Archived: SureCare Hereford

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

SureCare Hereford is a domiciliary care agency. It provides personal care to people living in their own houses in the community. The service supports older and younger adults, who may have learning disabilities, autistic spectrum disorder, dementia, mental health care needs, physical disabilities or sensory impairments. At the time of our inspection visit, 48 people were using the service.

Not everyone using SureCare Hereford 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.

The service is required to have a registered manager and there was a registered manager in post at the time of our inspection. 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.

The provider’s processes for assessing and managing the risks associated with people’s care and support needs were not sufficiently robust. Staff did not always have adequate travel time between people's care calls to provide a punctual service. People’s rights under the Mental Capacity Act were not always fully promoted by the provider.

The provider carried out pre-employment checks and provided staff with training to protect people from harm and abuse. People received support from staff to manage and take their medicines safely, where they needed this. Staff protected people from the risk of infection through, amongst other things, the use of personal protective equipment.

Before people’s care started, their individual care and support needs were assessed. Staff received an initial induction and ongoing training and support to succeed in their roles and work effectively. People had support to prepare meals and drinks of their choice, where this was an agreed part of their care package. Staff helped people to maintain their health and access professional medical advice and treatment as needed.

Staff took a caring and compassionate approach to their work and took the time to get to know people well. People and their relatives were encouraged to express their views about the care and support provided and were listened to by the provider. Staff understood and promoted people’s rights to privacy, dignity and independence.

People’s care plans were developed and reviewed with their input and followed by staff. People received care and support that reflected their individual needs and requirements. People and their relatives were clear about how to raise any concerns or complaints about the service, and these were addressed by the provider.

The registered manager promoted a positive, open culture within the service. They made themselves available to people and their relatives and were responsive to any issues raised with them. Staff were clear what was expected of them and felt valued and supported at work. The provider took steps to involve people, their relatives and staff in the service. The registered manager and senior care staff completed audits and checks to assess, monitor and improve the quality of the service people received.