Background to this inspection
Updated
14 August 2015
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 was meeting the legal requirements and regulations associated with the Health and Social Care Act 2014 and to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
This visit took place on 25, 26 and 30 June 2015 and was carried out by an inspection team of two inspectors. The visit was announced, and the provider and registered manager was given 48 hours- notice of the inspection. This was to make sure that the manager was available. Before our inspection we reviewed information we held about the service including statutory notifications relating to the service. Statutory notifications include information about important events which the provider is required to send us.
As part of the inspection we spoke with six people who used the service, three relatives, three members of staff, and the registered manager. We received feedback from health and social care professionals. We viewed five people’s support plans and four staff files.
Updated
14 August 2015
This inspection was carried out on 25, 26 and 30 June 2015 and was announced.
Surecare (St Albans and Dacorum) is registered to provide personal care to people living in their own homes. 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 and associated Regulations about how the service is run.
When we last inspected the service on 22 July 2014, we found them to be meeting the required standards. At this inspection we found that they were not meeting the standards.
People who used the service were not protected from the risks associated with poor recruitment practices. Pre-employment checks were not always carried out. References were not validated; gaps in employment histories were not challenged or explored. There were signatures in care records of people who had delivered care, who the manager told us they were not aware of and who there was no record of employment checks for.
People who used the service told us their needs was not always met by the provider. Care was provided around the availability of staff and not the assessed needs of people using the service Their personal care needs, assistance with medicines, assistance with the provision of food and drink was not delivered at the agreed times leaving people at risk of neglect.
Medicines were not always managed safely. Although staff had received training, the process of assessing staff competency was irregular and ineffective.
We saw certificates showing that staff had attended various training courses. However other documentation seen suggested that staff were delivering care at the times they were attending training. Training was not managed effectively and staff training needs had not been assessed.
Care plans did not contain sufficient details to inform care staff of the type of support people required and there was little information about people’s medical conditions, religious, spiritual or cultural needs. People’s food and hydration needs were not always met and there was little monitoring in this regard.
There were insufficient processes in place for managing staff, monitoring the delivery of service, keeping accurate records or following polices which were available but not in use. Although a quality monitoring survey had been completed it had not been evaluated or an action plan put in place to address shortfalls.
At this inspection we found the service to be in breach of regulations 9, 10, 12, 13,16,17,18 of the Health and Social care Act 2008 (Regulated activities) Regulations 2014, and regulation 18 of the Registration regulations 2009.
The overall rating for this service is ‘Inadequate’ and the service is therefore in 'Special measures'.The service will be kept under review and, if we have not taken immediate action to propose to cancel the provider’s registration of the service, will be inspected again within six months.The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe."