Background to this inspection
Updated
24 February 2023
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
This inspection was carried out by one 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.
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 48 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 17 November 2022 and ended on 21 December 2022. We visited the office on 21 December 2022.
What we did before the inspection
We reviewed information we had received about the service since the last 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. We used information gathered as part of our monitoring activity that took place on 28 September 2022 to help plan the inspection and inform our judgements. We used all this information to plan our inspection.
During the inspection
We used technology and electronic file sharing to enable us to review documentation relating to people’s care. We spoke with the registered manager and reviewed documents relating to recruitment and overall management of the service. We spoke with 1 person and 2 relatives on 12 December 2022. On 15 December 2022 we spoke with 3 staff.
Updated
24 February 2023
About the service
Options Health Care Services is a domiciliary care agency providing care and support to older people in their own home. At the time of our inspection there were 6 people using the service.
Not everyone who used the service received personal care. The Care Quality Commission (CQC) only inspects where people receive personal care. Where they do, we also consider any wider social care provided.
Options Health Care Services changed its registered office address on 09 January 2022. It was previously registered at Unit 14A Meadway Court, Rutherford Close Stevenage SG1 2EF. The address changed to 241 Kings Court, London Road, Stevenage, Hertfordshire, SG1 2NG. The provider had not notified us of this, despite prompting at our DMA on 29 September 2022. It was only changed as a result of this inspection.
People’s experience of using this service and what we found
Risks relating to people’s care and support were not always assessed and care records lacked key information about how to manage those risks. We have made a recommendation about documenting people’s known health needs.
Staff were not always deployed to meet people's needs in a timely manner and at the time agreed.
Staff were clear on what actions they needed to take in relation to infection prevention and control (IPC), including the wearing of personal protective equipment (PPE) and regular hand washing. However, we were told that staff did not always wear masks which people preferred.
Quality assurance systems in place were not being fully effective and did not highlight the concerns we found during this inspection, or made improvements following previous recommendations. Notifications of significant events were made to CQC as required.
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.
People told us they felt safe with the care provided. People received their medicines as the prescriber intended.
People were positive about the care they received and the management of the service.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was requires improvement (published 26 July 2019) and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found some improvements had been made but the provider remained in breach of one regulation.
This service has been rated requires improvement for the last two consecutive inspections.
Why we inspected
This inspection was prompted by a review of the information we held about this service. This indicated concerns in relation to staffing, risk management, consent and overall management of the service.
As a result, we undertook a focused inspection to review the key questions of safe and well-led only. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.
The overall rating for the service has remained requires improvement based on the findings of this inspection.
We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Options Health Care Services on our website at www.cqc.org.uk.
Enforcement
We have identified a breach in relation to good governance at this inspection.
Please see the action we have told the provider to take at the end of this report.
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 follow up in a couple of months and request evidence of actions taken. 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.