Background to this inspection
Updated
8 August 2019
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 Care Act 2014.
Inspection team
The inspection team consisted of one inspectors. 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
Choice East Midlands is a domiciliary care agency providing care and support to people in their own home's. It provides personal care to people living in their own houses and supported living accommodation. It provides this service to people with learning disability and people who are on the autistic spectrum.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
This inspection was announced. We gave the service 48 hours notice of the inspection visit because the manager is often out of the office supporting staff. We needed to be sure that they would be in. We carried out the inspection visit on 4 July 2019.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and we used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.
During the inspection
We spoke with one person who used the service and three relatives about their experience of the care provided. We spoke with four members of staff including the registered manager, another manager and two support workers. We reviewed a range of records. This included three people’s care records. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
Updated
8 August 2019
About the service
Choice East Midlands is a domiciliary care agency. At the time of the inspection they were providing personal care to 20 people with learning disabilities living their own homes and supported living accommodation.
People’s experience of using this service
People felt safe and were protected from abuse and avoidable harm. Staff knew when and how to report concerns. Systems and processes were in place to identify and manage risk. Action was taken when things went wrong to reduce the risk of reoccurrence. People were routinely asked if they had any problems or concerned and staff knew how to recognise when people were worried even when they may not be able to verbally express this.
There were enough staff with the right skills and experience to meet people’s needs. People’s medicines were managed in a safe way. Staff supported people to keep their homes’ clean and tidy. They had access to personal protective equipment such as gloves and aprons and followed infection prevention and control policies to reduce the risk of infection.
People had their needs and choices assessed before they began using the service. Care and support was delivered in line with evidence based best practice guidance. Staff received the training and support they required to meet people’s needs. They had access to ongoing training and opportunities for professional development. People were supported to eat and drink enough and staff promoted a healthy balanced diet. Staff recognized changes in people’s health and supported them to access the healthcare services they required.
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 received kind and compassionate care and support. They were supported by staff who knew them well and had developed positive relationships. Staff understood how to meet people’s needs and how to provide comfort and reassurance. People were involved in making decisions about their care and support. People had their privacy and dignity protected.
Care and support was person centred and was delivered in the way people preferred and met their individual needs. Staff understood people’s needs with regards to the protected characteristics of the Equality Act 2010. Information was available to people in accessible formats and staff communicated with people effectively. People were occupied with activities and were able to pursue their interests and hobbies. People and relatives knew how to make a complaint and said they would feel confident doing so. Complaints were investigated and used as an opportunity to learn and improve.
People’s advanced care wishes were explored and recorded. Staff knew about people’s individual preferences for end of life care.
People, relatives and staff had confidence in their managers and felt supported. They told us the registered manager was accessible and approachable. There was an effective quality assurance system. Checks were carried out to ensure staff were following policies and procedures and people were safe. Action plans were developed when shortfalls were found and this contributed to continual learning and improvement. The registered manager was supported by a senior manager and departments from within the wider organization.
People, their relatives and staff were asked for their feedback and this was used to develop the service and ensure it was meeting people’s needs and preferences. The registered manager and staff worked closely with healthcare professionals and other agencies such as the local authority to make sure people received joined up care and support.
Rating at last inspection
The last rating for this service was ‘Good’ (published 13 October 2016).
Why we inspected
This was a planned inspection based on the previous rating.
Follow up:
We will continue to review information we receive about the service until the next scheduled inspection. If we receive any information of concern, we may inspect sooner than scheduled. For more details, please see the full report which is on the CQC website at www.cqc.org.uk