Background to this inspection
Updated
7 May 2022
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 undertaken by one inspector.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own homes.
Registered Manager
This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
At the time of our inspection there was a registered manager in post.
Notice of inspection
This inspection was unannounced. Inspection activity started on 14 April 2022 and ended on 20 April 2022. We visited the location’s office on 19 April 2022.
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. 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 to four people who used the service and four relatives about their experience of the care provided. We spoke to five members of staff including the registered manager and care staff. We reviewed a range of records. This included nine people's care records and multiple medication records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including customer and stakeholder feedback, policies and procedures were reviewed.
Updated
7 May 2022
About the service
Choice Care 4U is a domiciliary care agency. The service provides personal care to people living in their own homes in Selsey and Bognor Regis. At the time of the inspection 43 people were receiving the regulated activity of personal care. Some people were living with dementia, learning disabilities, neurological and health conditions and general frailty.
Not everyone who used the service received personal care. 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.
People’s experience of using this service and what we found
Improvements had been made to quality monitoring of the service. Further development of quality monitoring and governance processes were required to ensure these were effective. A service improvement plan had been implemented to address the concerns found at the last inspection and we were able to see improvements made.
The registered manager had worked hard to make service improvements and meet the required level of compliance. People and their relatives were happy with the service they received. Feedback from people included " I am very happy with the service I am receiving," and "The staff treat me with kindness and respect". Staffing levels were enough 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.
Systems were in place to protect people from the risk of abuse and improper treatment and staff knew how to identify potential harm and report concerns. People told us they received a safe with the service and did not have reason to doubt staff skills, integrity or honesty. Processes had been implemented to ensure support plans and risk assessments contain detailed and person-centred information. Risks to people's health and wellbeing were managed. Medicines were administered safely.
We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.
Based on our review of key questions safe and well-led the service was able to demonstrate how they were meeting the underpinning principles of Right support, Right care, Right culture.
Right support: The model of care maximised people's choice, control and Independence and measures had been taken by the provider to meet the needs of people with a learning disability in line with best practice guidance. Care plans identified which aspects of their care people could manage themselves or the type of support people required in order to promote their independence.
Right care: People with a learning disability received person-centred care and the support people received promoted dignity and equality. People's needs and preferences were known and respected.
Right culture: The ethos and values of the service ensured people using services were empowered to have choice and control over their lives. Staff had received training to ensure they had the skills and abilities to meet people's needs.
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 24 January 2022) and there were breaches of regulations. 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 improvements had been made and the provider was no longer in breach of regulations.
This service has been in Special Measures since 24 January 2022. 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. We carried out an unannounced comprehensive inspection of this service on 9 December 2021. Breaches of legal requirements were found in relation to providing safe care and treatment, medicines, protecting people from harm, staffing and the management of the service. The provider completed an action plan after the last inspection to show what they would do and by when to improve.
We undertook this focused inspection to check the provider had followed their action plan and whether the Warning Notice we previously served in relation to Regulations 12 and 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 had been met, and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.
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 has changed from inadequate to requires improvement. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Choice Care 4 U Services Limited on our website at www.cqc.org.uk.
Follow up
We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect