We undertook an announced inspection of SR Homecare on 19 July 2016. This was the first inspection we have completed at the service since their initial registration in October 2014.
SR Homecare provides personal care to people living in their own homes within the Bristol area. At the time of our inspection the service was providing personal care and support to 45 people.
A registered manager was in post at the time of the 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.
The provider had failed to notify the Commission, as required, of multiple safeguarding referrals.
The provider had undertaken an assessment of people’s risks, and where required, risk management guidance was recorded. People and their relatives spoke positively about the staff. People told us they were confident care would be delivered as arranged. All of the surveys we sent prior to the inspection that were returned by people and their relatives spoke positively about feeling safe. Staff had received training in how to identify and respond to suspected abuse and policies to guide staff on how to report concerns were available.
There was sufficient staff on duty to meet people’s needs and to complete the required number of scheduled care appointments. Recruitment processes were safe. The service had systems to ensure care appointments would still be met in the event of unforeseen circumstances arising, such as staff illness. Staff felt they had time to meet people’s needs and said appointments were not rushed. Medicines were managed in a way that ensured people received them when they needed them.
People felt that staff were competent and provided effective care. The surveys we sent prior to the inspection that were returned by people and their relatives contained positive feedback about the effectiveness of staff. All of the surveys said they would recommend the service to others. The provider had an induction and training programme available for staff. This supported staff to provide effective care and to develop their knowledge and skills. Additionally, nationally recognised training in health and social care was available to staff to enhance their knowledge. The provider supported staff through a regular supervision programme.
Staff understood the principles of the Mental Capacity Act 2005 and gave examples of how they empowered people by supporting them to make decisions about their care and daily lives. People were independent when arranging medical appointments, but where required the service liaised with relevant healthcare professionals to meet people’s needs. People were supported with their meals and drinks when required.
The provider had ensured continuity in care and staff told us this had enabled them to build a relationship with people and their relatives. We received positive feedback from people about the caring nature of the staff. The surveys we sent before the inspection were positive, with all respondents saying their care and support workers always treated them with respect and dignity and that the care and support workers were caring and kind. There was a compliments book that reflected the feedback given to us during our conversations with people. Staff had ensured they were aware of people’s individual needs and understood their preferences. People were given important information about the service.
People felt staff were responsive to their needs and the survey results contained positive information about people’s views on the responsiveness of the service. A small number of people did feel they were not consistently involved in decision-making about their care and support needs. People’s care records were personalised and most people we spoke with confirmed they were involved in making choices and decisions in relation to their care.
The service had a system that ensured regular care reviews were completed every six months or sooner if required, for example following a hospital admission. There were examples of how the service had been responsive to support people. The provider had a complaints procedure and people were given the required information they needed on how to complain if they wished to.
People and their relatives spoke positively about the management of the service. Staff felt supported by the registered manager and senior managers at the service. The results of the survey we sent showed that people answered mostly positively when asked if they knew who to contact in the care agency if they needed to. There were systems to obtain the views of staff and key messages were communicated to staff. There were recently launched staff incentive schemes.
There were auditing systems to monitor the quality of care provided and the accuracy of records and documentation used by staff. Observations of care provision were completed that ensured people received care in line with their assessed needs and reflective learning would be completed if required. The service had developed links with the local community centre and was working towards this having a positive impact for people to avoid them feeling isolated.
We found one breach of the Care Quality Commission (Registration) Regulations 2009. You can see what action we told the provider to take at the back of the full version of this report.