Choices Healthcare Limited

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

People felt safe and they were confident to raise any concerns. People and their relatives were involved in planning and reviewing their care and were regularly asked for feedback to help the management team improve the quality of the care provided.

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 told us they felt safe with the staff team that visited them. Comments included, "I do feel safe with them (staff) when they were here, and if I need to cancel because of an appointment, I am able to do that ” and, "As I live on my own, it is nice to have them (staff) checking up on me. I certainly feel safe knowing they are checking.”

Safeguards had been raised and CQC notified where required. Registered Manager was aware of their responsibilities to send in notifications appropriately to CQC.

Staff had received training in safeguarding.

Staff understood the risks to people well and were kept up to date when there were any changes to people’s needs.

Risks to people's safety and wellbeing were assessed and risk assessments had been developed to help staff support people’s safety as far as possible. These included risks relating to people's mobility, falls, skin care and eating and drinking. There were systems in place for staff to report concerns, incidents, and accidents. Lessons learnt were cascaded to staff to share learning. The management team completed regular audits and action plans were developed if any risks were identified.

People were supported by staff who had the appropriate training and instruction to provide safe and effective care. People were informed about risks and supported to keep themselves safe. Risk assessments about care were person-centred and regularly reviewed with the person, where possible.

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

During our last inspection the provider was in breach of Reg 19. The provider had made improvements and were no longer in breach of this regulation. Since our last inspection the service had recruited two human resources staff plus an administrator. All staff files had been audited to ensure they were up to date and contained all the required documentation. Complaints received regarding call times were recorded in the complaints log, these had been actioned in line with the provider's policy. Actions taken to improve this included increased staff supervision and rolling out an electronic monitoring system for staff to log in and out of care calls. Staff had received basic core training and were expected to obtain the care certificate.

Staff said they felt they had enough time to carry out their care calls. They told us if they felt they needed longer then they spoke with the registered manager who arranged for the package to be extended to enable them to have adequate time to complete the needs of the person. The registered manager told us they were aware of some negative feedback with regards to care call timings. However, they explained people had a three hour window when the care staff could visit. People were told this when they first signed up with the agency. The registered manager told us they would explain this again to people in order for them not to feel the carer was turning up late.

During our last inspection the provider was in breach of Regulation 18. The provider had made improvements and were no longer in breach of this regulation. People's feedback reflected negative experiences of the service. Comments included “I don’t get any calls to tell me if they are running late ” and, “I have had choices for a couple of years and its 1 carer 3 times a day and then 2 carers for the night call. Timings have been all over the place and the first call can be anything between 7.30am and 11am some days. I certainly don’t get kept informed” and, “ [Relative] does have to have their critical medicines 12 hours apart and then they have painkillers during the day when they need them. We did have problems with the timings of calls and this threw the critical medicines out. I did complain and to be fair, they did listen but it took a while to sort out. They are now much better at getting the morning call at the right time (8.30-9.30 range).” Feedback from people in regard to staff competency was mixed. Comments included. “I asked a (carer) that came recently, to do me a meat and pickle sandwich. They couldn’t find the covered meat in the fridge and presented me with a pickle sandwich and a cup of tea with the teabag still in it. I think they come from somewhere where they are not used to our way of life. I have even had a carer cutting a tomato for a sandwich as they held it in their hand" and, “I can testify that the staff care has improved recently and I am now, just about able to step back and let them do their job.”

Staff confirmed they had received the training necessary to support good infection control practice and they had appropriate stocks of PPE available to them.

At the previous inspection (published February 2023) the provider’s Infection, Prevention and Control policy and procedure was not up to date and had not been reviewed in line with COVID19 safeguards. This was a breach of regulation 12 (Safe care and treatment) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The provider had made improvements and were no longer in breach of this regulation. The provider’s policy and procedure had been reviewed and updated to reflect current guidelines. Training was provided for the staff team and their competency was assessed by spot checks undertaken of practice and quality questionnaires completed by people and families. Staff signed to confirm when they had taken stocks of PPE, this was also monitored by the management team.

People's feedback remained mixed regarding the use of personal protective equipment (PPE) with some people telling us staff always wore gloves and aprons appropriately and some people saying they did not always do so. We shared this feedback with the registered manager who immediately acted to address this concern.

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