The Inspection took place on 25 January 2018, 8, 9, and 13 February 2018 and 14 March 2018 and it was announced.

This service is a domiciliary care agency. It provides personal care to people living in their own homes. It provides a service to older people and younger adults.

At the last inspection, the service was rated requires improvement in effective and well led. This gave them an overall rating of requires improvement. At this inspection, we found the service had made improvements in both effective and well led and now was rated good overall. Care workers had received training, and regular updates had been planned. The quality assurance system had improved and included all of the necessary checks to ensure people received a good quality service.

There was 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 received safe care and support. Care workers knew how to support people and protect them from the risk of harm. There were risk assessments in place for people using the service and for care workers. The service operated safe recruitment practices and employed sufficient care workers to meet people’s needs. Although there were some issues with the medication system, they have now been put right. People received their medication safely as prescribed. Care workers demonstrated a good knowledge of infection control procedures and had completed infection control training..

People’s needs had been assessed and their care plans regularly reviewed and updated. Care workers received regular supervision and senior staff completed spot checks to ensure they carried out their work safely and effectively. Where required, staff supported people with food and drink and with their healthcare. The service worked well in partnership with other professionals to ensure people had the right support.

The service worked in line with other legislation such as the Mental Capacity Act 2005 (MCA). People were supported to have maximum choice and control of their lives and care workers supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People were cared for by kind, caring and respectful care workers. They listened to what people had to say, treated people with dignity and ensured they had the privacy they needed. People and their relatives said they were kept involved and informed. People’s independence was encouraged as much as possible while minimising any risks to help keep them safe.

People received responsive personalised care. Their care plans and daily communication sheets were detailed and informative. There was a clear complaints procedure and complaints had been dealt with appropriately. People had confidence in the registered manager and in how the service was being run. Several people said they would recommend the service to others. The care workers training had improved and they said they felt supported by the registered manager. The quality assurance system was more effective and management and care workers learnt from mistakes and made improvements to the service provided.

Further information is in the detailed findings below.

The announced inspection took place on the 20, 22 and 23 December 2016.

SureCare (Southend) provides a reablement service, personal care and support to people in their own homes. At the time of inspection there were 109 people who used the service.

The service is required to and did have a registered manager. 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 branch manager responsible for daily operations, had been newly appointed three weeks prior to the inspection. They had identified the need to improve systems to provide assurances that staff received support and adequate training regularly. To address this matter all staff were required by the organisation to complete another induction to the service within a three month timeframe. Therefore further work and time was needed to complete the processes to be able to evidence that all staff had the knowledge and skills to carry out their roles and responsibilities effectively.

The service needed to improve their monitoring systems. Systems were in the process of being developed and implemented to achieve robust quality monitoring of the service. An effective leadership team had been put in place although more time was required to embed these monitoring arrangements within the service.

People’s safety was ensured and care was provided in a way that intended to promote people’s independence and wellbeing. Staff supported people with the administration of their medications and management responded to medication concerns robustly and appropriately. There were sufficient numbers of staff to provide people with either; general support with daily needs, or reablement to significantly improve people’s health, with an aim to increased independence. A robust recruitment process was in place and staff were employed upon completion of appropriate checks.

Staff supported people to attend healthcare services when required. Staff also worked with a range of external services, such as social workers, occupational therapists, physiotherapists and GPs, to adopt and implement necessary care and support plans for the improvement of people’s health.

Staff understood their responsibilities and how to keep people safe from harm. People’s rights were also protected because management and staff understood the framework of the Mental Capacity Act 2005 (MCA). The registered manager knew how to apply such measures appropriately.

Staff were respectful and caring towards people ensuring privacy and dignity was valued. People were supported in a person centred way by staff who understood their roles in relation to encouraging independence whilst mitigating potential risks. People were supported to carry out their own choices to increase and maintain independence. The complaints system was used as a tool to identify and develop areas of improvement and to actively listen to people’s concerns or worries.

Systems were in place to make sure that people’s views were gathered. An effective leadership team had been put in place to execute the analysis and action plans developed from people’s views.