About the service Surecare Barnet is a domiciliary care provider based in Barnet, North London and provides personal care to adults and older people in their own homes. At the time of this inspection the service was supporting 40 people.
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
Most people and their families were positive about the level of care and support they received from the service. Most praised the caring nature of care staff.
Care planning had improved. We found that the processes for assessing risks and medicines management had also improved, however further improvements were needed.
Despite the overall positive feedback received and improvements seen, we found concerns with the governance and management oversight of accidents, incidents and complaints. We were not assured that concerns raised were appropriately investigated and used to improve the service people received.
Most people and families told us they received their care visits in a timely manner. However, we found some concerns with rota management with lack of travel time scheduled in for some care staff between visits. We made a recommendation around staff working hours.
There were gaps in the providers recruitment process with regards to obtaining appropriate employment references and exploring gaps in employment.
There were concerns with staff morale and a culture of some staff not feeling able to raise concerns in an open way with the management team.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was Requires Improvement (report published 19 November 2019). The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection enough improvement had not been made and the provider was still in breach of regulations.
Why we inspected
This was a planned inspection based on the previous rating. However, the inspection was prompted in part due to concerns received. A decision was made for us to inspect and examine those risks.
We have found evidence that the provider needs to make improvements. We received concerns in relation to staffing, the management of accidents and incidents and overall care delivery. As a result, we undertook a focused inspection to review the key questions of safe, responsive and well-led only.
We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection. The overall rating for the service has remained as Requires Improvement. This is based on the findings at this inspection.
We have found evidence that the provider needs to make improvement. Please see the safe and well-led sections of this full report.
You can see what action we have asked the provider to take at the end of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Surecare Barnet on our website at www.cqc.org.uk.
Enforcement
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and to hold providers to account where it is necessary for us to do so.
We have identified breaches in relation to safe staff recruitment and overall good governance at this inspection.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.