Choices Care Ltd (Birmingham)

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question good. At this assessment the rating has remained good.

This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

People and their loved ones confirmed that prior to being supported by the service, they were visited in their own homes and involved in a full pre-assessment. One relative told us, “[Person] requires Punjabi speaking staff, it was the main priority, and they have always been able to provide that.” Another relative told us, “They came and visited [person] and asked what they wanted to be called, what they liked to eat, how they wanted their care, what was important to them, etc.” Communication care plans were in place which identified people’s communication needs and how to support them. One person who was Bengali speaking had their support plan printed in Bengali to support their understanding and involvement in their care.

Reviews were carried out within 48 hours of a care package starting to ensure everything was working well. This was followed by further reviews at 6–8 weeks, 6 months, annually, and whenever needed.

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

People’s care records held personalised information regarding their lives and how they wished to be supported. Information regarding people’s health and wellbeing was also recorded and staff confirmed they were kept regularly up to date with changes in people’s needs.

A relative told us, “They [care staff] deal with pressure care. If they see anything they call us in and see if we need a district nurse – they’ve done it quite a few times – they notice things straight away.”

In order to improve the way the service delivered care, the registered manager kept themselves up to date with new and innovative approaches by attending other registered manager’s forums and signing up to regular updates from the local authority and Skills for Care.

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

Staff reported they had access to the information they needed to support people and were kept informed of any changes in people’s needs. Staff worked alongside family members to support them and share information regarding their wellbeing. Information was shared at handover and though daily exchanges with staff.

On-call staff had access to people’s care records and were able to ensure information was passed onto staff where appropriate.

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

People were supported by a consistent group of staff who understood their individual needs and preferences and what was important to them. Where people required additional support, for example, with catheter care, this was provided. A relative told us, “They [care staff] were very good with catheter care and cleaning around the site.” They went on to add they had no concerns regarding staff’s ability to support their loved one and considered them to be well trained.

Where people required their food and fluid intake to be monitored in order to support particular health care needs, this was done. Auditing of these records took place to ensure appropriate actions were taken if the information collected highlighted any concerns. Staff alerted management to any concerns regarding people’s wellbeing and appropriate action was taken. This included contacting the GP [with the permission of the person] when concerns were raised regarding their wellbeing and, for another person, contacting SALT [Speech and Language Therapy], for additional guidance when supporting a person with particular dietary needs.

Relatives spoken with provided a number of examples demonstrating how responsive the staff were to any concerns they may have. One relative provided an example as to how staff monitored their loved one’s skin, for any possible redness as they were prone to this. They told us, “If they see anything at all, for example, even a small scratch on the leg, they have called me straight away.”

People were supported by staff who knew them well and had been supporting them for some time. A relative described how on 2 occasions staff had noticed their loved one had suddenly become unwell and had contacted them immediately. On both these occasions this person was admitted to hospital. The relative added, “They picked it up straight away.” Relatives confirmed they were kept informed of any changes in their loved one’s needs.

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

People were supported by staff who were aware of and mindful of their needs. Staff were encouraged to report any potential concerns regarding people’s health and wellbeing and worked alongside loved ones in order to meet people’s needs. For example, where it was noted one person was losing their appetite resulting in a weight loss, staff shared information regarding different types of food the person may enjoy, in an attempt to encourage them to eat more.

The registered manager ensured they checked daily handovers to provide them with oversight of the service and any areas of potential concern that may need acting on. They told us, “We get information from care plans and reviews and sometimes the conversations carers are having in the office – we work closely together and learn from each other as well.” Systems were in place to ensure the management team also had access to this information in the absence of the registered manager.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

People were supported by staff who were mindful of obtaining their consent prior to supporting them. People spoken with confirmed this was the case. Care records recorded people’s capacity and ability to consent to all elements of their care.

A member of staff said, “If someone lacks capacity you need to evidence you are working in their best interests.”

People and relatives were aware of their rights around consent to care and treatment and confirmed their views and wishes were taken into account when their care was planned and delivered.

The registered manager was aware of advocacy services they could signpost people to, should they require this additional support.