We carried out a review of the data available to us about First Option Healthcare on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about First Option Healthcare, you can give feedback on this service.
First Option Healthcare Ltd is a domiciliary and nursing care agency providing complex care and support across the country. It provides personal care and nursing care to children and adults living in their own houses and flats in the community. At the time of the inspection it was providing a service to 95 people.
Not everyone using First Option Healthcare receives a regulated activity; CQC only inspects the areas where people are in receipt of personal care or treatment of disease, disorder or injury. Where a person is in receipt of personal care CQC, only inspects the service provided to people receiving help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided. First Option Healthcare also provided treatment of disease, disorder or injury. This meant they also provided nursing assistance to people within their own homes in respect of long-term healthcare conditions.
People’s experience of using this service and what we found
We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. We considered this guidance as there were people using the service who have a learning disability and or who are autistic.
Right Support:
People and their relatives felt involved in the planning of care and support. Regular meetings and reviews allowed people to make any changes necessary to ensure the service continued to meet their needs. Staff supported people to achieve their best healthcare outcomes by working with other healthcare professionals, families and commissioners. When people were supported to follow their hobbies, staff worked with them to help them achieve their goals and aspirations. 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.
Right Care:
People’s relatives told us staff were kind and respectful. People were provided with a team of fully trained staff to provide a bespoke care package tailored specifically for their needs. Both nurses and care staff received extensive training from the provider before they started working for the service and received regular refresher training, so their skills and knowledge were updated and relevant. When people used specialist equipment the provider made sure staff received the training they needed to use the equipment safely. Care records were person centred and focused on clinical support but also considered people’s hobbies, interests and cultural beliefs. When possible, the service provided people with opportunities to enhance and enrich their lives to achieve positive outcomes.
Right Culture:
The provider worked well with staff and other healthcare professionals to make sure people received good quality care and support. The provider was committed to embedding its values into the culture of the service and constantly strived for excellence. The provider had systems in place to look for areas of risk and improvement and when something went wrong, the provider worked with people to make things better. People, their family and staff were asked for their views about the service and how the service was managed, they felt they were listened to and changes were made to improve 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 good (published 25 July 2018).
Why we inspected
The inspection was prompted in part due to concerns received about staff training and management systems leading to poor communication with staff and people using the service. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led. We found the provider had recognised and acted on the issues raised and had made improvements in these areas.
Please see the safe, effective and well-led sections of this full report. 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 good.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for First Option Healthcare on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
This service is a domiciliary care agency. It provides personal care for people living in their own houses and flats in the community. It provides a service to people of all ages. At the time of the inspection they were supporting eight people all of whom were under the age of 16. Not everyone using First Option Healthcare receives a regulated activity; CQC only inspects the service being received by people provided with ‘Personal Care’ or ‘Treatment of Disease, Disorder or Injury’. Where a person is in receipt of personal care CQC only inspects the service provided to people receiving help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided. First Option Healthcare also provided ‘Treatment of Disease, Disorder or Injury’. This meant they provided nursing assistance to people within their own homes in respect of long-term healthcare conditions.
There was no registered manager at the service. 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. At the time of our inspection the provider had employed a manager who had submitted their application for registration to the CQC. The manager was being supported by a senior manager within the organisation who also assisted us during our inspection.
People’s care records contained detailed and comprehensive information related to their long-term medical conditions as well as clear instructions for nurses and care workers as to how they were expected to manage these conditions. Care records contained detailed instructions about people’s complex nutritional needs and records were kept of people’s nutritional intake.
The provider’s quality assurance systems supported the delivery of good care. The senior manager sought people’s feedback in relation to the care they were receiving during regular, unannounced spot checks of service delivery.
Care and nursing staff understood the principles of the Mental Capacity Act 2005 (MCA). Care records were signed by people’s relatives to indicate their consent to the care provided.
There was an up to date and comprehensive safeguarding policy and procedure in place. Nursing and care staff had a good understanding about their responsibilities to safeguard adults and children.
People’s relatives gave good feedback about staff. Staff ensured people’s privacy and dignity was respected.
Care records contained detailed risk assessments for both nursing and care staff. Risk assessments contained explanations of the known risks to people’s health and safety as well as clear guidelines for staff to follow in the event of an emergency.
Care plans contained details of people’s personal preferences in relation to their care and staff demonstrated a good understanding of these.
People’s families were involved in the creation and ongoing management of their care plan. Care records included information about how people’s families were involved in their care as well as information about the need to provide daily updates to family members about the care and support given.
The provider’s staff recruitment procedures ensured staff were suitable to work with people using the service. Staff records included evidence of comprehensive background checks to help ensure only suitably qualified and experienced staff were employed to care for people. The provider ensured there were a sufficient number of staff to meet people’s needs.
There was an effective complaints procedure in place. Complaints records were clear and demonstrated that appropriate actions were taken to resolve these.
The provider ensured staff received regular training and supervisions of their performance.