This inspection took place on 8,12 and 13 February 2019. At our last inspection on 30 June and 5 July 2016 we rated the service ‘Good’ overall and in each key question. At this inspection we found the service continued to be ‘Good’.

SureCare (Croydon and Sutton) is a domiciliary care agency. It provides personal care to people in their own homes.There were 253 people using the service at the time of this inspection.

The was a registered manager in post at the time of our inspection. 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 continued to receive their care safely. Staff reduced known risks to people by assessing them and following plans to reduce the possibility of people experiencing avoidable harm. Staff were trained to protect people from improper treatment. The provider cooperated with local safeguarding enquiries. Suitably vetted staff were available in sufficient numbers to deliver people’s care safely and on time as planned. Staff followed appropriate medicines and infection control practices.

People and their relatives participated in their needs assessments. The registered manager ensured that staff were trained, supervised and appraised. People were treated in line with mental capacity legislation and were supported to access healthcare services. People received the support they required to eat and drink enough.

People and their relatives told us that staff were friendly, gentle and kind. Staff respected people’s privacy and treated them with dignity. People’s cultural needs were identified and met. Staff made the time to talk with people.

SureCare (Croydon and Sutton) delivered responsive care. People’s care records guided staff on people’s preferences for how their care needs should be met. The provider was responsive to people’s changing needs. People’s independence was promoted and the provider participated in a project which supported people to regain their independence as quickly as possible following hospital discharge. The provider responded appropriately to complaints.

The registered manager audited the quality of care and support people received and gathered people’s views about their experiences. Care staff felt supported by the registered manager and the office team. There was effective communication throughout the provider’s organisation. The service worked in partnership with other organisations to meet people’s needs and advance research.

The inspection of Surecare (Croydon and Sutton) was undertaken on 30 June and 5 July 2016 and was announced. We gave 48 hours' notice of the inspection to ensure the registered manager and other senior staff were available at their office to talk with us. At our last inspection in November 2013, we found the provider was meeting the regulations we inspected.

Surecare (Croydon and Sutton) provides care and support for people who live in their own homes. There were 529 people actively using the service at the time of our inspection. Their office is based in South Croydon.

The service had 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 using the service told us they were treated in a respectful and caring manner by regular staff members who knew them well and supported them safely and effectively.

People were supported by staff who were trained and well supported in their job roles. Staff members had been safely recruited and had received an induction to the service. Staff we spoke with were confident that they provided a good service to people and said they would recommend Surecare (Croydon and Sutton) to their family and friends. They had access to supervision and were given regular opportunities to discuss their performance with the management team. The staff said they felt valued by the service.

Staff understood how to help protect people from the risk of abuse. The agency had procedures in place to report any safeguarding concerns to the local authority. People and staff were protected from potential risk of harm as the service had identified and assessed any risks to them and reviewed these on a regular basis. People had assessments which were individual to the person and their environment.

Medicines were administered in a safe way. Staff received training and a new competency framework had been introduced to make sure they understood and followed safe procedures for administering medicines.

Staff had received training in the MCA (Mental Capacity Act) and understood the importance of gaining people’s consent before assisting them.

The service completed detailed assessments of people’s needs and these were used to inform the care plan for each person. The service kept people’s needs under review and made changes as required. Staff had a good understanding of people’s health needs and had the knowledge and support to manage emergency situations.

People and their relatives felt able to raise any concerns or complaints. There was a procedure in place for people to follow if they wanted to raise any issues. Staff also said they felt comfortable in raising any concerns should they have any.

The service was well led. The registered manager monitored the quality of the service and made changes to improve the service provided when required. Staff and people who used the service found the management team approachable and responsive.

We visited five people using the service in their homes and spoke to two of these people’s relatives. We also spoke on the telephone with five people using the service and the relatives of two other people using the service. All made positive comments about the agency and the care staff and the service they or their relatives received. All told us that staff turned up on time and carried out the care tasks recorded in their care plans. All told us they knew how to make a complaint if they needed to.

One person using the service said “I have been using the agency for ten years, I am very fussy, but the agency is very good”. Another person said “I am very lucky. I have four lovely carers. I couldn’t ask for better. I am very happy with Sure Care”. Another person said “I am very happy with my carers; they are all very nice to me”. A relative said “I am satisfied with the agency. They always turn up on time and do what they have to do”. Another relative said “They are absolutely first class, I could not be happier with them”.

We spoke with one of the agency’s care coordinators. They said they carried out regular reviews of peoples care plans and risk assessments. They also carried out checks on staff to make sure they turned up on time, wore their uniforms and carried their identification cards.

We spoke with four members of staff. All said they had been well trained and felt confident to do their jobs. They also said they would not be expected to support people with specific care needs or medical conditions unless they had received the relevant training.

We found that appropriate recruitment checks were undertaken before staff began work.

Croydon and Sutton local authorities commission services from Sure Care. We contacted these local authorities commissioning/contract monitoring teams. They told us they had no concerns about the service.

We spoke to three people who use the service and three relatives of people who use the service. One person who uses the service told us “I have been using Sure Care for about fifteen years and they are an exceptional company, I am very pleased with the reception I get when I call them”. Another person told us “I have been with them for six years, they are excellent and I have recommended them to others”. A relative of a person using the service told us “They go that extra mile, they put themselves out for my mother, and it’s a really good service”. Another relative told us “two things I like about them, we always get regular staff and it’s really easy to contact the office anytime day or night if I need to”.

People who use the service and their relatives told us they had been consulted and involved in the care planning process. A copy of the care plan was kept at home and another copy was kept at the agency office. They told us staff turned up on time and carried out the tasks recorded in the care plan. They told us they were given a copy of the service user’s guide and knew how to make a complaint if they needed to.

We spoke with five members of staff, they all told us they received regular supervision and an annual appraisal and were up to date with their training. They told us they would not be expected or asked by managers to support someone with a specific need or medical condition unless they had the relevant experience and training to do so.

One person who uses the service told us, "the staff are very good they treat me well, I have used them for eighteen months and have been very happy with the service".

All of the people we spoke to told us that they were involved in drawing up their care plans and had agreed consent to treatment and care at that point.

All of the people we spoke to told us that generally staff turned up on time. One person told us, "staff consistently turn up on time or as near to the time as can be expected, they are amazingly punctual, Sure Care offer a good service".

All of the people we spoke to told us they had good relationships with their regular staff, when the regular staff are not available, for example on annual leave, the service provides other staff who are competent and able to carry out the tasks as stated in their care plans.

One person told us, "I have a very good carer, If I had a problem with staff, or felt they were not doing what they were supposed to or did not come on time, I would contact the office and tell them, they would sort it out, the office staff are always friendly when I have called before. I have not really had any problems with the staff and the service has always made sure that I am covered".

People who use the service and their relatives told us that they knew who to speak to if they had any cause to complain. One person told us, “I really have had no cause to complain, and I am good at that when I need to, but if I did have something to complain about they would soon know about it”. A relative told us, “I can tell the staff or call the office if I have a complaint and I know they would do something about it, I don’t have anything to complain about because they always offer a good service”.

A member of staff told us they have regular supervision and an annual appraisal, they attend regular team meetings and had received lots of training. They told us they would not be expected or asked by managers to support someone with a specific need or medical condition unless they had the relevant experience or training to do so. They told us they were very well supported by the managers and they felt proud and privileged to work for the service.