SureCare (Reading & East Berkshire)

SureCare Reading and East Berkshire is a domiciliary care agency. It provides personal care to people living in their own homes. The service supports older people, younger adults, people living with dementia, physical disabilities, mental health needs and sensory impairments. Not everyone who uses the service may receive personal care. The Care Quality Commission (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. At the time of the inspection the service was providing personal care to 31 people in the Reading and East Berkshire area with 28 staff.

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

People were supported safely by staff, who understood how to safeguard people from discrimination, neglect, and abuse. There were enough staff deployed, with the right mix of skills to deliver care and support to meet people’s needs. Staff effectively assessed risks to people’s health and well-being, which were managed safely. People experienced good continuity and consistency of care from regular staff who knew them well and how they wished their care to be delivered. The provider recruited staff safely in accordance with regulations. People received their prescribed medicines safely, from staff who had their competency to administer medicines assessed regularly. Staff raised concerns and reported incidents, which ensured action was taken to protect people from similar events in the future. We were assured that staff followed good infection control and safe food hygiene practices.

Staff assessed all aspects of people’s physical, emotional and social needs and delivered support to ensure these were met to consistently achieve good outcomes for them. The registered manager effectively operated a system of spot checks, supervision, appraisal and staff meetings, which supported staff to deliver care based on best practice. Staff were supported to access training, develop and maintain skills relevant to their role. Staff supported people to eat and drink to maintain a healthy balanced diet. Staff worked in partnership with healthcare professionals to make sure care and treatment effectively met people’s changing needs.

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 registered manager had developed the care coordinators and team leaders into an effective management team that worked well together. The management team effectively operated systems to review the quality and safety of the service. The registered manager encouraged critical feedback from people and staff to drive continuous improvement in the service. Staff had developed positive relationships, effective communication and information sharing with community health care professionals.

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

The last rating for this service was requires improvement (report published 21 June 2021) and there were breaches of regulation. The provider completed an action plan after the last inspection 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.

Why we inspected

We had received concerns in relation to staffing, staff training, unsafe care relating to moving and

positioning people and infection prevention and control. As a result, we undertook a focused inspection on 28 April 2021 to review the key questions of safe, effective and well-led only. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment and good governance.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions of Safe, Effective and Well-led which contain those requirements. For those key questions not inspected, we used the ratings awarded at the inspection before the last inspection to calculate the overall rating. The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for SureCare Reading and East Berkshire on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

SureCare Reading and East Berkshire is a domiciliary care service providing personal care to 50 people 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. SureCare Reading and East Berkshire provides support to older people, younger adults, people living with dementia, physical disabilities, mental health needs and sensory impairments.

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

People did not always experience safe care from the required number of staff, using recognised best practice, exposing the person to risk of significant harm.

The service management was inconsistent and governance of the organisation did not always assure the delivery of high-quality and person-centred care. The provider had not consistently ensured care and treatment was provided safely by staff who had the required competence.

There were enough suitably experienced staff deployed to ensure people did not experience missed calls.However, due to a recent high turnover of staff some people told us they experienced mistimed calls and did not always experience good consistency and continuity of care staff.

Safe recruitment practices were followed and appropriate checks completed to ensure that only suitable staff were employed. Staff understood their responsibilities to protect people from abuse and avoidable harm. People received their medicines safely, as prescribed, from staff who had completed the required training and had their competency assessed to do so. People were supported to maintain standards of cleanliness and hygiene, which reduced the risk of infection. Staff followed the required standards of food safety when preparing and handling food.

The registered manager operated a system of training, competency assessments, supervision and appraisals to develop staff skills and knowledge to support people according to their needs. Staff knew about people's specific dietary requirements and how people wished to be supported to maintain a healthy diet. Staff engaged with other agencies to ensure people had access to the necessary support to meet their healthcare and wellbeing needs. Staff consistently sought people’s consent before completing any personal care, were encouraged to make choices themselves and be involved wherever possible in decisions about their care.

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 this practice.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was Good (Published 1 April 2020).

Why we inspected

We had received concerns in relation to staffing, staff training, unsafe care relating to moving and positioning people and infection prevention and control. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection. We have found evidence that the provider needs to make improvement. Please see the safe, effective and well-led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for SureCare (Reading & East Berkshire) on our website at www.cqc.org.uk.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to safe care and treatment and good governance at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

SureCare (Reading & East Berkshire) is a domiciliary care agency providing care and support to people living in their own homes who have a range of needs. CQC only inspects where people receive personal care. Not everyone who used the service received personal care. This is help with tasks related to personal hygiene and earing. Where they do, we also consider any wider social care provided. At the time of the inspection 35 people were receiving personal care.

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

People received safe care and treatment. Individual risks and environmental risks were identified and managed safely.

Care staff understood the importance of safeguarding people they supported, and knew how to report any signs of abuse, or any accidents or incidents.

Appropriate recruitment procedures were in place to help ensure only suitable staff were employed.

Staff had completed training in the safe administration of medicines. People were happy with how they were supported to manage their medicines.

New staff had an induction into their role and received appropriate training that equipped them to

support people effectively. They had their competency assessed to help ensure they continued to be sufficiently skilled and knowledgeable.

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.

People were treated with kindness and compassion. Staff had developed positive relationships with people and knew what was important to them.

People were treated with respect and dignity. Staff encouraged people to remain as independent as possible in their daily routines.

People were involved with planning and reviewing their care. Care records were written in a person-centred way and guided staff on the most appropriate way to support people.

A complaints procedure was in place, which ensured concerns were investigated and acted upon appropriately.

Staff, people and relatives told us they had a good relationship with the management team and could seek support and assistance easily when needed. The service had positive working relationships with health and social care professionals to promote good outcomes for people.

There were effective systems in place to monitor the safety and quality of the service. Feedback about the service was sought from people, their relatives and staff.

Rating at last inspection

The last rating for this service was Good (published 25 July 2017).

Why we inspected

This was a planned inspection based on the previous rating.

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.

At the last inspection the service was rated Good. At this inspection we found the service remained Good.

Why the service is rated Good:

People received safe care from the service. Improvements had been made so that staff were recruited as safely as possible. Medicines were managed safely by staff who had received appropriate training. Risk assessments were completed to enable people to receive care with a minimum of risk to themselves or the care staff.

People continued to receive effective care from staff who were trained in the necessary skills to fulfil their role. Staff were supported through one to one meetings, appraisals and staff meetings. They had opportunities to develop their skills and knowledge as well as gain relevant qualifications.

People’s healthcare needs were monitored and advice was sought from healthcare professionals when necessary. 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.

The service remained caring and people reported staff were kind and patient. Staff protected people’s privacy and dignity and treated them with respect. People told us they could make decisions about their care.

The service remained responsive to people’s individual needs. Care plans were person-centred and focused on the preferences of each person. People and their relatives knew how to make a complaint or raise a concern.

The service continued to be well-led. The registered manager promoted an open culture and worked toward improving the service. People’s views were sought and the quality of the service was monitored. Action was taken to make improvements when issues were identified.

Further information is in the detailed findings below.