Background to this inspection
Updated
19 November 2022
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 Health and Social Care Act 2008.
Inspection team
The inspection was carried out by 1 inspector.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.
Registered Manager
This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.
At the time of our inspection there was a registered manager in post.
Notice of inspection
We gave the service 24 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.
Inspection activity started on 28 October 2022 and ended on 9 November 2022. We visited the location’s office on 1 November 2022.
What we did before 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. We used all this information to plan our inspection.
The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make.
During the inspection
We spoke with 2 people who used the service and 3 relatives about their experience of the care provided. We spoke with 5 members of staff including the registered manager, operations director and care workers.
We reviewed a range of records. This included 3 people’s care records and multiple medication records. We looked at records 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.
Updated
19 November 2022
About the service
Care with Choices is a domiciliary care agency. It provides personal care to people living in their own houses and flats. It provides a service to younger and older adults with various needs including, physical disabilities, sensory impairments, and people living with dementia or a learning disability. At the time of this inspection 8 people were using the service. Not everyone who used the service received personal care. The Care Quality Commission (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.
We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.
People’s experience of using this service and what we found
People were protected from the risks of abuse and staff were trusted to keep them safe. Staff had received training in how to safeguard people. Staff received training in infection prevention and control and told us Personal Protective Equipment (PPE) was readily available to them. Medicines were managed safely. People received their medicines as prescribed.
Recruitment checks were robust to ensure staff were suitable to work with vulnerable adults. The provider had systems in place to monitor staffing levels and ensure people received their visits. Staff had received an induction when they first started working at the service and training relevant to their roles had been provided.
People's needs were assessed prior to starting with the service and care plans were developed according to people’s needs. People and relatives were involved in their care planning. Timely care was provided. Relatives told us staff were on time for their visits and if on an occasion staff were delayed, they would be informed.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
The service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture. Care plans were person-centred and were focused on promoting people’s independency and empowering their lives. The care provided was person-centred and promoted people's dignity, privacy and upheld their human rights.
People’s views and decisions about care were incorporated when their care packages were devised. People were involved in making decisions about their day to day care. People’s independency was encouraged where possible and this was reflected in people’s care plans. Staff received training in equality and diversity and they were committed to ensuring people were treated well.
Care plans provided guidance for staff about how best to support people's needs and preferences. People and relatives were involved in reviews and care plans were accessible electronically with live updates. End of life care was not routinely provided. Staff had access to end of life training and end of life care could be facilitated alongside community healthcare professionals if required.
Governance systems were in place to monitor the standard of care people received. The service worked in partnership with other health and social care organisations and the community to achieve better outcomes for people using the service.
The registered manager and staff demonstrated a commitment to people, and they displayed person-centred values. The registered manager had regular contact with people and completed care visits themself. People and relatives’ feedback was sought through people's care plan reviews and people were encouraged to submit feedback online. Staff views were sought through regular meetings and supervisions. Staff praised the registered manager and wider management team, they felt supported in their roles.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk.
Rating at last inspection
This service was registered with us on 25 October 2021 and this is the first inspection.
Why we inspected
This inspection was prompted by a review of the information we held about this service.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.