Background to this inspection
Updated
9 March 2018
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, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
The inspection took place on 20 and 24 October 2017 and was announced. The provider was given 48 hours’ notice as they provide a domiciliary care service to people in their own homes. We needed to be sure someone would be in the office.
The inspection was completed by one inspector.
Before the inspection the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. This information was reviewed, along with the information submitted when they applied to register with us. We sought feedback from the local authority where the service was based.
During the inspection we spoke with three people who received a service and three relatives. We spoke with 13 members of staff including the registered manager, the compliance manager, the quality and compliance manager, the clinical lead, the training manager, the service manager, a care coordinator and six care workers. We reviewed four people’s care files including care plans, risk assessments and records of care. We reviewed 13 staff files including recruitment, training, supervision and appraisal records. We reviewed various meeting records, incident records, complaints, compliments and audits relevant to the management of the service.
Updated
9 March 2018
The inspection took place on 20 and 24 October 2017 and was announced. The provider was given 48 hours’ notice as they are a domiciliary care service providing care to people in their own homes and we needed to be sure someone would be in.
This was the first inspection since the service registered with us in October 2016.
Sugarman Health and Wellbeing – Stratford is a domiciliary care service registered to provide both personal care and treatment of disease, disorder and injury to people in their own homes. At the time of our inspection they were delivering personal care to 24 people. They were not delivering treatment of disease, disorder and injury but did provide clinical training and oversight over care workers performing nursing tasks, such as tracheotomy care, delegated to them by healthcare services.
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 2008 and associated Regulations about how the service is run.
People and relatives felt safe with their care workers. Care workers were knowledgeable about the different types of abuse people might be vulnerable to. However, the provider had not followed local safeguarding adults processes.
Staff were knowledgeable about the Mental Capacity Act 2005 and people's choices and decisions were respected.
The quality and detail in risk assessments varied. Although some risks had been effectively mitigated with clear measures in place, other risks did not have clear guidelines in place to mitigate them.
People were supported to take medicines by care staff. It was not always clear from records that medicines had been managed in a safe way.
The provider’s quality assurance mechanisms had identified issues with the quality and safety of the service, but effective action to address these concerns had not been taken by the time of the inspection.
The provider had not notified us of all the incidents that affected the service it was required to.
People were allocated a fixed team of care workers who were recruited in a way that ensured they were suitable to work in a care setting. People and relatives told us the allocation of a fixed team of workers supported the development of trusting, caring relationships. People told us they liked their care workers and felt they were treated with respect.
The provider completed thorough needs assessments and care plans and people felt involved in the creation of their care plans. People’s relationships, religious beliefs and cultural background were included in the assessment and care plans reflected people’s preferences. People and relatives were asked for regular feedback on their care and the provider completed regular reviews.
People and their relatives had confidence in the skills and abilities of their care workers. Care workers told us they received the training they needed to meet people’s individual needs as well as support and supervision for their personal development.
People had complex health and nutrition needs and the provider ensured these were met and people were supported to access healthcare services when they needed to.
People and relatives felt confident to raise concerns and complaints. Records showed the provider responded appropriately to complaints made.
People, relatives and staff felt the service was organised and well run. The provider completed surveys of people and staff to receive feedback on the quality of the service. The provider completed a range of audits to monitor the quality and safety of the service.
We identified breaches of four regulations. Full information about CQC's regulatory response to any concerns found during the inspection is added to reports after any representations and appeals have been concluded.