Archived: CARE4U - SURREY

Updated 12 June 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. We planned this inspection to check whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

The inspection team consisted of two inspectors.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats. The service had a manager registered with the Care Quality Commission. This means that they 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 24 hours’ notice of the inspection site visit because the service is small and we needed to be sure that the registered manager would be in the office to support the inspection. The inspection took place on 13 May 2019. We visited the office location on this date.

What we did before the inspection

We used the information the provider sent us in the provider information return (PIR). 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 sought feedback from the local authority who work with the service.

During the inspection

We spoke with three members of staff including the registered manager, and two care workers. We reviewed a range of records. This included four people’s care records and multiple medication records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures, were reviewed.

After the inspection

We spoke with one person who used the service and two relatives. We looked at training data and quality assurance records sent to us by the registered manager.

Updated 12 June 2019

About the service

Care4U - Surrey is a domiciliary care agency. At the time of our inspection, it was providing personal care to four people living in their own houses and flats. It provides a service to older adults, some of whom are living with dementia. Everyone using Care4U - Surrey 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.

People’s experience of using this service and what we found

People and their relatives told us they felt safe, and staff were aware of their role in safeguarding people from abuse. Risks to people were appropriately recorded, but more information was required around people’s medical conditions and what support was required to manage these. Medicine recording and administration was safe, and accidents and incidents were recorded appropriately. There was a sufficient number of safely recruited staff to meet people’s needs.

People were supported to have maximum choice and control of their lives and staff did support them in the least restrictive way possible; the policies and systems in the service did support this practice. Staff were up to date with mandatory training and received regular supervision and competency checks. Staff felt there was an effective communication system in place and referrals to healthcare professionals were made where required. People’s dietary preferences were recorded in their care plans which staff followed. At our previous inspection, there were shortfalls in national guidance and standards not being followed or adhered to. We found there had been significant improvement during this inspection, but further work was needed to fully embed this in to the service.

People and relatives told us staff were kind and caring and treated them with dignity and respect. We were told of occasions where staff had gone above and beyond people’s expectations when providing their care. People were encouraged to be independent and involved in decisions around their care where possible. Where people were unable to be involved in these decisions, their next of kin had been approached.

Care plans were personalised to reflect the individualised care that people received. Complaints were dealt with in a timely manner and in line with the provider’s policy. The service was not delivering end of life care to anyone at the time of the inspection, but this topic had been approached with people and their relatives and their preferences documented.

There had been significant improvements to the management oversight of the service since our last inspection. Further work was now needed to ensure new systems and practices were fully embedded and sustained over time. Robust internal quality audits had been completed by the registered manager, and feedback sought from people and staff. People and relatives felt the management team were approachable and staff felt valued. There were links to local organisations where best practice, knowledge and training resources could be shared to support further improvement to the service. For more details, please see the full report which is on the CQC website at www.cqc.org.uk.

Rating at last inspection (and update)

At the last inspection the service was rated Inadequate (18 December 2018) and there were multiple breaches of regulation. Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

This service has been in Special Measures since 17 December 2018. During this inspection the service demonstrated to us that improvements have been made and is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection.

Follow up

We will continue to monitor intelligence 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.