Archived: Choices Home Care Limited

Choices Homecare is a domiciliary care agency providing personal care to people living in their own homes in Kirklees, Wakefield and the surrounding areas. At the time of this inspection, the service was providing care to 99 people and there were 66 staff members. 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

People and relatives told us they felt safe with the care provided and were complimentary about the way in which care was delivered.

The provider completed person centred assessments and care plans were updated in response to changes. Some aspects of the recording of medication, risk assessments and care plans required further detail, but this was not found to have impacted on people using the service and the provider immediately addressed the issues found.

Staff showed a good understanding of their roles and responsibilities for keeping people safe from harm. Individual and environmental risks had been assessed to minimise the risk of harm to people and staff during care visits. There was after-hours support to assist staff when working on their own and out of office hours.

The registered manager had processes for monitoring visits and were using a computer-based monitoring system to monitor whether staff were visiting as planned.

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 received support to maintain good nutrition and hydration and their healthcare needs were

understood and met.

People and family members knew how to make a complaint and they were confident that their complaint would be listened to and acted upon quickly.

The service was going through organisational changes and the provider had developed plans to manage and communicate these changes to people and staff. There was a clear vision about the quality of care the provider wanted to provide and there was an open and person-centred culture in the organisation. Staff told us the provider was a considerate employer and staff retention was good.

The provider had identified improvements were required in their quality assurance processes and were working to implement the necessary changes.

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 in 5 January 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

The service is registered to provide personal care to people living in their own homes. At the time of our inspection 27 people were receiving support. The service supported older and younger people, people with a learning disability, mental health concerns and people with physical disabilities. Some people were living with dementia and some with sensory impairments.

The service had a registered manager who was also the registered provider. 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.

Systems were in place for the management of medicines so people received their medicines safely. Some improvements were needed to ensure all good practice guidelines were used. We made a recommendation the registered provider did this and work had already started on day two of our inspection.

The registered provider ensured risk assessments were in place for staff to follow when they supported people and also around the equipment they used in people’s homes they visited.

This meant the registered provider took steps to ensure the safety of people and staff. Formal assessment tools were not used for areas such as pressure care and nutrition. The registered manager told us they will start to use these where appropriate to ensure staff have all of the written guidance they need to help people to remain safe.

Care plans we saw contained information about the person's likes, dislikes and personal choices. Care plans were reviewed regularly and any actions from those reviews were carried out to improve the service people received.

People were supported to access their choice of food and drinks which helped to ensure their nutritional needs were met. Staff worked with other healthcare professionals to support people to have their health needs met.

There were systems and processes in place to protect people from the risk of harm. Staff were aware of the different types of abuse and what would constitute poor practice. People and their relatives told us staff treated them with dignity and respect. Staff showed compassion, were patient and gave encouragement to people. People were supported to have choices and be independent.

The registered manager and staff we spoke with had an understanding of the principles and responsibilities in accordance with the Mental Capacity Act (MCA) 2005. People were supported to make their own decisions and were involved in decisions about their care and support.

There was enough staff employed to provide support and ensure people’s needs were met. Effective recruitment and selection procedures were in place and we saw appropriate checks had been undertaken before staff began work.

Staff told us the registered manager and senior members of staff were supportive. Staff had received regular supervision and appraisal. The registered provider had a system in place to ensure staff received all of their training and this confirmed training was up to date. Staff told us they felt they had received enough training to enable them to fulfil their role.

The registered provider had a system in place for responding to people’s concerns and complaints. People told us they knew how to complain and felt confident staff would respond and take action to support them.

There were systems in place to monitor and improve the quality of the service provided. Staff told us the service had an open, inclusive and positive culture.

Comments included,

"They are outstanding, very good indeed.'

'They do an exceptionally good job."

'They look after all my needs.'

'Exceptional carer the service is responsive to changing needs.'

'Always there to help if you need it.'

The care records we reviewed showed that the care plans were up to date and people had their health and welfare needs met.

Care staff were very complimentary about the agency and the support they received. One care worker told us "I love my job'.