Archived: Supreme Healthcare Services - Surrey

Supreme Healthcare Service - Surrey is registered to provide personal care to adults and children in their own homes and was providing care to 49 people at the time of the inspection. The service operates from a location based in Woking Surrey.

Following our last inspection in March 2016 we found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We asked the provider to take action in relation to how risks to people’s safety were managed and how medicines were managed. Following the inspection the provider submitted an action plan to us to tell us how they planned to address these concerns. We carried out this inspection to check if the provider had made the changes required. We found that improvements had been made regarding how risks were managed to keep people safe and that safe medicines practices were being followed.

There was no 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. A manager was in post and supported us during our inspection. The manager had submitted an application but they had failed to ensure the process was completed in a timely way. They then withdrew a subsequent application when they left. The failure to have a registered manager is a breach of regulation 5 and a limiter on achieving a rating of ‘good’ as it is a condition of the provider’s registration to provide the service.

Risks to people’s safety were assessed and control measures implemented to keep them safe. . People were protected from the risk of abuse and avoidable harm because staff understood their roles and responsibilities in protecting them. People received their medicines in line with prescription guidelines. There was a 24 hour on-call system in place and guidance was available to staff regarding the action to take if an emergency occurred. Systems were in place to monitor accidents and incidents and where changes were required to people’s support to keep them safe these were implemented.

Staff understood the importance of gaining consent from people and acted in accordance with the principles of the Mental Capacity Act 2005. Staff were kind and caring towards people and upheld their privacy and dignity. Staff had a good understanding of people’s needs and supported them effectively. People and relatives told us that staff were respectful and supported them to maintain their independence.

There were sufficient staff employed to cover all care calls at the agreed times. People told us they had not experienced any missed calls and that staff arrived on time. Robust recruitment processes were in place to ensure that staff employed were suitable to work in the service. Staff received training which was relevant to their role and training needs were monitored by the provider. There was an induction programme in place which included new starters shadowing more experienced staff before working on their own. Staff told us they felt well supported by the provider and could contact them at any time to discuss concerns. The provider had a contingency plan in place to ensure that people would continue to receive a service in the event of an emergency.

People’s needs were assessed prior to their service starting and detailed care plans were in place to guide staff on how to support people well. Staff were able to describe people’s needs and regular reviews were completed. The service had good links with health care professionals to ensure people kept healthy and any concerns were responded to promptly. Where people required support with eating and drinking this was recorded within their care plan and people told us staff provided the support they required.

There was a complaints policy in place and people told us they were confident that any concerns would be addressed. Records showed that complaints were investigated and responded to in line with provider’s policy. However, a central log of complaints was not maintained to enable trends to be identified. We have made a recommendation regarding this. There were systems in place to monitor the quality of service provided to people. Regular audits were completed and an action plan was maintained of areas of development. Records were regularly updated and people’s personal information was stored securely. People and their relatives told us that they were given the opportunity to feedback on the service provided through regular calls and questionnaires.

There was no registered manager at the service. 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.

Risks to people were not always adequately assessed and reviewed regularly to ensure people's individual needs were being met safely. People told us they were confident with the support they received to take their medicines. However, we found gaps in recording which meant people may not always receive their medicines in line with their prescriptions. We have made a recommendation about this.

The provider followed safe recruitment processes and there were sufficient numbers of staff to meet people’s needs.

Relatives told us they felt their family members were safe and were confident in the staff that supported them. A contingency plan was in place to ensure that people’s care could be provided safely in the event of an emergency.

Relatives told us that staff were competent and skilled in carrying out their role. The provider had effective arrangements in place to train, supervise and provide induction to staff. Staff told us they felt supported by the provider and could call for assistance at any time.

People were supported by staff who respected their dignity and maintained their privacy. People were supported to make choices and decisions about their care. A policy was in place to guide staff in the principles of the Mental Capacity Act 2005.

Assessments were completed prior to people receiving a service to ensure their needs could be met. Personalised care plans were in place although records of people’s care were not always updated. People were supported to access support from healthcare professionals where required.

People told us they were confident to raise any issues about their care. There was a complaints policy in place and there was evidence that complaints had been recorded, investigated and responded to

The service had systems in place to monitor and improve the quality of the service provided. People told us they had seen improvements in their care and responsiveness of the office staff.

During the inspection we found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.

We completed this inspection to check if the provider had taken the necessary action to ensure changes were made. As part of this inspection we spoke with four people who used the service, and four members of staff.

We saw evidence that people`s care records had been reviewed and risk assessments were up to date.

We saw that the provider had taken steps to ensure that all staff they employed were able to communicate in English.

We saw that the provider had taken steps to ensure staff were consistent in their time keeping and new staff were introduced to people before commencing working with them.

You can see out judgement on the front of this report.

We carried out this inspection to check that the provider had taken the necessary action which ensured changes were made. As part of this inspection we spoke with five members of staff and seven people who used the service.

We saw evidence that people's care plans had been reviewed and risk assessments developed.

We saw that the provider had taken steps which ensured that the staff they employed had an appropriate standard of English.

We observed that the provider had ensured that staff were trained, and provided with, information on safeguarding vulnerable adults.

We spoke with three relatives of people who used the service. They all told us that they felt that the care their relative received was good and that they had been involved in their care plans. One relative told us 'Yes, we told them what we needed.'

The people that we spoke with told us that they felt safe in the agency's care. One person said 'Yes, I have no worries about the carer's that come to me.' However, we found that the provider did not hold appropriate information for staff on how to report any concerns.

We looked at staff files and found that the service had robust recruitment processes in place that ensured that only suitably qualified staff were employed.

The service had systems in place that monitored the quality of the service and identified when things needed to be improved. This included sending a questionnaire to people to gather their views of the service as well as carrying out telephone surveys with people to obtain their feedback. However, we found that the provider did not always act on the feedback that was given to them.