Option Care Ltd

Option Care Ltd is a domiciliary care service that provides personal care and support to people living in their own homes. At the time of our inspection there were 41 people using the service.

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

Comprehensive and detailed care records were now in place which provided staff with the information they needed to support people. People’s risks had been assessed and their care plans described the actions staff should take to help mitigate people’s risks.

People were safeguarded from the risk of harm and abuse. All incidents and concerns were recorded, reported and actioned to help reduce the risk of reoccurrence. The provider was aware of their responsibility to notify CQC of significant events and concerns.

Enough staff were available to support people. People and their relatives confirmed that staff were kind and reliable. They felt the provider and managers were responsive to any concerns that they had raised.

Safe recruitment practices were being used when recruiting staff from the UK and abroad. However, we have made a recommendation about recruiting staff from abroad and any associated risks. Staff felt supported and trained to carry out their role.

People’s medicines were managed effectively by staff who had been trained in the management and administration of people’s medicines. Protocols relating to ‘as required’ medicines were being reveiwed and implemented.

People and their relatives were assured that safe infection controls measures were taken by staff such as wearing PPE.

Improvements had been made to the provider’s governance and quality assurance systems. This had helped them identify shortfalls and take any actions needed to drive improvement.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 12 November 2021).

The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

We carried out an announced focused inspection of this service on 12 October 2021. A breach of legal requirements was found. The provider completed an action plan after the last inspection to show what they would do and by when to improve their governance systems.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions of Safe and Well-led which contain those requirements.

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 changed from Requires Improvement to Good. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Option Care Ltd 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.

Option Care Ltd is a domiciliary care service that provides personal care and support to people living in their own homes. The service supported 17 people at the time of the inspection.

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

Accurate and complete care plans of people’s care and medicine support requirements and associated risks were not in place. This meant staff did not have the information they needed to guide them on how to support people and to assist people in mitigating their personal risks.

The provider’s quality assurance systems had not been expanded to help them identify the quality and accuracy of people’s care records. Further development of the provider’s quality systems was needed to ensure the service fully complied with legal requirements.

There was no registered manager in post. However, the manager of the service intended to be registered with CQC. The manager managed the day to day running of the service and also delivered care to all the people the service supported. This helped them to have oversight and monitor the service which reduced the risk of people receiving unsafe care. However, this approach would not be sustainable if the service expanded or the manager was not available. At the time of the inspection new staff were being managed through the provider’s recruitment and induction process to help reduce the pressure on current staff and to enable the provider to expand the service.

Since our last inspection the provider had implemented changes to their safe recruitment practices to ensure new staff were of good character and fit to work.

People’s relatives complimented the staff. They told us people felt safe when being supported by staff and confirmed staff were kind and provided care which was personalised and responsive to their needs. People were supported by a consistent staff teams who were familiar with their needs.

Staff told us they felt trained and supported. They were confident that the manager would address any concerns around their personal development and the safety of people who use the service.

Safe infection control practices were in place and being used to help prevent the spread of infection.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection (and update)

The last rating for this service was requires improvement (published 23 February 22021). The provider completed an action plan after the last inspection to show what they would do and by when to improve.

At this inspection we found improvements had been made and the provider was no longer in breach of regulation 19 (Fit and proper persons employed).

Why we inspected

We carried out an announced comprehensive inspection of this service on 25 January 2021. A breach of legal requirements was found. The provider completed an action plan after the last inspection to show what they would do and by when to improve.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.

The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has not changed. This is based on the findings at this inspection.

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

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to accurate recording keeping and governance at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Option Care Ltd is a domiciliary care service that provides personal care and support to people living in their own homes. The service supported five people at the time of the inspection.

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

Option Care Ltd registered with CQC in April 2018. Since registration, the service had experienced some management changes which had disrupted their quality monitoring and governance systems.

We found the provider had not always ensured that there had been a consistent approach in their quality checks of the service and safe recruitment practices. The provider carried out employment and background checks as part of their recruitment process, however there was limited evidence that the provider had fully explored staff employment histories to check they were of good character.

We found the new manager and provider had identified the areas of improvement and were working together to take action to improve the service and governance systems. Progress was being made in staff development and reviewing people’s care needs and care records.

The manager had oversight of the service while improvements were being made as they worked alongside staff to deliver care which enable them to monitor the quality of care and staff practices.

People and their relatives complimented the service and told us staff were kind, supportive and caring. People were supported by a small team of staff who visited them regularly and were familiar with their needs. Relatives told us they found that staff provided them with emotional support and found them friendly and caring.

People confirmed that staff were responsive to their needs and felt safe amongst staff. Staff had been trained in safeguarding and knew where to report concerns.

Where required, people were supported with their nutritional needs and medicines. Safe medicines management practices were being used.

Care plans were in place to direct staff on how people’s support should be delivered in line with people’s preferences and care assessments. People’s risks were assessed and known by staff. However, staff would benefit from further recorded details of how to support people to mitigate their risks and escalate any concerns.

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. However, we have made a recommendation that the provider seeks further guidance about the management of people’s lawful consent to care.

Enough staff were available to support people. Staff told us they felt trained and supported to carry out their role.

The provider and manager valued the feedback from people and staff and were responsive to any concerns raised.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

This service was registered with us on 23/04/2018 and this is the first inspection.

Why we inspected

This service had not been inspected since their registration in April 2018 and there was currently no registered manager in post. Therefore, this inspection was carried out to gain assurances about the quality of care and systems used to monitor and the manage the service.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to safe recruitment of staff at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.