Background to this inspection
Updated
3 October 2019
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
Inspection team
The inspection team consisted one inspector and an assistant inspector.
Service and service type
SureCare Hereford is a domiciliary care agency. It provides 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 help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.
The service did not have a manager registered with the Care Quality Commission at the time of the inspection. However, the manager was in the process of registering with the Care Quality Commission. Registered managers and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
We gave the service 48 hours’ notice of the inspection. This was because we needed to be sure that the provider would be in the office to support the inspection.
Inspection activity started on 20 August 2019 and ended on 10 September 2019. We visited the office location on 22 August 2019.
What we did before inspection
We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority who work with the service and Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used all of this information to plan our inspection.
During the inspection
We spoke with three people using the service, two relatives and a family friend to ask about their experience of care. We spoke with two provider representatives, the manager, six staff members, including care supervisors and care staff.
We looked at six people's care records, multiple medication records and information relating to the quality and management of the service. This included minutes of staff meetings, complaints and compliments, staff training records and systems for managing accidents or incidents.
Updated
3 October 2019
About the service
SureCare Hereford is a service providing personal care to people in their own homes. People supported include younger and older people who may live with dementia, mental health needs, physical disabilities or sensory impairments. Fifty-eight people were in receipt of care 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
There had been improvements in the guidance provided to staff, so they could provide care which supported people’s safety. People’s risks were clearly identified, and staff were supported to understand what action they needed to take to address people’s safety needs.
Staff knew how to recognise abuse and were confident the manager and senior staff would assist people, should any concerns be identified. People received their care at the times planned. People were supported by staff who took action to reduce the likelihood of them experiencing infections. Systems were in place to take learning from any incidents.
There had been improvements in the way people’s capacity was assed. 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 provider and registered manager gave us assurances improvements in the recording of decisions taken in people’s best interests would be further embedded.
People’s care needs and preferences were assessed before they started to receive care. Staff used their knowledge and skills when caring for people and were supported to provide good care through induction and training programmes, which reflected the needs of the people they supported. People, relatives and family friends were confident staff would support people to see other health professionals, and to have enough to eat and drink, so they would enjoy the best health possible.
People told us they liked the staff who supported them and found them to be considerate and kind. Relatives and family friends told us staff knew people well and had developed good relationships with the staff caring for them. Staff encouraged people to make their own decisions about their care, and promoted people’s rights to dignity, independence and privacy.
People, relatives and family friends were involved in planning people’s care, and said their views were listened to. Staff recognised when people’s needs changed and supported people to ensure these were met. Systems were in place to take learning from any complaints, to prevent reoccurrences. People’s wishes at the end of their lives had been established. The provider told us they planned to further enhance opportunities for people wishes to be explored, in case of sudden death.
People, relatives and family friends were positive about the way the service was managed and were encouraged to make suggestions about the care provided. There had been changes to the senior management team, and staff told us this had brought about improvements in people’s care and their support. Staff knew how they were expected to care for people and had received compliments regarding the quality of care provided to people. The manager and provider checked the safety and quality of the care, so they could be assured people’s needs were met. The manager understood their responsibilities to drive through improvements to people’s care, and development of the service was informed by work undertaken with other organisations.
Why we inspected
This was a planned inspection based on the previous rating.
Rating at last inspection
The last rating for this service was Requires Improvement (published 23 August 2018).
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.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk