Archived: Supreme Healthcare Services - Surrey

Updated 24 May 2017

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 an announced inspection which took place on 23 March 2017. We gave 48 hours’ notice to make sure that the people we needed to speak to were available. The inspection team consisted of two inspectors and an expert-by-experience who spoke to people and their relatives on the telephone. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service.

We looked at all the key information we held about the service which included notifications. Notifications are changes, events or incidents the provider must tell us about. During the inspection we spoke with the manager and four staff member. We also spoke with 6 people and 3 relatives to gain their views on the service they received.

We looked at the care records of seven people who used the service, five recruitment files for staff, and staff training records. We looked at records that related to the management of the service including, audits, risk assessments and contingency plans.

Updated 24 May 2017

The inspection took place on 23 March 2017 and was announced.

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.