First Call Community System T/A SureCare Scarborough

Inspection site activity took place on 22 and 28 November 2018. At the time of inspecting 112 people were receiving a regulated activity. Not everyone using SureCare receives a regulated activity; CQC only inspects the service being provided by people 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.

The service provided care visits between the hours of 7am and 10pm. Care visit lengths range from 15 minutes onwards. The maximum call length being provided when we inspected was four hours. An on-call service was available out of hours for emergencies only. This was managed by senior members of staff and the registered manager.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People living with learning disabilities and autism using the service can live as ordinary life as any citizen.

The service had a registered manager in place. They were present throughout the inspection. A registered manager is a person who has registered with 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.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

People felt safe when staff were supporting them. They were confident that staff had the knowledge and skills needed to use any equipment safely.

People’s safety was supported through effective risk management. Risks assessments contained relevant information for each person, recognising risk may fluctuate and how to support people to reduce this.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

Staff received training and support to help them understand their roles. People felt staff were all sufficiently trained to provide their care effectively. Supervisions and appraisals were used to support staff development and monitor their performance.

Staff understood the roles of other professionals. People received support at GP visits and staff acted on any advice given.

People formed trusting relationships with staff. Relatives valued the patient, caring approach staff adopted, taking time to provide the person with reassurance. People’s privacy and dignity was respected. Staff established what people’s preferred means of accessing their homes was.

The provider was responsive to changes in people’s needs and care arrangements. They reviewed people’s care jointly with them and their relatives. Care times were organised to accommodate people’s activities and other commitments.

Staff understood people’s preferred routines and lives. Details of people’s interests and significant relationships were recorded in care plans.

Feedback from people and their relatives was welcomed. People were able to provide their feedback through a variety of means. Any improvements suggested were listened to and actioned.

There were high levels of staff satisfaction. Staff felt well supported by the staff team and managers. staff wellbeing was an ongoing consideration, which was monitored. Staff were encouraged to develop and their professional development was promoted.

The registered manager was motivated and innovative, reflecting on improvements that could be made to the service and areas for development. An initiative to support people in hospital to promote their independence and reduce their social isolation on leaving hospital had been identified and put forward to the local authority.

The service worked proactively with other services to share learning and promote best practice.

Further information is in the detailed findings below.

First Call Community System T/A SureCare Scarborough provides a domiciliary care service offering support and personal care to 109 adults who live in their own homes. We have referred to the service as SureCare in our report.

There was a registered manager in post at this service. 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.

SureCare was last inspected on 31January 2014 and met all the required standards we looked at.

The service delivered safe care and support to people ensuring that staff were aware of safeguarding policies and procedures and how to respond to concerns related to abuse. There were policies and procedures in place to guide staff if there were any incidents of suspected abuse.

Risk assessments relating to the care people received and their environment were completed and reviewed regularly. The results of risk reviews and actions taken to reduce risk were recorded in people’s care plans.

Records showed that staff were given appropriate and current training and refresher courses that ensured they were competent to deliver support and care safely. The registered manager was qualified to train staff in house and they delivered some of the training to staff. The service completed competency reviews and spot checks to ensure safe practice was offered and maintained in a consistent manner.

Staff received regular supervision which allowed them to have a one to one discussion with the manager. They told us they felt supported and motivated by the service and benefited from supervision meetings.

The service was working within the principles of the Mental Capacity Act (MCA) 2005 and staff had received appropriate training. People were asked for their consent before care and support was delivered and they were encouraged to make their own choices.

The staff respected people’s rights to dignity and privacy and had a caring approach and positive attitude to their role and the people they supported. The service encouraged people to maintain their independence and they gave positive feedback about the attitude and approach of staff and management.

People received person centred care, were treated as individuals and developed respectful and positive relationships with care workers. They knew how to make a complaint and felt confident that staff would support them to resolve a problem.

The service regularly asked people and staff for their opinions of the quality of the service and the responses were recorded and used to assess service standards and improve quality. Staff and people who used the service told us that the management team were approachable, easy to talk to and understanding.

The culture of the service was open and positive. Staff were happy, motivated in their work and had confidence in the way the service was managed. The management team were proactive in increasing their skills and knowledge to develop the service further. People who used the service had their needs met by a well led service.

We looked at the ways staff were recruited and the induction they were given. This was done safely and induction included mandatory areas of training to be completed by staff before they started working.

There was a quality assurance system in place and this was used to ensure that the quality of support being provided was always developing and improving. The provider listened to feedback from people who used the service and staff.

There was a complaints system in place and this was being used although the recording of this required some improvement. Documentation and paperwork was in good order and was detailed, accurate and up to date. It was stored and disposed of appropriately.