The inspection took place on 18 July 2017. We gave the provider short notice of the visit to the office in line with our current methodology for inspecting domiciliary care agencies. This was to make sure there would be someone in the office. At the last inspection of the service in April 2015, Surecare Doncaster Ltd was given an overall rating of ‘good’. At this inspection, the service was rated ‘requires improvement’ and we found two breaches of regulations.You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for "Surecare Doncaster Ltd" on our website at ‘www.cqc.org.uk'.
Surecare Doncaster is a domiciliary care service. They are registered to provide personal care to people in their own homes. At the time of this inspection, 106 people were receiving support from the service.
There was a registered manager in post at the time of this 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.
People told us they felt safe and were protected from abuse by staff who were knowledgeable and had the right skills to meet their needs. People said they received high quality care and that staff treated them with dignity, respect, kindness and care.
Risk assessments relating to people’s health needs and the environment helped protect the health and welfare of people who used the service without placing any unnecessary restrictions on them. People were supported to maintain good health and referrals were made to healthcare professionals when required.
There were enough staff employed by the service to cover all care calls and meet people’s needs. However, travelling time was not always factored into care staff rotas which meant some care visits were shorter than the assessed and agreed times to allow staff to travel to the next call. We found that care visit arrivals and departures were logged, however the information was not monitored.
Pre-employment checks were not always effective and we identified some issues with documentation in staff files that needed to be addressed by the provider.
Arrangements were in place to ensure medicines were administered safely by staff who had received training in this area. Medication Administration Records (MAR) were checked each month to ensure no gaps or omissions were present.
The registered provider acted in accordance with the Mental Capacity Act and consent was sought from people and/or their legal guardian.
Although staff told us they felt supported, staff supervisions and appraisals did not always take place with appropriate frequency, or in line with the provider’s policies. There was no planned systematic approach to staff training, supervision and appraisal and no monitoring of this to ensure staff were appropriately trained and supported.
People were involved in their care and support planning. We saw information in care records relating to each person’s likes and dislikes, family life and favourite activities or pastimes.
There was a complaints procedure in place so people could voice their concerns if needed. People we spoke with said they had no need to complain but they knew how to complain if the need ever arose.
The service asked people for their views and opinions about the service they had experienced via annual surveys. We saw evidence actions were put in place in response to people’s feedback.
We found issues around the governance of the service as the systems to monitor the quality and safety of services provided did not cover all aspects of service provision and therefore was not effective. No monitoring was carried out of safeguarding concerns or accidents and incidents. Call monitoring systems were not used effectively and call durations, start times and finish times were not monitored. Staff files were not audited and we found some information was missing or not current. There was no systematic approach to training, supervisions or appraisals and no oversight of these.
We found two breaches of regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
You can see what action we told the provider to take at the back of the full version of the report.