Bestchoice Global Ltd

This service is a domiciliary care agency and is based in the London Borough of Barking & Dagenham. The service provides personal care to adults in their own homes. 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.

At the time of our inspection, the service provided personal care to 15 people.

People’s experience of using this service

Since our last inspection on 16 July 2018, improvements had been made on risk assessments and quality assurance processes. Care plans contained suitable and sufficient risk assessments to effectively manage risks and keep people safe. Audits were being carried out to ensure people always received safe, high quality care.

People and relatives told us that people were safe when supported by staff. Pre-employment checks had been carried out to ensure staff were suitable to support people. People and relatives told us staff were punctual and systems were in place to monitor time keeping. Systems were in place for infection control and to learn from lessons following incidents.

Staff had been trained to perform their roles effectively. 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 received care from staff who were kind and compassionate. Staff treated people with dignity and respected their privacy. Staff had developed positive relationships with the people they supported. They understood people’s needs, preferences, and what was important to them.

Care plans were person centred and included people’s support needs. Care plans had been reviewed regularly to ensure they were accurate. Complaints had been managed in a timely manner.

Systems were in place to obtain feedback from people and relatives. People, relatives and staff were positive about 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 1 September 2018). We identified one breach of Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 relating to Safe Care and Treatment in relation to risk assessments.

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 improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

This was a planned inspection based on the rating of the last inspection.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Not everyone using Bestchoice Global Ltd receives a regulated activity; CQC only inspects the service 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 has a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are registered persons’. Registered persons have legal responsibility for meeting the requirements of the Health and Social Care Act and associated Regulations about how the service is run.

People we contacted were not able to speak with us because of their ill health. We however, received positive feedback from their relatives. They informed us that they were satisfied with the care and services provided. They told us that people had been treated with respect and dignity by their care workers. There was a safeguarding adults’ policy and care workers were aware of the procedure to follow if they suspected people were being abused.

The service had a policy and procedure for the administration of medicines. Medicines administration records (MAR) charts we looked at had been correctly completed and we found no gaps in them. This provided a level of assurance that people were receiving their medicines as prescribed.

Risk assessments were seen in the care records of people. However, some of them were not sufficiently comprehensive as they did not inform care workers of what specific risks may be experienced by people concerned and how to keep people safe. These included risk of falls and seizures. Risk assessment forms for these were provided soon after the inspection.

The service had a recruitment procedure to ensure that care workers recruited were suitable and had the appropriate checks prior to being employed. We examined a sample of five records of care workers. We noted that these records had the necessary documentation such as a Disclosure and Barring Service check (DBS), references, evidence of identity and permission to work in the United Kingdom. We found three of these records did not contain references from a previous employer although two of them had professional references and one had character references. The registered manager explained that these care workers had not previously been employed.

The service had a training programme to ensure care workers were competent and able to care effectively for people. Certificates were seen in the records of care workers. They had the necessary support and supervision from the registered manager. Teamwork and communication within the service was good. New care workers had received a comprehensive induction.

Care workers were caring in their approach and able to form positive relationships with people. There were arrangements for encouraging people and their representatives to express their views and make suggestions regarding the care provided. Individual assessments and care plans had been prepared for people. However, the care documentation lacked information regarding people’s cultural and religious background. After the inspection, the registered manager provided us with their assessment form for recording this information. Reviews of care had been carried out to ensure that people received appropriate care which reflected their current needs.

The service had a complaints procedure and people and their representatives knew who to contact if they had concerns. No complaints were recorded. The registered manager stated that none had been received. People's relatives expressed confidence in the management of the service.

The registered manager stated that some audits had been done. This included audits of MAR charts and entries in the log book. However, we did not see any comprehensive completed audits including audits of care plans, risk assessments, recruitment records, accidents, complaints and punctuality. We have made a recommendation in respect of this. The registered manager informed us that the service had only started getting more work recently and they were in the process of preparing a comprehensive audit checklist.

We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what actions we told the provider to take at the back of the full version of the report.