Archived: Surrey Quality Care Limited

Surrey Quality Care Limited is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service for older people, some who were living with the experience of dementia, and younger adults with disabilities. At the time of our inspection in August 2019 31 people were using the service.

The agency operated in the Surrey towns of Dorking, Redhill, Reigate and Horley. The service was the only location for the provider, who were a private organisation.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

People’s experience of using this service and what we found

People told us they felt safe due to the care and support given by Surrey Quality Care. Hazards to people’s health and safety had been assessed by staff, and plans were in place to minimise the risk of people coming to harm. Staff understood their roles and responsibilities for keeping people safe from abuse. Staff were recruited in a safe way, and the deployment of staff had improved to ensure that carers being late to calls were kept to a minimum. People were supported to have their medicines when they needed them, and staff followed safe practice with regards to infection control.

Peoples needs were assessed before they began to use the service. Staff training and supervision was effective at ensuring staff had the skills and experience to meet people’s needs. Where required staff supported people to have the food and drinks they enjoyed, and guidance was in place to ensure people had enough to eat and drink.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People told us the staff were kind and caring and spent time to get to know them as individuals. Staff involved people in day to day choices about their care and support, and treated people with dignity and respect. Peoples equality and diversity needs were understood and respected by the staff that supported them.

Care plans contained information and guidance for staff in how to provide care and support in the way people wanted. Where complaints had been received these had been investigated and addressed to the satisfaction of the people who raised them. Where people may be being supported at the end of their lives, the preferences and wishes had been clearly documented, and were understood by the staff that cared for them.

There was a new manager in post, who had begun their registration process with the CQC. They had made a number of positive changes which were reflected in the positive feedback we received when we spoke with people who use the service. The positive and open approach by the manager was reflected in staff telling us they felt more supported and were happy in their roles. Quality assurance processes driven by the manager’s focus on continuous improvement were now effective at identifying and addressing issues where positive change was needed.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was requires improvement (published 10 August 2018). At this inspection we found improvements had been made to address the recommendations made at the last inspection.

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

The inspection took place on 16 July 2018. We told the provider two working days before our visit that we would be coming because the location provides a domiciliary care service for people in their own homes and staff might be out visiting people.

This was the first inspection of the service since it was registered in July 2017.

Surrey Quality Care Limited is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service for older people, some who were living with the experience of dementia, and younger adults with disabilities. At the time of our inspection 45 people were using the service. The agency operated in the Surrey towns of Dorking, Redhill, Reigate and Horley. Some people had their care funded by the local authority or National Health Service, whilst others paid for their own care. The service was the only location for the provider, who were a private organisation.

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.

At this inspection we have rated the service requires improvement overall and in the key questions of ''Is the service safe?'' and ''Is the service well-led?'' This was because we found some aspects of the service did not always ensure people received safe care and treatment. And the systems for identifying this were not always effective. However, the provider supplied us with evidence that they took immediate action to improve these areas of the service following our inspection visit. We have rated the key questions of, ''Is the service effective?'', ''Is the service caring?'' and ''Is the service responsive?'' as good.

People told us they felt safe with the service and with the care workers who supported them. Some people reported that visits did not always take place at the planned time or care workers did not stay the full allocated time. From the records we viewed, we saw that most visits took place on time, although many visits were shorter than the allocated time. The registered manager told us that this was sometimes the choice of people using the service. Following the inspection visit, they introduced a system so senior staff would investigate why any visits were shorter than expected each week. This meant that if this was not the choice the person action could be taken.

People told us they received support with their medicines. However, we found a large number of medicines administration records we viewed had not been signed to show whether these had been administered. The provider's audits of these had identified gaps but had failed to improve practice to make sure staff followed the correct procedures for recording administration. The staff also used an electronic system for recording medicines administration, and in some cases they had signed the electronic records but not the paper ones. Following our inspection visit, the registered manager introduced more robust and regular auditing which asked the auditor to record the action they took if they found any problems with medicines management.

The provider's systems for identifying risks and concerns were not always effective. Whilst they took action to respond to concerns we identified, they had not previously acted on these.

People told us that the care workers were kind, thoughtful and compassionate. They had good relationships with them and told us they had the skills they needed to care for them. A small number of people spoke about specific concerns, which we discussed with the registered manager and felt confident these had been appropriately dealt with.

People told us they were involved in planning and reviewing their care. They felt their needs were being met and they were supported to live the lives they wanted. They also were supported to stay independent and do as much for themselves as they could and wanted. The risks to their safety had been assessed. Care plans and risk assessments were regularly reviewed and updated to reflect changes in people's needs. People had the support they needed at mealtimes and the care workers made sure people had access to drinks. The care workers monitored people's health and wellbeing and there was evidence they worked with other healthcare professionals when needed.

There were procedures designed to safeguard people from abuse, to prevent and control the spread of infection, for making complaints and for investigating any incidents. People using the service and their relatives had information about these. The staff had received electronic handbooks, which included the policies and procedures. They undertook a range of training which was appropriate for the work they were undertaking. There was evidence that the provider carried out spot checks to see how each care worker was working and if any improvements were needed. The staff were also invited to regular individual meetings where they were able to discuss their practice and how they felt about the job.

The provider had systems for monitoring and improving the quality of the service. They worked closely with the local authority to assess whether they were meeting people's needs. The registered manager took immediate action to make improvements where we identified concerns. The provider contacted people using the service, staff and other stakeholders for feedback about their experiences and responded to this by adapting the service.