Safe Choice Care

Safe Choice Care is a domiciliary care agency which provides care and support to people in living in their own homes. 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. At the time of the inspection 70 older people were receiving support with personal care.

People’s experience of using this service and what we found

People were not supported by staff who had been safely recruited. Gaps in previous employment had not been explained. People’s views about the timing of care calls varied and there was not always travel time factored in between calls.

Risks to people’s health, safety and welfare had not been consistently assessed to make sure measures were in place to reduce the risks.

People were not always supported by staff who understood the importance of robust infection control measures. Staff re-training had been completed and the monitoring of staff increased.

People received their medicines as prescribed. When there had been medicines errors, these had been investigated and action taken to ensure it did not happen again. When people required medicines on an ‘as and when’ basis, the guidance for staff had not been consistently completed.

Checks and audits on the quality and safety of the service were not consistently effective. The registered manager’s checks had not identified the shortfalls found during the inspection. Checks had not been completed to make sure staff stayed the length of time they should, and no checks were made to ensure travel time had been allotted.

People and their relatives generally spoke positively about the quality of service they received. Staff felt valued and felt supported by the management team.

Staff worked closely with health care professionals, such as community nurses and GPs. People were referred to health care professionals when needed to ensure they received the support they 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.

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 14 June 2019).

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 the provider remained in breach of regulation.

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 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 Safe Choice Care on our website at www.cqc.org.uk.

Enforcement and Recommendations

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to recruitment of staff, risk assessments and good governance.

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 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.

Safe Choice Care is a domiciliary care agency. It provides personal care to people living in their own houses and flats. At time of the inspection there were 16 people were receiving a regulated activity, most people using the service were older people.

The service was also registered to provide care and support to people living in ‘supported living’ settings, so that they can live as independently as possible. However, at the time of the inspection no one using the supported living service was receiving a regulated activity. CQC only inspects services where people are receiving a regulated activity. Therefore, the supported living service is not included in this report.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

People’s experience of using this service:

People using the service and their relatives were positive about the service and the support they received. One person said, “When people asked me about my carers, I told people I couldn’t be more pleased.”

There were some areas where documentation needed to be improved. For example, some risks assessments were not in place prior to the inspection, since the inspection these are now in place. Record keeping around recruitment needed to be improved as did medicine records. However, we did not find any impact on people’s care or experience of the service related to these concerns and people told us that they felt safe using the service.

People and their relatives told us that they felt listened to and involved in planning their care. No one using the service had made any complaints. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

The service was reliable and had enough staff to cover calls. People told us that calls were always covered, and that staff timekeeping was good. Staff were not rushed during calls and people were positive about the support being individualised to the person. Staff had the training they needed which meant that they knew how to support people safely and effectively.

People were offered choices and staff understood when people needed to be supported to make decisions. People were encouraged to express their views and do things for themselves to maintain their independence. The staff we spoke to knew people well, people were treated with respect and their privacy and dignity was protected. Where people needed support with food and drink this was provided.

The staff we spoke to were positive about the support they received and the management of the service. People and their relatives were also positive about how the service was run. Where people needed support to access to healthcare services this was provided. The management learnt lessons from any accidents and incidents and used this learning to make improvements to the service.

Rating at last inspection:

This is the first inspection of this service.

Why we inspected:

This inspection was a scheduled inspection based on when the service registered.

Follow up:

We will ask the provider to send us and action plan detailing how they plan to make improvements. We will visit the service again in the future to check if the service has improved and if there are any other changes to the quality of the service.