Archived: First Choice Homecare and Employment Services Ltd

Updated 19 October 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, and to check that improvements to meet the legal requirements planned by the provider after our inspection on 23 and 27 February and 1 March 2017 had been made.

We inspected the service against two out of five questions we ask about services: Is the service safe and is the service effective? The inspection team consisted of two adult social care inspectors. Prior to the inspection we reviewed the information the Care Quality Commission (CQC) held about the service. This included notifications of significant incidents reported to the CQC and the previous inspection report. We also reviewed the provider’s action plans that had been sent to CQC since the last inspection.

During the inspection we spoke with the branch manager, a care coordinator and the finance manager. We checked a range of documents including 10 care plans with accompanying risk assessments, medicine administration records, staff training and supervision records, minutes for staff meetings, the complaints log and quality monitoring audits. Due to the planned closure of the service and the need for the provider to discuss this with employees, we did not contact care workers.

Following the inspection we spoke by telephone with three people who received a service and the relatives of three other people who used the service. We also spoke with commissioning representatives from the two local authorities that use the service.

Updated 19 October 2017

This focussed inspection was conducted on 13 September 2017 and was announced. We gave 24 hours’ notice because the location provides a domiciliary care service and we needed to ensure that someone would be in. At the previous inspection on 23 and 27 February and 1 March 2017, one breach of legal requirement was found. The provider had not done all that was practicable to mitigate risks to people’s safety, and had not ensured that care and treatment was provided in a safe way in regards to operating effective systems for the proper and safe management of medicines. We also made a recommendation that the provider sought advice and guidance from a reputable source in relation to the Mental Capacity Act 2005 (MCA), in order to ensure people’s rights were protected. The provider sent in an action plan to tell us what they were going to do to make improvements.

First Choice Home Care and Employment Services Limited is a domiciliary care agency which provides personal care and support to people living in their own homes. At the time of this inspection 182 people residing in the London Boroughs of Newham and Waltham Forest were receiving a service. We were informed by the branch manager that most people using the service were funded for their care package by their local authority.

We carried out this inspection to check that the provider had adhered to their action plan and to establish if they now met the legal requirement and the recommendation. This report only covers our findings in relation to these areas. You can read the report from our last comprehensive inspection by selecting the ‘all reports’ link for First Choice Homecare and Employment Services Limited on our website at www.cqc.org.uk.

There was no registered manager in post at the service. 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 2008 and associated Regulations about how the service is run. The service was being managed by a branch manager who was present during the inspection.

Comments from people who use the service and relatives were predominantly positive. The remarks we received from people indicated that they felt their needs were being met in a safe way and they felt their care workers provided person centred care that respected their choices and wishes. One person told us, “They are very supportive, please put it on record that I am very grateful. The carers are excellent and bring me cheer when I feel at a low ebb” and another person said “I am very happy, they are very nice and never do nothing wrong.” One relative told us, “The care workers work hard, they (office staff) keep us informed, I couldn’t fault them” and another relative said, “[My family member is happy, they don’t treat [him/her] roughly, there is no rudeness and [care worker] is fantastic, always friendly. Some care workers are really good. We have asked for a change of one care worker and they (office staff) are sorting things out.”

We found that some improvements had been achieved with the quality of documentation for supporting people with their medicines, and the use of risk assessments to identify and mitigate risks to people’s safety and welfare. However, there were still some inconsistencies in this documentation. The branch manager told us he thought the service had made progress with staff training and supervision, with a particular focus on how to keep people safe.

Actions were being undertaken to make sure that people were asked for their consent to their care. We noted that people’s care plans were being updated to ensure that people signed their consent to care forms wherever possible or a relative with appropriate legal authority signed instead.

The branch manager informed us that the provider had decided to deregister the service. We noted that a formal application for deregistration had been submitted by the provider to CQC on the day before the inspection visit, after we gave notice of our intention to conduct an inspection. At the time of the inspection the provider stated that they had not informed employees about its plans but had set up staff meetings that week to engage in discussions about the closure. We were informed by the branch manager that plans were being developed with the two local authorities to ensure that people’s care packages were transferred to a different provider in a safe and seamless way, to ensure no disruption for people using the service and their care workers. The completion of this process was due by the end of October 2017 for people who use the service and live in Newham, and the end of November or early part of December 2017 for Waltham Forest residents. The commissioning representatives for both local authorities confirmed that arrangements were in place to make sure that people who use the service experience a smooth transition of their care to other organisations.