Background to this inspection
Updated
1 September 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 Care Act 2014.
As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.
Inspection team
The inspection team consisted of 3 inspectors including a medicines inspector 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 provides care and support to people living in 13 ‘extra care' and 'supported living' settings, so that they can live as independently as possible. People's care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people's personal care and support.
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.
A new manager had been in post for 4 months and had submitted an application to register. We are currently assessing this application.
Notice of inspection
We gave the service 24 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.
What we did before inspection
We reviewed information we had about the service. We sought feedback from the local authority and professionals who work with the service. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection.
During the inspection
We spoke with 14 people who used the service and 5 relatives about their experience of the care provided. We spoke with 13 members of staff including the head of care operations, the quality manager, service managers, senior care workers and care workers. We reviewed a range of records. This included 16 people's care records and multiple medication records. We looked at 9 staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
Updated
1 September 2023
About the service
Choices Housing Association is a care at home service providing personal care to 154 people at the time of the inspection. The service supported people across 13 extra care and supported living settings across Staffordshire, Shropshire and Stoke some of whom were living with dementia, mental and physical health needs, and learning disabilities.
We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.
People’s experience of using this service and what we found
Right Support: 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's medicines were managed safely. However, we did identify the need for some improvements in the management of time-specific medicines, rotation of pain patches and medicines care plans, to ensure these reflected best practice. People were protected from the risk of abuse. The provider took a proactive approach to assessing and mitigating risks to people's safety. The provider was meeting the requirements of the Mental Capacity Act 2005. There were systems in place to identify when things went wrong.
Right Care: Care was person-centred and promoted people's dignity, privacy and human rights. There were enough staff on duty to meet people's needs. There was a system to monitor and assess the care provided. People achieved good outcomes from their care. The service worked collaboratively with other agencies to ensure people received the care they needed.
Right Culture: The ethos, values, attitudes and behaviours of leaders and care staff ensure people using services lead confident, inclusive and empowered lives. Management used questionnaires and meetings to take suggestions from people and acted on feedback. There was a culture of continuous learning. The management team understood their responsibilities under the duty of candour and was meeting these.
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 12 July 2019).
Why we inspected
The inspection was prompted in part due to concerns received about management of medicines. A decision was made for us to inspect and examine those risks. We found no evidence during this inspection that people were at risk of harm from these concerns.
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 is Good.
You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Choices Housing Association 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.