Choices Care Ltd

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

Well-led – this means we looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture.

At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant the service was consistently managed and well-led. Leaders and the culture they created promoted high-quality, person-centred care.

This service scored 71 (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 had a shared vision, strategy and culture. This was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and understanding challenges and the needs of people and their communities.

Staff felt there was a culture of collaboration and felt listened to. They reported a strong sense of teamwork and mutual respect. One staff member said, “My co-workers are really good, we have a good understanding between us, we all help each other and cover one another.” The registered manager said long serving staff were recognised and received higher pay. Processes were in place to seek both people’s and staff feedback.

The provider had inclusive leaders at all levels who understood the context in which they delivered care, treatment and support and embodied the culture and values of their workforce and organisation. Leaders had the skills, knowledge, experience and credibility to lead effectively. They did so with integrity, openness and honesty.

Staff felt supported by the registered manager and management team. Comments included: “It’s a good company, good support and I enjoy working there. They give us training and if we need any assistance they help us out.” “It’s a heavy job, they support us to do our best. Every few weeks we have supervision so I can discuss with the senior carers if there’s any problems, but I also feel confident to call the office phone.”

The provider fostered a positive culture where people felt they could speak up and their voice would be heard.

Staff demonstrated a clear understanding of how to recognise and report concerns, including safeguarding issues, and told us they felt confident to speak up if they witnessed poor practice or anything that placed people at risk. They described knowing who to report to and felt their concerns would be taken seriously. The provider had a whistleblowing policy in place, which set out how staff could raise concerns both internally and with external agencies. This helped create an environment where staff felt supported to report issues and contribute to a safe culture.

The provider valued diversity in their workforce. They worked towards an inclusive and fair culture by improving equality and equity for people who worked for them.

Staff told us they were treated fairly and felt well supported in their roles. They described a positive working culture where they could raise issues and seek guidance. The provider considered reasonable adjustments to help staff carry out their roles safely and effectively, including support with travel between calls and allocating work within appropriate geographical areas. One staff member told us, “My coworkers are good. The company listens to us and they are flexible.” Staff had completed equality and diversity training, which helped promote an inclusive approach and ensured they understood their responsibilities in delivering equitable care.

The provider did not always have clear responsibilities, roles, systems of accountability or good governance. They did not always act on the best information about risk, performance and outcomes, or share this securely with others when appropriate.

The registered manager and senior team carried out a range of audits and checks to monitor risk, quality and performance. However, they failed to identify the shortfalls we found during this inspection. For example, where responsibility for managing medicines was shared between the provider and family members, records did not clearly show which elements were managed by staff and which were undertaken by the family as described in the Safe key question. We also found staff had not consistently completed the full range of training required to support people with complex needs. Although the provider took immediate action to address this, the improvements were prompted by the inspection rather than identified through existing governance systems.

Processes were in place to have oversight of the care people received which included supervisions and spot checks. Staff we spoke with confirmed this and feedback was given to improve their practice.

The provider understood their duty to collaborate and work in partnership, so services worked seamlessly for people. They shared information and learning with partners and collaborated for improvement to the service

People and their relatives told us the service worked well with health professionals to ensure people received safe care. Staff explained they made referrals to health professionals via the office team, and that advice or guidance received was shared promptly so people’s needs could be reviewed and responded to. Partner agencies told us the provider attended local forums.

The provider focused on continuous learning, innovation and improvement across the organisation and local system. They encouraged creative ways of delivering equality of experience, outcome and quality of life for people. They actively contributed to safe, effective practice and research.

The provider had linked into further training through the local authority and this learning was shared through team meetings. Learning was also shared across the provider’s other branches. The provider offered further training to support positive outcomes for people, including opportunities that helped staff develop their skills and progress within a career in health and social care. Staff told us this contributed to feeling valued and supported in their roles. The registered manager welcomed our feedback and had started to take action to address the issues identified during our inspection.