First Option Healthcare

Updated 5 November 2022

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

Inspection team

The inspection was carried out by one inspector and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

This service is a domiciliary and nursing care agency. It provides personal care and nursing care to children and adults living in their own houses and flats in the community.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

We gave the service 48 hours' notice of the inspection. This was because we needed to be sure that the provider or registered manager would be in the office to support the inspection.

What we did before the inspection

We looked at all the information we held about the provider, which included information they provided us since their last inspection. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We sought feedback from the local authority and professionals who work with the service. We used all this information to plan our inspection.

During the inspection

We spoke with 19 relatives of people who used the service about their family members experience of the care provided. We spoke with eight members of staff, including the nominated individual, registered manager, office managers, nurses and care staff. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We reviewed a range of records. This included five people's care records and multiple medication records. We looked at three staff files in relation to recruitment and supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

Updated 5 November 2022

About the service

First Option Healthcare Ltd is a domiciliary and nursing care agency providing complex care and support across the country. It provides personal care and nursing care to children and adults living in their own houses and flats in the community. At the time of the inspection it was providing a service to 95 people.

Not everyone using First Option Healthcare receives a regulated activity; CQC only inspects the areas where people are in receipt of personal care or treatment of disease, disorder or injury. Where a person is in receipt of personal care CQC, only inspects the service provided to people receiving help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided. First Option Healthcare also provided treatment of disease, disorder or injury. This meant they also provided nursing assistance to people within their own homes in respect of long-term healthcare conditions.

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

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. We considered this guidance as there were people using the service who have a learning disability and or who are autistic.

Right Support:

People and their relatives felt involved in the planning of care and support. Regular meetings and reviews allowed people to make any changes necessary to ensure the service continued to meet their needs. Staff supported people to achieve their best healthcare outcomes by working with other healthcare professionals, families and commissioners. When people were supported to follow their hobbies, staff worked with them to help them achieve their goals and aspirations. 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.

Right Care:

People’s relatives told us staff were kind and respectful. People were provided with a team of fully trained staff to provide a bespoke care package tailored specifically for their needs. Both nurses and care staff received extensive training from the provider before they started working for the service and received regular refresher training, so their skills and knowledge were updated and relevant. When people used specialist equipment the provider made sure staff received the training they needed to use the equipment safely. Care records were person centred and focused on clinical support but also considered people’s hobbies, interests and cultural beliefs. When possible, the service provided people with opportunities to enhance and enrich their lives to achieve positive outcomes.

Right Culture:

The provider worked well with staff and other healthcare professionals to make sure people received good quality care and support. The provider was committed to embedding its values into the culture of the service and constantly strived for excellence. The provider had systems in place to look for areas of risk and improvement and when something went wrong, the provider worked with people to make things better. People, their family and staff were asked for their views about the service and how the service was managed, they felt they were listened to and changes were made to improve the service.

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 25 July 2018).

Why we inspected

The inspection was prompted in part due to concerns received about staff training and management systems leading to poor communication with staff and people using the service. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led. We found the provider had recognised and acted on the issues raised and had made improvements in these areas.

Please see the safe, effective and well-led sections of this full report. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has remained good.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for First Option Healthcare on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.