This was an announced inspection carried out on 12 and 24 January 2018.Surecare North Leeds is a domiciliary care service. The service provides personal care for people living in their own homes. It provides a service to older adults. This was Surecare North Leeds’ first inspection since their registration with the Care Quality Commission (CQC) in January 2017.
At the time of our inspection 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 2008 and associated Regulations about how the service is run.
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. People provided consent to staff to receive care and support with their care needs.
People told us they received their medicines as prescribed. Staff completed training in the safe administration of medicines. However, we found that medicine administration records (MARs) were not always used correctly and were incomplete. Plans describing where topical medicines were to be applied and how people preferred to be given their medicines were not always completed. This was a breach of legal requirements.
Staff identified and managed risks to people's health and well-being. Staff developed risk management plans that contained details of the risks and action staff should take to manage them. However, we found some risk assessments lacked detail and others did not reflect people’s current needs.
People using the service and their relatives were involved in making decisions about the care they received. Assessments included people's care and support needs. Care was not always planned and documented in a way that was person centred and care plans lacked detail about people's likes, dislikes and personal preferences.
The registered provider had quality assurance systems in place. Staff completed regular checks of the quality of care. However, audits had not identified the areas of concern we found during our inspection in relation to medicines management and care records.
Staff were supported by the registered manager and office based staff. Staff received training, supervision and an appraisal. Newly employed staff underwent an induction and worked with experienced staff.
There was enough staff available to meet people's care needs. The staff rota showed when two members of staff were required to safely care for people, because of their specific care needs.
The registered provider's safeguarding policies and processes guided staff to help protect people from abuse. Staff knew the types of abuse and when to raise a safeguarding alert.
The environments where staff would be working had been assessed and staff were aware of infection control measures to reduce the risk of infection. Staff accessed equipment to protect against cross contamination.
The registered manager followed safe recruitment processes. New members of staff had pre-employment checks completed, such as criminal record checks via the Disclosure and Barring Service (DBS) and references from previous employers. This helped to ensure suitable staff were employed.
People's nutritional needs were met by staff. This helped people to maintain their health and wellbeing. People had meals they wanted and in sufficient quantities. Staff supported people with shopping for food items if they wanted to make meals for themselves.
Staff supported people to access healthcare services if they needed such support. Staff followed the guidance of health care professionals to help people maintain their health.
Staff provided care and support to people in a way that showed they respected their dignity and privacy. Staff had a good understanding of people’s needs.
People were supported to attend activities of their choice. People were supported to live a life that met their abilities and helped them to maintain some independence. People continued to have contact with people in their lives that mattered to them.
People using the service and their relatives understood what actions they needed to take to complain about the care they received, should this be necessary. The registered manager kept the CQC informed of notifiable incidents, which occurred at the service.
The registered manager demonstrated clear leadership, which staff told us they valued. There was a positive culture within the staff team. Staff we spoke with said they enjoyed their job and were proud to work for the service. People were able to provide feedback about the service and staff underwent regular observations and spot checks to ensure they delivered safe care.
We identified one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, namely Regulation 17 - Good governance. You can see what action we told the provider to take at the back of the full version of this report.