Background to this inspection
Updated
18 May 2021
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
Inspection team
The inspection team consisted of three inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service. Two inspectors visited the office of the service whilst an inspector reviewed evidence off site.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats and specialist housing.
The service did not have a manager registered with the Care Quality Commission (CQC). This means that the provider is legally responsible for how the service is run and for the quality and safety of the care provided. The service was in the process of registering two managers with us but this process had been delayed due to the pandemic.
Notice of inspection
We gave the service short notice of the inspection. This was because we needed to be sure that the provider and managers would be in the office to support the inspection.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
During the inspection
We spoke with one person who used the service and thirteen relatives about their experience of the care provided. We spoke with seventeen members of staff including the provider, managers, care workers and the consultant.
We reviewed a range of records. This included seven people’s care records and medication records. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were also reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. We spoke with professionals who work with the service.
Updated
18 May 2021
About the service
Secure Healthcare Limited is a care agency providing personal and complex nursing care to 65 people at the time of the inspection, some of whom where children. 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 did not always have regular staff to enable them to build relationships with staff and to ensure staff knew them well. The provider had recruited more staff to make improvements to this area. People and their relatives found communication within the service to be poor. People were not always able to contact staff out of hours where there were concerns and office staff did not always return people's calls.
People were supported by staff who were trained and recruited safely. People had care plans in place which detailed their needs and gave staff clear guidance to meet them. People were supported to receive their medicines as they were prescribed. People were safeguarded from potential harm and abuse.
Quality assurance tools were in place and were effective at identifying where improvements were required to people's care. People and their relatives were encouraged to give feedback about their care. Staff worked alongside external professionals, where required to support people's care.
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 good (published 04 April 2019).
Why we inspected
The inspection was prompted in part due to concerns received about the quality and continuity of care, communication and the management of the service. As a result, we undertook a focused inspection to review the key questions of safe 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 the same. This is based on the findings at this inspection. We have found evidence that the provider needs to make improvements. Please see the well led section of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Secure Healthcare Limited on our website at www.cqc.org.uk.
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.