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The Caring Choice Limited Inadequate

We are carrying out a review of quality at The Caring Choice Limited. We will publish a report when our review is complete. Find out more about our inspection reports.

Inspection Summary


Overall summary & rating

Inadequate

Updated 11 January 2019

We carried out this inspection on 7 and 8 November 2018. This inspection was announced, which meant the provider was given 48 hours’ notice of our inspection visit. We did this because the service is small and the manager was sometimes out of the office and we needed to be sure that they would be available. We also wanted to arrange to visit some people using the service.

The Caring Choice Ltd is a domiciliary care agency. It provides support to people living in their own houses and flats in the community. Not everyone using The Caring Choice Ltd receives support with the regulated activity of ‘personal care’; The Care Quality Commission (CQC) only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided. At time of this inspection The Caring Choice Ltd was providing support to 41 people.

At our last inspection on 10 and 13 November 2017 we found three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in respect of Regulation 17, Good governance, Regulation 18 Staffing and Regulation 19, Fit and proper person employed. The overall rating of the service was requires improvement.

Following our last inspection the registered provider sent us an action plan with details of the improvements they planned to make to meet the requirements of the regulations. At this inspection we found that sufficient improvements had not been made and the registered provider remained in breach of these three regulations. We also found three further breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These were; Regulation 12, Safe care and treatment; Regulation 13, Safeguarding service users from abuse and improper treatment; and Regulation 16, Receiving and acting on complaints.

The overall rating of the service is inadequate and the service is in ‘special measures’. Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the provider’s registration of the service, will be inspected again within six months. The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe.

If not enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. This service will continue to be kept under review and, if needed, could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement so there is still a rating of inadequate for any key question or overall, we will take action to prevent the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration.

For adult social care services the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.

There was a manager at the service, but they were not registered with the CQC. The nominated individual (representative of the registered provider) told us the manager had applied to be registered. 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 20

Inspection areas

Safe

Inadequate

Updated 11 January 2019

The service was not safe.

Staff recruitment and selection procedures were not safe.

The systems in place to ensure medicines were managed and administered in a safe way were not effective.

The service did not have adequate systems in place to ensure people were protected from abuse.

Effective

Requires improvement

Updated 11 January 2019

The service was not always effective.

Staff did not receive regular supervision, annual appraisals, or appropriate training to support them to carry out their jobs effectively.

Staff were clear on the importance of involving people in making decisions.

People were supported with their dietary needs, where this was part of their care plan.

Caring

Requires improvement

Updated 11 January 2019

The service was not always caring.

The privacy of people using the service was not always respected.

People and their relatives told us the staff were caring.

Responsive

Inadequate

Updated 11 January 2019

The service was not responsive.

Not everyone had access to their care records. Some were incomplete and none had been reviewed in the last five months. This meant the information recorded did not always fully or accurately reflect the person’s current level of need.

There were no records or analysis kept of any complaints that were raised.

Well-led

Inadequate

Updated 11 January 2019

The service was not well-led.

There was no evidence of regular quality audits being undertaken. This would have enabled the registered manager to assess the safety and quality of the service they provided.

The service had policies and procedures in place. However, they had not been reviewed and therefore may not have represented the most up to date legislation and good practice guidance.

Staff told us the manager and nominated individual were approachable and supportive.