Choices Homecare (Bolton and Bury)

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

There were enough staff to meet people’s needs. However provider did not always manage staff rotas effectively and people did not always receive care in a timely manner and as outlined on their schedules. People told us staff did not always arrive on time and people were not informed about changes made to their schedule. We have received mixed feedback form staff. Some staff told us there were enough staff on duty and they were happy with the schedules. Others told us there are frequent changes to the schedule which can impact on people. Staff were not always recruited safely. The provider obtained references for any new staff. However not all of the references could be verified. Staff criminal checks were undertaken. However some of the checks took place after staff started their employment which could put people at risk. Risks to people were not always assessed effectively. Where key risks had been identified by the local authority, appropriate risks assessments were not always completed by Choices Homecare staff. Reviews of some people’s risk assessments had not been carried out for over 12 months.

This service scored 62 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We did not look at Learning culture during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Safe systems, pathways and transitions during this assessment. The score for this quality statement is based on the previous rating for Safe.

People who used the service and relatives said they felt safe. One person said, “They keep me safe and handle me well." A relative added, “(Person) is feeling very safe with the carers”.

Staff did not always know how to identify abuse or have a good understanding of policies and procedures. Staff raised concerns about closed culture within the office.

There was some evidence of processes in regards to gathering people’s views and feedback. For example, provider utilises ‘care circle’, a digital real time tool for people and their relatives to respond directly to the provider with feedback and linked to actual care visits. However, processes have not always been followed. For example, the service user guide stated that the following methods of contact with people were undertaken. The service user guide stated: ‘Our quality assurance includes regular review of all services, annual surveys of service user satisfaction, and where appropriate their relatives or representatives, to obtain views and opinions, service users forum to include service users in discussion about how the service is delivered.’ This meant that the provider did not always follow their own policies and procedures in regard to seeking people’s views.

People and relatives said risks were well-managed. One relative said, "They’re lovely girls. They know me well and what I need. They don’t have much time, but they get me a cup of tea with my tablets.”

Staff knew about risks to people and said they received appropriate training including moving and handling and medication.

Appropriate risk assessments were not always in place. For example, we found risk assessments were not completed for areas such as diabetes, choking and skin integrity, despite being identified as key risks within assessments carried out by the local authority. Reviews of risk assessments had also not been completed for over 12 months. The service were in the process of updating all care plans and risk assessments at the time of our visit.

We did not look at Safe environments during this assessment. The score for this quality statement is based on the previous rating for Safe.

There was enough staff to meet people’s needs. However the provider did not always manage staff rotas effectively and people did not always receive care in a timely manner and as outlined on their schedules. People told us staff did not always arrive on time and people were not informed about changes made to their schedule. One person told us, "I’m supposed to get 45 minutes of support but some of them say I’m going now-everything’s done even though they have only been with me for 30 minutes.” Another person told us. I don’t have any other concerns about my care other than reliability.”

We have received mixed feedback form staff. Some staff told us that there is enough staff on duty and they were happy with the schedules. Others told us there are frequent changes to the schedule which can impact on people. One staff member told us, "You come to work and they send you to another area. Changes to the rota happen even when you are on the job. This happens to me a lot.” Another staff member told us, "It feels like there could be more staff. I feel I have enough time. I don’t have to cut the call short. I have enough time to travel.”

Staff were not always recruited safely. Provider obtained references for a news staff. However not all of the references could be verified. Staff criminal checks were undertaken. However some of the checks took place after staff commenced their employment which could put people at risk. One staff member told us, "I went to the office and had an interview. They have asked me for a reference but this was from a friend as I have never worked before. I had DBS completed and another last year.” Another staff member told us, "I had an interview and had to give references. I had a DBS and they have asked me to do another one.”

We did not look at Infection prevention and control during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Medicines optimisation during this assessment. The score for this quality statement is based on the previous rating for Safe.