23 February 2023
During an inspection looking at part of the service
At the time of the inspection, the location did not care or support for anyone with a learning disability or an autistic person. However, we assessed the care provision under Right Support, Right Care, Right Culture, as it is registered as a specialist service for this population group.
About the service
Best Choice Care is a domiciliary care service for people living in their own homes in the community. At the time of our inspection, there were 72 people using the service. The provider was also newly registered as a supported living service, but at the time of the inspection had not begun to offer this service. Additionally, the provider had moved location since the last inspection.
Not everyone who used the service received personal care. 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.
People's experience of using this service and what we found
The service was not always able to demonstrate how they were meeting the underpinning principles of right support, right care and right culture.
Right Support
The provider had not always ensured people received care in line with the principles of the Mental Capacity Act 2005 (MCA). People were not always supported to have maximum choice and control of their lives and the provider could not demonstrate people were always supported in their best interests. While the provider had policies and systems in place, these were not always robustly implemented. The provider had not always notified the CQC as required. We recommended the provider is consistent in following their safeguarding policy and procedures in protecting adults at risk of abuse. Risks to people were assessed and monitored. Medicines were managed safely, and staff enabled people to access healthcare appropriately.
Right Care
Staff understood people’s cultural needs, provided culturally appropriate care and responded to people’s individual needs. Overall, people were satisfied with the care provided. People’s care plans reflected their range of needs and this promoted their wellbeing. Staff received appropriate training to meet people's care needs. People were supported by the same staff which provided consistency.
Right Culture
During the inspection we found recording systems were not always robust enough to monitor and mitigate the risks relating to the health, safety and welfare of people using the service. Additionally, systems were either not in place or robust enough to demonstrate service improvement was effectively managed. People and those important to them were involved in planning their care. Staff told us they felt supported by the management team. People and their relatives said they knew who to approach if they had a complaint.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was requires improvement (published 29 July 2021).
Why we inspected
This inspection was prompted by a review of the information we held about this service.
We have found evidence that the provider needs to make improvements. Please see the safe, effective and well led sections of this full report. You can see what action we have asked the provider to take at the end of this full report.
You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Best Choice Care Limited on our website at www.cqc.org.uk.
Enforcement and Recommendations
We have identified breaches in relation to good governance and consent to care at this inspection. Please see the action we have told the provider to take at the end of this report. We also recommended the provider is consistent in following their safeguarding policy and procedures and notify CQC as required.
Follow up
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.