The Care Quality Commission
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Archived: SureCare (St Albans & The Dacorum)

Overall: Inadequate read more about inspection ratings

Unit 22A/C Herts Business Centre, Alexander Road, London Colney, St Albans, Hertfordshire, AL2 1JG (01727) 828203

Provided and run by:
Dunmore Care Ltd

All Inspections

25, 26 and 30 June 2015

During a routine inspection

This inspection was carried out on 25, 26 and 30 June 2015 and was announced.

Surecare (St Albans and Dacorum) is registered to provide personal care to people living in their own homes. 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 and associated Regulations about how the service is run.

When we last inspected the service on 22 July 2014, we found them to be meeting the required standards. At this inspection we found that they were not meeting the standards.

People who used the service were not protected from the risks associated with poor recruitment practices. Pre-employment checks were not always carried out. References were not validated; gaps in employment histories were not challenged or explored. There were signatures in care records of people who had delivered care, who the manager told us they were not aware of and who there was no record of employment checks for.

People who used the service told us their needs was not always met by the provider. Care was provided around the availability of staff and not the assessed needs of people using the service Their personal care needs, assistance with medicines, assistance with the provision of food and drink was not delivered at the agreed times leaving people at risk of neglect.

Medicines were not always managed safely. Although staff had received training, the process of assessing staff competency was irregular and ineffective.

We saw certificates showing that staff had attended various training courses. However other documentation seen suggested that staff were delivering care at the times they were attending training. Training was not managed effectively and staff training needs had not been assessed.

Care plans did not contain sufficient details to inform care staff of the type of support people required and there was little information about people’s medical conditions, religious, spiritual or cultural needs. People’s food and hydration needs were not always met and there was little monitoring in this regard.

There were insufficient processes in place for managing staff, monitoring the delivery of service, keeping accurate records or following polices which were available but not in use. Although a quality monitoring survey had been completed it had not been evaluated or an action plan put in place to address shortfalls.

At this inspection we found the service to be in breach of regulations 9, 10, 12, 13,16,17,18 of the Health and Social care Act 2008 (Regulated activities) Regulations 2014, and regulation 18 of the Registration regulations 2009.

The overall rating for this service is ‘Inadequate’ and the service is therefore in 'Special measures'.The service will be kept under review and, if we have not taken immediate action to propose to cancel the provider’s registration of the service, will be inspected again within six months.The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe."

22 July 2014

During a routine inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008 and to pilot a new inspection process being introduced by CQC which looks at the overall quality of the service.

The inspection was announced, which meant the provider was informed about our visit two days beforehand to ensure managers and staff would be available in the office. When the service was last inspected on 02 April 2013, we found there were no breaches in the legal requirements for the areas we looked at.

The service is a franchise of a larger organisation that provides care and support to people living in their own homes. At the time of our inspection the service provided care and support to seven people.

The service had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law, as does the provider.

The CQC is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) and to report on what we find. We saw that there were policies and procedures in relation to the MCA to ensure that people who could not make decisions for themselves were protected. The records we looked at showed that all the care workers had received training in respect of the requirements of the MCA and they were able to demonstrate a good understanding of this.

People felt safe from abuse. The service had up to date policies and care workers had received effective training in the safeguarding of vulnerable adults (SoVA). Risk assessments, in which the people who used the service were involved, were carried out when risks to people’s health or well-being were identified.

There were enough trained care workers to provide the care and support that people needed. All the people we spoke with were very happy with the care and support they received. They thought that the care workers were well trained and treated them with dignity and respect.

For people using this service who were at risk care plans were in place to support them with their nutrition and hydration needs. Care workers were available to assist people to eat sufficient nutritious food. Care records included information that enabled the care workers to have meaningful engagement with the people for whom they supported.

The service was able to deliver care and support in a flexible way and were happy to adjust the number, times and length of visits as people’s needs changed. The service involved people in deciding how their care and support should be delivered and welcomed any suggestions people made to improve the service. People were aware of the complaints policy but no complaints had been received.

As it was a very small service the manager was able to monitor care workers practice whilst assisting with care delivery. They discussed care workers performance and development at regular supervision sessions.

The policies and procedures were mainly produced by the head office of the national organisation of which the service was a franchise. The manager had produced local policies and procedures where they had identified gaps in the national provision.

As a member of Hertfordshire Care Providers Association (HCPA) they were able to access practical advice and discuss best practice. They told us this was shared with care workers on a day to day basis as well as being discussed at team meetings.

2 April 2013

During an inspection looking at part of the service

We carried out this inspection as a follow-up to our inspection on 23 November 2012 when we had found that the provider was not meeting the essential standards for care and welfare of people who use the service or the requirements relating to workers. We had found at that time that risks to people had not been identified, managed and reviewed to ensure that their welfare and safety were maintained. We had also found that the provider did not have a robust recruitment system in place to ensure that relevant checks were carried out before staff were employed.

During the present inspection, we found that the provider was now meeting these essential standards. There were now risk assessments for people using the service, and there was a risk management plan in place, so that people were supported in a way that would reduce the risk of harm or injury. Relevant checks had been carried out on staff before an offer of employment had been made.

23 November 2012

During a routine inspection

During our visit, there was only one person who was receiving personal care from this service and they said that they were happy with the support they received from the manager. However, they also said that when other staff supported them, they had to rush because they had to catch the bus.

We found that the risk assessments did not state how the risks would be minimised and managed so that people would be supported appropriately to prevent any injury.

We also found that there had not been effective recruitment procedures in place to ensure that all required checks had been carried out prior to making an offer of employment. References had not been obtained and a criminal records bureau check had not been done before new members of staff had started work. As a consequence, people's welfare and safety may not have been protected.