plan telling us what steps they are to take to make the improvements needed. We will continue to monitor information and intelligence we receive about the service to ensure good quality is provided to people. We will return to re-inspect in line with our inspection timescales for Requires Improvement services.

Inspection carried out on 26 September 2017

During a routine inspection

The inspection was announced and took place on 26 September 2017. This service has not yet been rated and this is the first inspection to take place at this service.

Surecare Barnet provides personal care and support to people in their own homes and the wider community. At the time of the inspection it was supporting 17 people with a range of needs from learning disabilities to palliative care. It provides a range of support covering varied amounts of support hours, helping some people with a few hours a week to maintain independence, up to one person having a live-in carer to support them to live at home and have their complex health care needs met.

There was a registered manager in post at the time of our inspection that had been registered with the service since it first started in 2016. 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.

People told us they felt safe with care staff and there were enough staff to meet their needs. There was a safeguarding process in place and staff knew what abuse looked like and how to report it. There had been no safeguarding incidents in the year leading up to the inspection. Risks regarding care delivery were assessed and included action for staff to take to support each person to mitigate risks. Safe recruitment processes were followed. Medicines were managed safely but we did feedback that one person’s Medicine Administration Record was not clear and this was amended promptly. Infection control equipment was used.

The service was acting within the principles of the Mental Capacity Act 2005 and consent was sought for care provision and recorded in files. Staff understood consent and had attended training in this area. Staff were supported through regular supervisions, yearly appraisals and provided with training in areas required to meet the needs of people effectively.

People were supported to eat and drink where required and this was recorded appropriately. Positive health choices were encouraged and care staff supported people to link in with GPs and other health care professionals when needed.

People said the service was caring and they felt well looked after. People were treated with dignity and respect and care staff gave examples of how they could respect people whilst providing personal care. Cultural and religious preferences were recorded and observed during care provision.

People were involved in their care planning and reviews and there were regular checks on the quality of care. Feedback was sought from people and relatives, and was acted on. The complaints procedure was followed and complaints were appropriately recorded and acted upon.

Care staff fed back the service was well led and they felt supported by the registered manager. Audits to check the quality of care were robust and recorded where action was taken. The service worked in partnership with key health professionals to provide effective thoughtful care.