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Archived: Surround Care Requires improvement

The provider of this service changed - see new profile

Inspection Summary


Overall summary & rating

Requires improvement

Updated 5 January 2019

Surround Care is a domiciliary care agency providing personal care to people living in their own houses and flats. It provides a service to children above 13 years of age and adults who have a variety of care and support needs including: dementia, learning disability / autistic spectrum disorder and mental health. In addition to a personal care service, people can also choose to receive support with companionship and domestic tasks, such as shopping. At the time of this inspection there were 180 people using the service, all of whom were adults.

Not everyone using Surround Care receives a regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

At the last inspection on 28 September 2017, we rated the service Requires Improvement and asked the provider to take action to make improvements in the following five areas: person centred care, dignity and respect, safe care and treatment, good governance and staffing. The provider did take action to address our concerns.

During this inspection, which took place on 26, 27 and 28 November 2018, we found that progress had been made in each of these areas. We also received some very positive feedback from people using the service which confirmed the improvements that had been made so far. However, more time was needed to fully implement and embed some of the changes that had been made. We have therefore not changed the overall rating for the service on this occasion. This is the second time the service has been rated requires improvement. We will check these areas again at our next inspection.

Why we have rated the service Requires Improvement:

The provider had invested in a new electronic care system which would enable better oversight of care and support issues as they happened. However, the system didn’t support staff with recording the level of detail required to mitigate assessed risks to people. The registered manager told us they would request a change to the system to address this.

Improvements had taken place with staff recruitment checks, but some staff files did not contain details of staff member’s full employment history. This is a required check and needs to be obtained before new staff work at the service. The provider told us a new member of staff had been recruited to support them with making sure all required staff checks were in place in future.

Staff training had also improved, but some staff were not able to demonstrate they had the right knowledge to deliver effective care and support. Some staff were also not aware of changes in legislation and current good practice.

Improvements had been made to the systems used to monitor the quality of service provision. However, audits we looked at did not provide enough detail or in-depth analysis, to drive continuous improvement.

We found the service was providing a good service in other areas that we checked. For example:

Staff had been trained to recognise signs of potential abuse and knew how to keep people safe. Processes were also in place to ensure people received their medicines when they needed them, and to protect them by the prevention and control of infection.

Most people agreed that care staff arrived when they were expected and stayed for the correct length of time.

There was evidence that the service responded in an open and transparent way when things went wrong, so that lessons could be learnt and improvements made.

People were supported to have enough food and drink to maintain a balanced diet.

Staff worked with external teams and services to help ensure people received effective care, support and treatment. People received appropriate support with their on-going healthcare needs.

People received personalised care from staff who were helpful, kind and compassionate. They were supported to have maximum choice and co

Inspection areas

Safe

Requires improvement

Updated 5 January 2019

The service was not always safe.

Improvements were needed to ensure records contained sufficient information about how to manage assessed risks to people.

Improvements were needed to ensure staff recruitment practices included all legally required checks.

People were protected from abuse.

Improvements had been made to ensure people received their medicines when they needed them.

People were protected by the prevention and control of infection.

When things went wrong, lessons were learnt in order to improve the service.

Effective

Requires improvement

Updated 5 January 2019

The service was not always effective.

Improvements were needed to ensure people’s care and support was always provided in line with current legislation and evidence based guidance.

Staff training had improved, but some staff were not able to demonstrate they had the right knowledge to deliver effective care and support.

People were supported to eat and drink enough.

Staff supported people to maintain their health and wellbeing.

Caring

Good

Updated 5 January 2019

The service was caring.

People were treated with kindness and compassion.

Staff supported people to express their views and be involved in making decisions about their care and support.

People’s privacy and dignity was respected and promoted.

Responsive

Good

Updated 5 January 2019

The service was responsive.

Improvements were being made to ensure people received personalised care that was responsive to their needs.

Systems were in place to ensure people’s concerns and complaints were listened and responded to.

If needed, arrangements could be made to ensure people at the end of their life were supported to have a comfortable, dignified and pain free death.

Well-led

Requires improvement

Updated 5 January 2019

The service was not always well led.

Improvements had been made to the systems used to monitor the quality of service provision, in order to drive continuous improvement. However, more time was needed to fully embed the changes being made.

A registered manager was in post.

Arrangements were in place to engage with people and involve them in developing the service.

The service worked in partnership with other agencies for the benefit of the people using it.