Choices Care Ltd

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• 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 67 (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.

We received some mixed feedback from people and their relatives around being involved in the care planning process. One relative said, “There’s been no care plan review since 2024.” However, some relatives we spoke to said they were fully involved and discussed any changes to people’s needs. A relative told us, “Just recently, they called and checked if there were any changes to [family member] and asked how the care was.” Staff understood people’s assessed needs, they felt processes were in place to keep them up to date when people’s needs changed. One staff member said, “If I come back from holiday, before we do any work we do a handover or go to the office and ask if anything has changed.”

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.

Records provided guidance as to people’s dietary needs. People and their relatives raised no concerns around the management of this task. Staff told us they followed people’s care plans, giving people choice of what they wanted to eat and drink. People’s records set out clear guidance on their dietary requirements, including information that reflected and supported their cultural and religious needs.

The provider did not always work well across teams and services to support people. They did not always share their assessment of people’s needs when people moved between different services. People and their relatives told us that communication with the office team needed to be improved.

People and their relatives gave mixed feedback about communication with the office team and told us it was difficult to get through or receive timely responses. Comments included: “Absolute rubbish contacting the office, talk to the carers.” “The agency is ok but I guess like everyone else they are very busy and sometimes it is difficult to speak to someone.” Despite these concerns, most people and relatives said communication with care staff themselves was good, and they felt informed about day to day care and support. The registered manager told us they had positive relationships with health and social care professionals.

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’s and their relatives told us staff helped people to take an active role in maintaining their health and wellbeing. This included encouraging people to make their own decisions and advocating for them with the GP when needed. One relative said, “If [Person] develops a rash they just tell us and we will call the doctor; they will also tell us if the rash gets better or worse.” Another relative described how staff supported their family member to complete physiotherapy led exercises, and shared, “They do stretches every day; it’s important because it helps with breathing and coughing.” Staff knew people well, and the provider sent regular staff to support the needs of the person when possible. Staff told us this enabled them to recognise changes in a person’s health and refer concerns promptly to the appropriate health professional, next of kin or GP.

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.

Some people’s care records had outcomes in place such as maintaining independence. People and relatives we spoke with confirmed the purpose of the care was to promote independence and enable people to remain in their own homes. Staff described the signs and symptoms they would monitor for any decline. For example, indicators of a possible urinary tract infection or concerns relating to a medical device, demonstrating awareness of risks and when to escalate issues.

The provider did not always tell people about their rights around consent and did not always respect their rights around consent.

People’s capacity to make their own decisions had been considered. However, mental capacity assessments (MCA’s) were not decision specific and did not consistently evidence people had been given the best opportunity to make their own decisions. Some MCA’s we reviewed contained limited information about how people had been supported to understand the decision to be made. However, best interest decisions had been completed with those who knew the person well.

People told us they were involved in making day to day decisions about their care. One relative shared, “When [Person] is having personal care they ask [Person] if they would like me to leave he always says he doesn’t mind but it is nice to be asked.” The registered manager acknowledged MCA’s needed to be developed and improved. Staff had completed training in MCA’s and understood the need to seek people’s consent before providing care and support.