Surecare Wycombe and Chiltern

Updated 31 January 2019

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 is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This was a comprehensive inspection which took place on 14 and 15 January 2019. On the first day of the inspection we carried out a site visit to the service’s office during which we reviewed records, spoke to the registered manager and interviewed staff. On the second day of the inspection we conducted telephone interviews with people who use the service and relatives of people who use the service.

The inspection was announced and carried out by one inspector. We gave the provider 48 hours’ notice because the location provides a domiciliary care service and we needed to be sure that someone would be available in the office to assist with the inspection. However, when we called to give notice we were informed the registered manager was involved in delivering training and would not be available for the following three days. We therefore arranged the inspection for the next available day, Monday 14 January 2019.

The provider had not sent us a recent Provider Information Return (PIR). This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. The provider confirmed they had not been sent a PIR to complete prior to this inspection. We took this into account when we inspected the service and made the judgements in this report.

Before the inspection we reviewed the information we held about the service. We noted there had been no notifications sent to us since the service was registered. Notifications are sent to the Care Quality Commission (CQC) to inform us of events relating to the service which they must inform us of by law. We contacted the local safeguarding authority and two community health and social care professionals for feedback. The safeguarding authority raised no concerns.

During the inspection we spoke with three people who used the service and four relatives. We spoke with six members of staff including the registered manager, the field care supervisor, the director and three care and support staff. Following the inspection, we received feedback from a further four care and support staff.

We looked at records relating to the management of the service. We reviewed Four people’s care and support plans including medicine records and other associated records. We inspected five staff files including recruitment records and reviewed records of accidents, incidents and complaints. We looked at a selection of policies, minutes of meetings, training records and service audits.

Updated 31 January 2019

Surecare Wycombe and Chiltern is a domiciliary care agency. It provides personal care to people living in their own houses and flats. It provides a service to the whole population, including people living with dementia. Not everyone using Surecare Wycombe and Chiltern receives regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do, we also take into account any wider social care provided.

At the time of the inspection the service was providing personal care and support to 11 people.

The service had a registered manager as required. A registered manager is a person who has registered with the CQC 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 registered manager was present and assisted us during the inspection.

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

People told us they felt safe with the staff who visited them. Relatives felt their family members received support that was safe. Staff were trained and knowledgeable in how to protect and safeguard people from abuse. They understood their responsibilities to report concerns and were confident action would be taken if necessary by the registered manager. Medicines were managed safely, staff were trained competent to assist people with their medicines. People told us they received their medicines at the appropriate times. Risks to people and their well-being were assessed and measures were in place to reduce and minimise them without restricting people’s freedom. A robust recruitment procedure was followed to ensure as far as possible only suitable staff were employed. Staff had been trained in infection control, they were supplied with and used personal protective equipment appropriately.

People received effective support from staff who were trained and had demonstrated the necessary skills to fulfil their role. Staff felt well supported by the registered manager and other office staff. They were provided with regular supervision meetings as well as opportunities to meet as a team. People were supported with maintaining their diet and hydration when this was part of their support. People’s healthcare needs were monitored; staff sought advice promptly from healthcare professionals when necessary and called emergency services when required. 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.

The service was caring. People and their relatives told us staff were kind and patient. Staff had formed good relationships with people who spoke highly of them and told us they looked forward to their visits. Staff understood how to protect people’s privacy and relatives told us staff treated people with respect. People and when appropriate relatives had been involved in making decisions about their care and support. Staff encouraged people to maintain as much independence as they wished and were able to.

The service was responsive to people’s individual needs and took account of their personal preferences in relation to culture, beliefs and protected characteristics. Staff knew people very well and paid attention to following their preferred routines. Individual support plans were person-centred and detailed the diverse needs of each person. The service provided flexible support which was appreciated by people and their relatives. Complaints were recorded and managed in accordance with the provider’s policy; people were aware of how to raise concerns and who to speak to. Although the registered manager was not fully aware of the accessible information standard, records we reviewed were meeting its requirements.

The service was well-led, the registered manager provided strong leadership and staff felt supported in their roles. Records were relevant, complete and reviewed regularly to reflect current information. There was an open culture which supported person-centred and individualised care and support. Staff were clear on the values of the service and were motivated to deliver these. They told us the registered manager led by example. Feedback was sought and used to monitor the quality of the service. Audits were conducted and used to make improvements.

Further information is in the detailed findings below.