We carried out a review of the data available to us about Care Options 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 Care Options, you can give feedback on this service.
Care Options is a domiciliary care agency that was supporting 66 older people at the time of the inspection, some of whom were living with dementia.
People’s experience of using this service
People felt safe when staff provided their care. They said staff understood and followed the guidance in their care plans. Any potential risks to people were identified and managed effectively. Staff helped people keep their homes clean and wore gloves and aprons when necessary. Although people received their medicines when they needed them, there were some discrepancies in the recording of some medicines. We have made a recommendation about this.
There were enough staff employed to meet all the agency’s care commitments. The agency’s recruitment procedures helped ensure that only suitable staff were employed. Staff attended safeguarding training and knew how to recognise and report potential abuse.
People’s care was provided by regular staff who understood their needs and preferences. Staff were kind and caring and had developed positive relationships with the people they supported. People were encouraged and supported to maintain their independence. Staff treated people with respect and maintained their privacy and dignity when providing their care.
Staff had the induction and ongoing training they needed for their roles. The induction process included shadowing experienced staff to understand people’s needs and preferences about their care. Staff were well-supported by the management team and had access to advice when they needed it. Staff met with their line managers for one-to-one supervision, which provided opportunities to discuss their performance and training needs.
People’s needs were assessed before they used the service. People were involved in their assessments and planning their care. Care plans were reviewed regularly to ensure they continued to accurately reflect people’s needs. Staff monitored people’s health effectively and reported any concerns promptly. Some people told us the quality of support they received from staff had helped them regain good health. The agency communicated effectively with other professionals to ensure people’s healthcare needs were met. People who received support with meals said staff understood their dietary needs and prepared their food in the way they preferred. Staff encouraged people who were reluctant to eat to maintain adequate nutrition.
Care was planned to meet people’s individual needs. 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 had recorded their consent to care and told us staff asked for their consent on a day-to-day basis.
The agency provided reliable, well-planned care. People could always contact the agency when they needed to and access the information they required. People said staff time-keeping was good and that they were kept informed of any changes. Spot checks were carried out to ensure staff provided people’s care safely and in the way they preferred.
The agency contacted people regularly to seek their views and acted on their feedback. Any complaints received were managed in line with the agency’s written complaints procedure. Complaints had been investigated by the registered manager and action taken to address the issues raised.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection:
The service was rated Good at the last inspection (published 25 November 2016).
Why we inspected:
This was a scheduled inspection based on the rating awarded at the previous inspection.
Follow up:
We will continue to monitor the service through notifications and communication with partner agencies such as local authorities and other commissioners. We will inspect the service again according to the rating achieved at this inspection unless we receive information of concern, in which case we may inspect sooner.
The inspection took place between on 12 September and 5 October 2016 with visits to the Care Options office on both of these dates.
The service had a registered manager in post. 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 in the Health and Social Care Act 2008 and associated Regulations about how the service is run. The registered manager was also the provider of Care Options.
We previously carried out an inspection of this service on 19 December 2013 where we had no concerns. We made one recommendation as a result of this inspection. Whilst the service had received no formal complaints, it was clear that minor issues had been raised and dealt with by the management team. These issues were not always documented. As such we asked the provider to consider ways of capturing people’s concerns in order to identify and possible trends and themes.
There were systems in place to ensure the service safely recruited sufficient and appropriate staff to support people. Once employed, staff completed a comprehensive programme of induction and training to ensure they had the necessary skills and experience to meet people’s needs. Communication systems across the service were good and staff were supported and enabled by the management team to deliver safe and effective care.
People’s needs and homes were fully assessed before care was provided. As such, any risks associated with their care were identified and managed safely. The service had appropriate systems to safeguard people from the risk of harm or abuse and staff were knowledgeable about how to keep protect people and keep them safe.
Care staff worked in small geographical teams which meant that most people benefitted from the support of a regular team of staff. People told us that care staff knew them well and that as a result they received consistently good care. Staff were kind and compassionate and demonstrated the values of the agency to provide high quality care. People received care that was provided in a respectful way that promoted their privacy and dignity.
The service was responsive to changes in people’s needs and tailored their services accordingly. People were involved in the planning and reviewing of their care and supported to be as independent as possible. Staff respected people and their decisions. Staff understood the importance of gaining consent from people and demonstrated an awareness of the Mental Capacity Act 2005. Staff were clear about what they should do if a person refused to accept their care.
People were supported to maintain good health. The service worked in partnership with other healthcare professionals to ensure people had access to the necessary services and support they needed. Where people were supported with their medicines, this was done safely. Staff received training in the management of medicines and checks were carried out to ensure they were competent in this area. People told us that staff supported them with their medicines appropriately.
Staff understood the importance of supporting people to maintain adequate nutrition and hydration. Care plans identified people’s risks and staff were knowledgeable and creative in the way they supported people to eat and drink safely.
Care Options had good systems in place to monitor and improve the quality of its services. People were regularly asked for their feedback and satisfaction surveys sent to both people and staff were used to identify areas of concern or improvement.
We reviewed the care plans of nine people and we found that people's individual needs were assessed and that care was planned and delivered to meet their needs and promote their welfare. A person said "they (staff) listen to me and what I want - I am 100% satisfied". A person's relative said "if I need help I can call them they are brilliant with dad, their attitude is helpful and friendly and the care plan is accurate".
We found that the provider had appropriate arrangements in place to manage people's medicines.
People told us that they were satisfied with the standard of care they received from the provider's staff. We found that the provider carried out the relevant checks to ensure people were supported by staff that were trained, experienced and of good character. A person's relative said "they know their needs very well and are very good".
We found that people were asked about the quality of service they received and that the provider had suitable arrangements in place to identify and manage risks to people who used and worked in the service. A person said "my relationship with the provider is excellent".
We found that care plans were reviewed on a regular basis and information was clearly documented. Staff explained that they had to write a monthly report for each person, . If there were significant changes then the review of their care was brought forward and a new assessment was undertaken.
We found that people spoke positively about the agency, with comments such as "I am very happy with the carers that visit, and they are all friendly and accommodating." "We have always found the carers very good and helpful," and "All the staff that I have met have provided a good service and they have been very supportive."
There were policies and processes in place for ensuring that staff were trained, supervised and had yearly appraisals. The agency had systems in place to monitor the quality of the service and kept the Care Quality Commission informed of any incidents.
They all said that they were happy with the service provided and that, in general, the care given was good. All the people we spoke to described the staff as very good and one told us that the care staff who visit them were 'excellent'. However one representative told us that the care staff that work at the weekend were not very good and they had stopped receiving care at the weekends because of this.
We were told that the care staff were always polite, friendly and sometimes did 'above and beyond' what they should.
Some of the people we spoke to said there was sometimes a problem with the times that visits were carried out and that they were not always told when the care staff were running late.