First Choice Care Agency Limited

Updated 29 June 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

The inspection was carried out by 2 inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.

Registered Manager

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

This inspection was announced. 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.

We visited the location's office on 3 and 4 May 2023.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 4 people who use the service and 7 family members. We also spoke with the registered manager, office manager, 1 senior carer and 4 care staff. We reviewed a range of records. This included in part 6 care records, 3 staff files in relation to recruitment and supervision and multiple medication records; a variety of records relating to the management of the service, including audits, staff training, meeting records and the staff rota.

Updated 29 June 2023

About the service

First Choice Care Agency is a domiciliary care agency which provides care and support to people living in their own homes. At the time of the inspection there were 13 people using the service, of which 12 received support with personal care. Care Quality Commission (CQC) only inspects where people receive personal care. This includes 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

Improvements had been made and the service was no longer in breach of regulation. However, further time was required for new and improved systems and processes to become fully embedded and sustained.

Improvements had been made to safety. People’s care plans and risk assessments had been reviewed, updated, and developed further. Staff had detailed guidance of the action required to provide safe and effective care, which also reflected people’s routines and preferences.

People were supported by regular care staff who knew and understood their needs and routines. People were positive about the care and support provided. There had been no missed calls and late calls were minimal and within the agreed tolerance. Staff travel time had been added to the staff rota.

Staff had been safely recruited. Staff received ongoing opportunities to discuss their work, training, and development needs and their competency was checked.

Where people required support with their medicines and eating and drinking, staff had detailed guidance, and this was provided safely and effectively.

Infection prevention and control practice was followed to reduce the risk of cross contamination and the risk of infection.

People were protected as far as possible from the risk of abuse and harm. Staff had received safeguarding training and were aware of their roles and responsibilities to protect people.

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. New Mental capacity assessments had been implemented and completed when required.

People’s health care needs were assessed and monitored, and staff worked with external health and social care professionals to support positive outcomes.

New and improved audits and checks, systems, and processes in assessing, monitoring, quality and safety were in place. The registered manager had plans to further develop monitoring systems to enhance and develop the service.

The provider had developed their quality assurance process to enable people to share their experience of the service they received.

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 inadequate (published 21 January 2023), breaches in regulations relating to safety, staffing, consent, staff recruitment and governance were identified, and enforcement action was taken. At this inspection we found enough improvements had been made and the service was no longer in breach of regulation.

This service has been in Special Measures since the last inspection. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection. The overall rating for the service has changed from inadequate to requires improvement based on the findings of this inspection.

Please see the safe, effective, and well-led sections of this full report. You can read the report from our last inspection, by selecting the ‘all reports’ link for First Choice Care Agency on our website at www.cqc.org.uk.

Enforcement

Following the inspection in 2021 we recognised that the provider had failed to meet the conditions of their registration. This was a breach of regulation and we issued we issued a foxed penalty notice. The provider accepted a fixed penalty and paid this in full.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.