Archived: Choice Local Care Limited

Updated 21 October 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 21 and 22 September 2016 and was announced. The provider was given short notice of the visit. This was because we needed to be sure key staff would be available for us to speak with. The inspection was carried out by an adult social care inspector. We spoke on the telephone with two people who used the service and four relatives. We also visited one person in their own home and spoke with them and their relative. This helped us to understand the views and experiences of people who used the service.

Prior to the inspection visit we gathered information from a number of sources. We looked at the information received about the service from notifications sent to the Care Quality Commission by the registered manager. We also looked at the information sent to us by the registered manager on the provider information return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.

At the office we spoke with the registered manager, a team leader and the care coordinator who also delivered personal care and assisted the registered manager in the running of the service. We also spoke with six care staff who worked with people who used the service in the community.

We looked at documentation relating to six people who used the service, five staff files and the management of the service. The registered manager told us the care plans were also stored in people’s home. These were copies of the files held at the office.

Updated 21 October 2016

The inspection took place on the 21 and 22 September 2016 and was announced. The provider was given short notice of the visit. This was because we needed to be sure key staff would be available for us to speak with. At the last inspection in March 2014, the service was judged compliant with the regulations inspected.

Choice Local Care Limited is a domiciliary care agency registered to provide personal care. The agency is managed from Choice Local Care Limited head office at 27 Taplin Road. From this location all referrals, staffing and service provision is organised. It is the main point of contact for families/professionals that domiciliary care is provided to.

There is a registered manager which oversees services provided from the office. 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 there were 12 people using the service. We spoke on the telephone with two people who used the service and four relatives. We also visited one person in their own home and spoke with them and their relative. We asked people about their experiences of using the agency. People we spoke with told us they were mostly happy with the service provided. Two relatives raised concerns that they thought staff needed more training and they said there seemed a big turnover of staff and they sometimes did not stay for the allocated time.

People's care needs had not been thoroughly assessed, prior to the package of care being implemented. Care records at the office did not always demonstrate people’s consent to their care and treatment.

The provider did not have robust systems in place to ensure that people were safe. Care records were not sufficiently detailed to ensure staff could deliver care safely. Risk assessments did not provide guidance for staff on how to mitigate the risks when providing care and support to people who used the service.

Care records told us that staff were administering medication to people who used the service. However, records showed staff had not received training in the safe management of medicines. Care records did not always show the list of medication administered and medicine administration records [MAR] were not being used to record that medication had been given as prescribed. Staff had not had an assessment to ensure that they were competent in the management and administration of medicines.

Staff had not received the relevant training for the work they did. Not all staff had received regular

supervision and appraisals. Spot checks were not regularly carried out to establish whether they had the required skills, and experience for the work they did.

People were positive about how their care was managed by the care staff. They were treated with kindness and compassion. People were treated with respect and their privacy and dignity was promoted.

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘Special measures’.

Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the provider’s registration of the service, will be inspected again within six months.

The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe.

If not enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. This service will continue to be kept under review and, if needed, could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement so there is still a rating of inadequate for any key question or overall, we will take action to prevent the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration.

For adult social care services the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.