People's Choice UK

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• 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

As part of this assessment, we looked at 3 quality statements for the key question of safe. These were safeguarding, involving people to manage risks and safe and effective staffing. People were protected from avoidable harm and abuse with an emphasis on openness, transparency and learning lessons when things went wrong. People were fully involved in developing different approaches to keeping safe. This enabled them to take positive risks, to maximise control over their lives. Staff were recruited safely, and people were supported by a consistent staff team that knew them very well.

This service scored 75 (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.

Everyone we spoke with said they felt very safe with the support they received. Comments included, “I am absolutely safe. They can't do enough to keep you safe.” And “I just feel safe knowing the carer is coming. They never ever let me down.” And “I have all the equipment I need in my home to keep me safe. I have a stair chair, handles in the toilet, hand buzzer and the carers always check everything to make sure it's working. They make sure I walk slowly with my walker. They are all wonderful people.” People told us they felt able and comfortable to report any concerns or worries. One person said, “I would speak to [staff member] one of the seniors if I had a problem. Lovely person and very thorough. They periodically come to see me to make sure all is okay and always phones first. I feel I am really cared for.”

Staff were very knowledgeable about how to protect people from potential harm and were passionate about ensuring people were safe from harm. One staff member described the different types of abuse they would report and said, “I would report any form of safeguarding concern. If a crime has been committed, the vulnerable person will be supported to report to the police. As a Safeguarding Lead at People’s Choice UK, I would make a referral to Bedford Borough Council’s Adult Protection Safeguarding Team and ensure that the Bedford Borough Council Safeguarding Adult referral process is followed. I would also report to the Registered Manager and if any form of abuse or alleged abuse has occurred, this would also be reported to CQC.”

The service had policies and procedures which covered how to safeguard vulnerable people from abuse and how to ‘whistle blow’ if necessary. We saw safeguarding training was considered essential by the registered provider and all staff completed this and regular refresher courses. The training records and discussions with staff confirmed this. The manager maintained a safeguarding log, to ensure they had effective managerial oversight of any safeguarding concerns. There was information displayed around the office with contacts of who to call if staff had any safeguarding concerns. Quarterly reflections were used as a tool to learn lessons when things went wrong following safeguarding concerns. For example, there had been a safeguarding concern in relation to pressure area care which had resulted in staff completing refresher training in pressure area care and we saw the safeguarding concern had been discussed in staff meetings. In addition, all staff were given handouts in relation to pressure are care. Records showed the provider reported safeguarding incidents as required to the relevant agencies.

Detailed care plans and risk assessments were completed to help staff support people to minimise risk whilst ensuring they could make choices about their lives. One relative described the risks to their family member in relation to their mobility and described the steps staff took to keep them safe. They told us, “My [family member] has a standing hoist. The carers are very careful when moving and handling [family member]. I have no worries; they are all very experienced in what they do and keep family member protected.” People we spoke with said they had been involved in the developments of the risk assessments and 1 person said, “I suffer with diabetic feet, and we have a plan to deal with that. The carers are very attentive in what they do, and I feel very safe with them all.”

Staff told us they were able to keep people as safe as possible and that the risk assessments in place were a good guide to help keep people safe. One staff member commented, “One risk assessment is a medication risk assessment. If a person is unable to take medication themselves or they forget often, there is a risk of missed medication. If I thought a client was at risk of something I would report it to the assistant managers or registered manager. I think changes are made swiftly and the risk assessments help care staff determine what might happen if we don’t carry out our responsibilities in the right way. These assessments are detailed documents that identify potential risks to the person's safety and well-being, as well as the measures we need to take to mitigate these risks. For example, one risk assessment might be for a person who is at risk of falls due to mobility issues. The assessment would outline specific risks, such as slipping on wet floors, and the steps to reduce this risk, such as ensuring that non-slip mats are in place, using mobility aids, and providing supervision when walking.”

Care plans identified potential risks and provided brief guidance to manage these risks. The risk assessments captured the hazard and how to mitigate the risk with detailed guidance for staff to follow to keep the person safe. Risks were reviewed and updated if people’s needs changed. Environmental risks were identified for all properties staff visited. Risk assessments always addressed people's diverse needs. For example, people's specific needs around their mental health support were assessed. In all instances, these had been reviewed regularly to make sure they remained up to date and reflected changes to people's circumstances.

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 were sufficient staff to keep people safe and we received extremely positive feedback about the levels of staffing. Comments included, “I have 2 carers, 4 times a day. They always turn up and never let you down. And “They are so reliable. They always stay their full time and always call if they are running late.” And “They stick to their times. They are great and I have never had a problem. They never let us down and are very reliable.” People told us they saw the same staff which provided constancy and made sure they received their care by staff that knew them well. One person said, “I can’t believe what a team I have. Words fail me they are all wonderful to me.” Another person told us, “Yes, the staff are regular, I know them all. I know their faces.” A relative informed us, “The staff are regular and [family member] knows them very well. It’s so much better having the same staff.” People and relatives felt the staff were kind, caring and well trained to provide them with the support they needed. One person said, “They handle [family member] very carefully with the hoist and movement. They are very experienced in what they do.” Other comments included, “My [family member] suffers with a debilitating condition and also dementia. We have had care for a while now and the carers have been incredible. I have to say Outstanding. They are worth a bottle of champagne every time.” And “These people have transformed our lives really. They are Top Draw.” And “They really are 1st class carers.

Staff expressed satisfaction regarding staffing levels, and 1 staff member said, “The staffing levels are very good. The staff are able to cover all the calls without having an overwhelming workload.” Another member of staff commented, “I normally work with the same clients, and they are very familiar to me. I know their likes and dislikes. I also have a good professional relationship with their family. I always work my allocated time.” A third staff member told us, “The staffing levels at People’s Choice UK are very good, we have capacity to support our clients and are constantly recruiting to ensure we can accommodate new care package referrals. My workload is manageable as we have two assistant managers. We are therefore able to work together and also split the workload which avoids the management team feeling overwhelmed. One staff member who completed the rotas told us they supported a person with a learning disability. They said, “We have 1 person, with learning disabilities, and I have been involved in their care at People’s Choice for over 10 years. [Person] and family are familiar with me, so I often take [person] to their medical appointments. When I complete the rota, I allocate the carers to specific rounds, and they normally stay on those rounds. The service users and their families are then able to become familiar with their carers.”

The provider followed a very robust procedure when recruiting staff to work at the service, to ensure people were protected from staff that may not be fit to support them. We saw that robust international recruitment measures were in place to ensure people were recruited safely and there were extensive employment checks in place. An assessment of people’s needs was completed before a care package was agreed. This meant the provider was able to assess how much support a person needed and how many staff were required to provide that support safely. The assessment also identified the skill mix of staff needed to provide people’s care. Staff rotas showed that sufficient numbers of staff were deployed to meet people’s needs.

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.