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Inspection carried out on 17 June 2019

During a routine inspection

About the service

Ur Choice Care Limited is a domiciliary care agency that provides care and support to people living in their own homes. At the time of this inspection the service was providing support to 17 people.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

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

People felt safe using Ur Choice Care Limited. They told us they received continuity of care as the same staff assisted them at the time agreed. They did not feel rushed and they had confidence in the staff that supported them. The risks to people had been identified and managed and staff’s knowledge of this was good. People received their medicines as prescribed and were protected from the risks associated with infection. Staff had been safely recruited and there were enough of them to meet people’s needs safely and effectively.

Positive outcomes were achieved for people. This was because staff were skilled, had been trained and supported and understood their roles. Staff told us they were happy in their work and people agreed that staff were friendly and engaging which had a positive impact on them. People’s nutritional and healthcare needs were met, and staff supported them to achieve this. 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.

People described a staff team that were kind, considerate and compassionate. They felt comfortable with those that supported them and had built trusting relationships with them. Staff understood the need to maintain people’s dignity, privacy and independence and supported them to do so. People were partners in their care delivery and were involved in the planning of it. Staff took their lead from those they supported and were flexible in their approach.

Through person-centred care planning, people’s needs were met in an individualised manner. Preferences were adhered to and people received care that was personalised to them and those important to them. Care needs were reviewed regularly and as required and changes made as needed. People with specific communication needs had information in their desired method. The service had a complaints policy in place however people told us that the service was good at rectifying concerns should they arise.

The service was well managed by a registered manager people described as involved, engaged and supportive. Morale amongst the staff was good and effective team work was evident. The monitoring of the service was ongoing and achieved via several effective methods. The registered manager had developed strong relationships with other professionals. Registration requirements were mostly met however we have made a recommendation about events the service is required to tell us about by law.

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 (report published on 31 August 2016).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Inspection carried out on 4 August 2016

During a routine inspection

Ur Choice Care Ltd is registered to provide personal care to people who live in their own homes. There were nine people receiving personal care from the service when we visited. This comprehensive inspection took place on 4 August 2016 and was announced. It was carried out by one inspector.

There was a registered manager in post. 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.

Staff were knowledgeable about reporting any incidents of harm. There were a sufficient numbers of staff to provide the required care and recruitment procedures ensured that only suitable staff were employed.

There were effective procedures in place to ensure that people were safely assisted with their medicines.

The CQC is required by law to monitor the Mental Capacity Act 2005 (MCA). The provider was acting in accordance with the requirements of the MCA.. The registered manager demonstrated how they supported people to make decisions about their care and where they were unable to do so, there were records showing that decisions were being taken in people’s best interests.

Staff were supported and trained to do their job and additional training was provided for people's specific care needs to be fully met. The staff were in contact with health care professionals to ensure that care and support was well coordinated. Risk assessments were in place to help ensure that care and support could be safely provided.

People were treated by kind staff who they liked. They and their relatives were given opportunities to be involved in the review of their individual care plans. People’s privacy and dignity was respected and their support was provided in a caring and a patient way.

People were supported, where required, to ensure they ate and drank sufficient quantities and people were able to make choices about the meals and drinks provided.

Care and support was provided based on people’s individual personal and social care needs.

There was a process in place so that people’s concerns and complaints were listened to and these were acted upon.

There were quality assurance processes and procedures in place to monitor the quality and safety of the service and people’s care. People were able to make choices in relation to the support and care that was provided.

Inspection carried out on 5 August 2014

During an inspection looking at part of the service

A single adult social care inspector carried out this inspection to follow up concerns identified during our previous inspection of 11 October 2013. One of the key questions we ask ourselves during an inspection is whether the service is effective. During our October 2013 inspection we identified that training had not been provided to ensure that staff could help meet the needs of people living with dementia. In addition, we were unable to confirm that staff had completed induction training. This meant that the service was not operating effectively because people were not cared for by staff that had received appropriate training or induction.

Is it effective?

This inspection established that improvements had been made. We noted that all staff now undertook training in dementia. We also found, through a random sample of staff records, that staff had completed the provider�s induction programme before commencing duties. Consequently, the service was effective in ensuring that people were supported by staff who had received suitable training and induction.

Inspection carried out on 11 October 2013

During a routine inspection

We asked each person if they felt staff were respectful and ensured their dignity was maintained. We asked one person if they felt the carers that came in to their home respected their dignity, they responded; �Quite, it hasn�t worried me at all. I do not feel uncomfortable and I am always provided with a lady carer, which is my preference.�

People we spoke with told us that they could not fault the service at all. One person told us, �They are brilliant and they always go that extra mile.� and another person stated, �I have no concerns at all, the staff are very competent and they have helped my condition improve.� A third person told us, �I have been happy with every aspect of the service I have received � they go above and beyond what is required.�

All the people we spoke with told us that they felt safe whilst receiving care and support from this service. One person commented, �Yes, I do feel safe, the carers that come in to my home are very trustworthy, of course I was apprehensive at first but I now feel at ease with them around."

When we reviewed staff files and spoke with staff members we found that the service had not ensured it provided an effective induction programme or specialised training to help meet the needs of the people they were caring for.