Best Choice Care

Updated 3 June 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 Health and Social Care Act 2008.

Inspection team

The inspection was conducted by one inspector. After the inspection, two Experts by Experience supported the inspection by making phone calls to people who used the service and their relatives to ask for their feedback. 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 is a domiciliary care agency. It provides personal care to people living in their own houses and flats.

This service is also registered to provide care and support to people living in ‘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. However, at the time of the inspection, the provider had not begun caring for people in supported living settings.

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.

At the time of our inspection there was a registered manager in post.

Notice of inspection

We gave the service 48 hours’ notice of the inspection. This was because we needed to be sure that the provider or registered manager would be in the office to support the inspection.

Inspection activity started on 21 February 2023 and ended on 21 March 2023. We visited the location’s office on 23 February 2023.

What we did before the inspection

We reviewed information we had received about the service since the last inspection, including notifications of significant events. We used all of this information to plan our inspection. The provider was not asked to complete a provider information return prior to this inspection. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. We took this into account in making our judgements in this report.

During the inspection

We spoke with the registered manager and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We reviewed a range of records. This included 10 people's care records, multiple medicines records and 4 staff records. A variety of records relating to the management of the service, including audits were also reviewed. As part of the inspection we spoke with 13 people who used the service and 18 relatives. 19 care workers emailed us feedback of their experience of the service.

Updated 3 June 2023

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.

At the time of the inspection, the location did not care or support for anyone with a learning disability or an autistic person. However, we assessed the care provision under Right Support, Right Care, Right Culture, as it is registered as a specialist service for this population group.

About the service

Best Choice Care is a domiciliary care service for people living in their own homes in the community. At the time of our inspection, there were 72 people using the service. The provider was also newly registered as a supported living service, but at the time of the inspection had not begun to offer this service. Additionally, the provider had moved location since the last inspection.

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

The service was not always able to demonstrate how they were meeting the underpinning principles of right support, right care and right culture.

Right Support

The provider had not always ensured people received care in line with the principles of the Mental Capacity Act 2005 (MCA). People were not always supported to have maximum choice and control of their lives and the provider could not demonstrate people were always supported in their best interests. While the provider had policies and systems in place, these were not always robustly implemented. The provider had not always notified the CQC as required. We recommended the provider is consistent in following their safeguarding policy and procedures in protecting adults at risk of abuse. Risks to people were assessed and monitored. Medicines were managed safely, and staff enabled people to access healthcare appropriately.

Right Care

Staff understood people’s cultural needs, provided culturally appropriate care and responded to people’s individual needs. Overall, people were satisfied with the care provided. People’s care plans reflected their range of needs and this promoted their wellbeing. Staff received appropriate training to meet people's care needs. People were supported by the same staff which provided consistency.

Right Culture

During the inspection we found recording systems were not always robust enough to monitor and mitigate the risks relating to the health, safety and welfare of people using the service. Additionally, systems were either not in place or robust enough to demonstrate service improvement was effectively managed. People and those important to them were involved in planning their care. Staff told us they felt supported by the management team. People and their relatives said they knew who to approach if they had a complaint.

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 requires improvement (published 29 July 2021).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

We have found evidence that the provider needs to make improvements. Please see the safe, effective and well led sections of this full report. You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Best Choice Care Limited on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified breaches in relation to good governance and consent to care at this inspection. Please see the action we have told the provider to take at the end of this report. We also recommended the provider is consistent in following their safeguarding policy and procedures and notify CQC as required.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.