Background to this inspection
Updated
5 February 2019
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.
We gave the service 72 hours’ notice of the inspection visit because the location provides a domiciliary care service and the manager is often out of the office supporting staff or providing care. We needed to be sure that they would be available.
Prior to the inspection we gathered and reviewed information we held about the service. This included notifications the provider had sent us. Notifications are changes, events or incidents the provider is legally obliged to tell us about within required timescales. We contacted the local Healthwatch and the local authority safeguarding and quality performance teams to obtain their views about the service. Healthwatch is an independent consumer group, which gathers and represents the views of the public about health and social care services in England.
The provider had sent us their Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We used this information to help plan for the inspection.
The inspection team consisted of one inspector and an expert-by-experience. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service. The expert-by-experience had expertise in older people and dementia care. They contacted people that use the service and their relatives on 23 November 2018.
Inspection site visit activity started on 22 November and ended on 28 November 2018. It included reviewing quality assurance records, rotas and accident and incident documents. We visited the office location on both dates to see the manager and office staff; and to review care records and policies and procedures. We looked at nine care files and six medication records. We looked at three staff recruitment files and four staff supervision records.
We spoke with five people that use the service and one of their relatives via telephone. We visited three people and one relative in their own homes. We spoke with six members of staff, including the registered manager, team leaders and care workers. One professional; an occupational therapist provided us with feedback on working with the service.
Updated
5 February 2019
SureCare is a domiciliary care service providing personal care to people living in their own houses, flats and specialist housing in Scarborough, Filey and the surrounding areas. It provides a service to people living with dementia, learning disabilities or autistic spectrum disorder, mental health needs, older people, physical disability sensory impairment and young adults.
Inspection site activity took place on 22 and 28 November 2018. At the time of inspecting 112 people were receiving a regulated activity. Not everyone using SureCare receives a regulated activity; CQC only inspects the service being provided by people 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 provided care visits between the hours of 7am and 10pm. Care visit lengths range from 15 minutes onwards. The maximum call length being provided when we inspected was four hours. An on-call service was available out of hours for emergencies only. This was managed by senior members of staff and the registered manager.
The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People living with learning disabilities and autism using the service can live as ordinary life as any citizen.
The service had a registered manager in place. They were present throughout the inspection. A registered manager is a person who has registered with CQC 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.
At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.
People felt safe when staff were supporting them. They were confident that staff had the knowledge and skills needed to use any equipment safely.
People’s safety was supported through effective risk management. Risks assessments contained relevant information for each person, recognising risk may fluctuate and how to support people to reduce this.
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.
Staff received training and support to help them understand their roles. People felt staff were all sufficiently trained to provide their care effectively. Supervisions and appraisals were used to support staff development and monitor their performance.
Staff understood the roles of other professionals. People received support at GP visits and staff acted on any advice given.
People formed trusting relationships with staff. Relatives valued the patient, caring approach staff adopted, taking time to provide the person with reassurance. People’s privacy and dignity was respected. Staff established what people’s preferred means of accessing their homes was.
The provider was responsive to changes in people’s needs and care arrangements. They reviewed people’s care jointly with them and their relatives. Care times were organised to accommodate people’s activities and other commitments.
Staff understood people’s preferred routines and lives. Details of people’s interests and significant relationships were recorded in care plans.
Feedback from people and their relatives was welcomed. People were able to provide their feedback through a variety of means. Any improvements suggested were listened to and actioned.
There were high levels of staff satisfaction. Staff felt well supported by the staff team and managers. staff wellbeing was an ongoing consideration, which was monitored. Staff were encouraged to develop and their professional development was promoted.
The registered manager was motivated and innovative, reflecting on improvements that could be made to the service and areas for development. An initiative to support people in hospital to promote their independence and reduce their social isolation on leaving hospital had been identified and put forward to the local authority.
The service worked proactively with other services to share learning and promote best practice.
Further information is in the detailed findings below.