The inspection took place on 17 July 2018 and was announced. This was the service's first inspection.

SureCare Hereford is a domiciliary care agency. It provides personal care to people living in their own houses in the community. The service supports older and younger adults, who may have learning disabilities, autistic spectrum disorder, dementia, mental health care needs, physical disabilities or sensory impairments. At the time of our inspection visit, 48 people were using the service.

Not everyone using SureCare Hereford receives a 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.

The service is required to have a registered manager and there 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.

The provider’s processes for assessing and managing the risks associated with people’s care and support needs were not sufficiently robust. Staff did not always have adequate travel time between people's care calls to provide a punctual service. People’s rights under the Mental Capacity Act were not always fully promoted by the provider.

The provider carried out pre-employment checks and provided staff with training to protect people from harm and abuse. People received support from staff to manage and take their medicines safely, where they needed this. Staff protected people from the risk of infection through, amongst other things, the use of personal protective equipment.

Before people’s care started, their individual care and support needs were assessed. Staff received an initial induction and ongoing training and support to succeed in their roles and work effectively. People had support to prepare meals and drinks of their choice, where this was an agreed part of their care package. Staff helped people to maintain their health and access professional medical advice and treatment as needed.

Staff took a caring and compassionate approach to their work and took the time to get to know people well. People and their relatives were encouraged to express their views about the care and support provided and were listened to by the provider. Staff understood and promoted people’s rights to privacy, dignity and independence.

People’s care plans were developed and reviewed with their input and followed by staff. People received care and support that reflected their individual needs and requirements. People and their relatives were clear about how to raise any concerns or complaints about the service, and these were addressed by the provider.

The registered manager promoted a positive, open culture within the service. They made themselves available to people and their relatives and were responsive to any issues raised with them. Staff were clear what was expected of them and felt valued and supported at work. The provider took steps to involve people, their relatives and staff in the service. The registered manager and senior care staff completed audits and checks to assess, monitor and improve the quality of the service people received.