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Options Health Care Services Requires improvement

This service was previously registered at a different address - see old profile

Reports


Inspection carried out on 29 April 2019

During a routine inspection

Options Health Care Services is a small service that provides personal care to people in their homes. It does not provide nursing care. The people who use the service may be older people or living with dementia, learning disabilities, mental health issues or a physical disability. At the time of the inspection six people were receiving personal care.

People’s experience of using this service and what we found

A safeguarding incident that was being investigated by the local authority had not been reported to CQC as required.

The provider had been denied access to their office by the landlord due to a dispute. The provider told us they had not had access to the office since 4 March 2019.

Monitoring systems were not adequate to ensure people had received their calls and that people were safe.

The provider failed to demonstrate that adequate quality assurance processes were in place.

At the last inspection we had identified an issue with recruitment processes. At this inspection we were unable to review recruitment processes to ensure the required improvements had been made.

People and relatives told us they were happy with the care. People confirmed that they received their calls on time and if staff were running late they would be contacted and advised of the lateness. However, one person told us about a missed call.

People told us that they had contact details for the staff and the provider. They confirmed that they knew who to contact in an emergency. This was not everyone’s point of view one person told us that they were unable to contact the office and they had now resorted to sending emails, but this was not working effectively.

Staff confirmed they had regular training and supervisions. They felt supported by the provider.

Staff and relatives all commented that staff were kind and caring. People had developed caring relationships. People felt their privacy and dignity were promoted and staff supported their independence.

People confirmed they were supported with their nutritional and fluid requirements.

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 provider confirmed that all people they were providing care and support had full capacity.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

The last rating for this service was Good (the last report was published 4 May 2017).

Why we inspected

The inspection was prompted in part due to concerns raised. The local authority was investigating these concerns under their safeguarding procedures. Concerns included late care visits, missed care visits and not effectively and safely implementing the advice from the physiotherapist for moving and handing. The local authority visited the providers premises to carry out some checks and found that the provider had been locked out of their offices. The local authority withdrew their contracts from the service.

The provider under the regulations had a duty to inform CQC of the safeguarding but failed to notify us. A decision was made for us to inspect and examine those risks. The local authority confirmed the safeguarding concerns was substantiated. We found evidence that the provider needs to make improvements. Please see the Safe 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.

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Inspection carried out on 30 March 2017

During a routine inspection

This inspection took place on 30 March 2017. On the 03 and 04 April 2017 we contacted people and relatives to obtain feedback about the service people received. Options Health Care Services provides personal care to people in their own homes. It does not provide nursing care. Options Health Care Services was providing support to five people at the time of the inspection.

The provider for Options Health Care Services was also the registered manager for this location.

There was a manager in post who had registered with the Care Quality Commission (CQC). A registered manager is a person who has registered with the 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 and associated Regulations about how the service is run.

Recruitment processes were safe to ensure that staff employed to deliver care and support for people were of a good character and suitable to meet people`s needs safely. There were sufficient numbers of staff available to meet people’s individual needs.

Potential risks to people’s health and well-being were identified by staff and they knew how to manage these effectively and protect people from harm. Risk assessments were completed to keep people safe.

People told us that they were involved in their care and staff always asked for their consent when providing care.

People and their relatives told us that their family members were kept safe and cared for when they were being supported by the service. Staff had received training in how to safeguard people from potential abuse and knew how to identify the risks associated with abuse.

Staff were trained in safe administration of medicine; however people told us that they had not required staffs support to take their medicines.

People and their relatives were very complimentary about the abilities and experience of the staff that provided care and support. Staff received training and regular updates to ensure they were up to date with their knowledge and best practice guidance.

Staff supported people to stay safe in their homes, and people were supported to maintain their health and well- being. Staff developed appropriate positive and caring relationships with the people they supported and their families, and feedback from people was consistently positive about the service they received.

People and their relatives where appropriate were involved in the initial planning of the care and support people received. People's personal information was stored securely and confidentiality was maintained.

People told us they felt the staff provided care and support that was delivered in a way that promoted their dignity and respected their privacy. Staff were knowledgeable about people`s preferred routines.

People told us that they felt that staff listened to them and responded to them in a positive way. People and their relatives knew how to raise concerns and they were confident that the registered manager would take appropriate action to address any concerns they may have had in a timely way.

People were asked to provide feedback about the service they received regularly and we saw these were positive. People and their relatives were positive about the staff and the management of the service. The registered manager regularly audited the service any improvements needed were actioned.

Inspection carried out on 12 May 2016

During a routine inspection

This inspection was carried out on 12 may 2016. We gave the provider 48 hours’ notice to ensure the people we needed to assist with our inspection were available. This was the first inspection for this location.

Options Health Care Services provides personal care to people living in their own homes. At the time of our inspection, five people were receiving support from the service.

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 and associated Regulations about how the service is run. In this instance the registered manager was also the provider.

Where people had been supported with medication this had not always been documented accurately and the provider was unable to demonstrate that audits had been completed.

There were inadequate systems in place to monitor the quality of the service and address any shortfalls.

People received care and support that met their needs. Staff respected people’s choices, preferences and promoted their dignity.

People were supported by sufficient numbers of staff who had been recruited safely and had the appropriate skills for their role. Staff received regular support and supervision and had the opportunity to attend meetings.

Staff knew how to identify abuse and risks to people and respond appropriately. People’s medicines were managed safely. The management team were available for guidance and support should it be needed. Everyone we spoke with was positive about the management of the service and the ethos of the service. Staff knew what was expected of them and people told us that they were all very kind and caring.

People’s feedback was sought and this was responded to appropriately.

We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.