Healthcare 1st Choice Ltd

Healthcare 1st Choice is a domiciliary care agency providing personal care to people living in their own homes. 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.

At the time of the inspection 73 people received personal care.

The service can support older adults, people with learning disabilities, physical disabilities, younger adults and people with mental health conditions.

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

People were supported by staff who had received safeguarding training and had confidence to speak up if there were any concerns. Risk assessments were completed before care tasks were undertaken and contingency plans were in place for adverse weather conditions.

Staff were recruited following the application of robust recruitment procedures and there was enough staff to meet people’s needs.

People received their medicine by staff who had been trained and deemed competent to administer. Staff had access to personal protective equipment which they used when supporting people with personal care. Lessons were learnt when things went wrong.

People’s care needs were assessed in line with national guidance and contained enough information to ensure staff knew how people wanted to be supported.

Staff received the training they needed to ensure they were able to fulfil their role. This included food hygiene training which they needed to support people with meals. The environments in which staff worked were assessed to ensure staff safety and make sure the correct equipment was available.

Staff worked with other agencies to help provide consistent care and ensured people were supported during more difficult times. People were supported to access health appointments when needed and staff knew how to support people with any diagnosed health conditions.

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 were treated with kindness and respect and their protected characteristics were recorded in their care plan. People told us that they were involved in the care planning process and that they were always asked their opinion before any care tasks were completed. People’s privacy and dignity was respected, and their independence was promoted.

People received care that was reflective of their needs. Some people said they wished care times could be a little more consistent but confirmed they were told if staff were going to be late. People’s communication needs were assessed, and people were supported by staff who took time to talk with them and make sure they had all they needed before they left.

People had access to a complaints procedure and any complaints were investigated and feedback was shared.

No one was in receipt of end of life care at the time of inspection.

People were complimentary of the service they received and would recommend it to others. Staff felt well supported and listened to. The staff we asked, were aware of their duty of candour.

The management team were aware of their responsibilities and had effective governance systems in place which included monthly spot checks. People’s care was reviewed on a monthly basis to ensure people were happy with the service and any concerns were addressed.

The service could demonstrate partnership working and that it worked to continuously improve the care provided.

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 4 August 2017).

Why we inspected

The inspection was prompted in part due to concerns received about staffing and the recruitment checks in place. A decision was made for us to inspect and examine those risks.

We found no evidence during this inspection that people were at risk of harm from this concern.

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.

Healthcare 1st Choice Limited provides personal care for people in their own home. At the time of this inspection they were providing care and support for eight people.

The provider has not had a registered manager in post since February 2017. The provider had recently appointed a manager who was present on the day of the inspection. The manager confirmed they were in the process of completing an application form to register with the Care Quality Commission. 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.

People and staff were aware of the appointment of the new manager and felt supported by them and the provider. The provider did not have any formal systems in place to monitor the quality and effectiveness of the service provided to people. There were no systems in place to give people the opportunity to have a say in how the agency was run.

People felt safe with the service they received and staff were aware of their responsibility of safeguarding them from the risk of potential abuse. People were protected from the risk of harm because systems and staff’s practices reduced the risk of accidents. People were cared for and supported by sufficient numbers of staff who had been safely recruited. People did not require support to take their prescribed medicines. However, staff were skilled to support them with their medicines if and when needed.

People were cared for by staff who were skilled and who were supported in their role by the manager. People’s human rights were promoted as staff respected their decisions. People did not require any support to eat and drink sufficient amounts and they were independent in accessing healthcare services when needed. However, this support would be provided when required.

People were cared for by staff who were kind and who respected their rights to privacy and dignity. People’s involvement in their care planning ensured they received a service that reflected their preference.

People’s involvement in their care assessment ensured they received a service the way they liked. People were supported by staff in a way that suited their daily routine. People could be confident their concerns would be listened to and acted on.