Background to this inspection
Updated
22 November 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
This inspection was carried out by one inspector and one 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
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.
Notice of inspection
We gave the service 48 hours’ notice of the inspection. This was because it is a domiciliary care agency and we needed to be sure that the provider or registered manager would be in the office to support the inspection.
Inspection activity started 17 October 2019 and ended on 18 October 2019.
What we did before the inspection
Before the inspection we reviewed the intelligence, we held on the service including notifications and information received from the local authority. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all of this information to plan our inspection.
During the inspection
We spoke with seven people who used the service and three relatives about their experience of the care provided. We spoke with ten members of staff including the provider, manager, deputy managers, care supervisors, and care workers.
We reviewed a range of records. This included three people’s care records and multiple medication records. We looked at four 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
22 November 2019
About the service
Healthcare 1st Choice is a domiciliary care agency providing personal care to people living in their own homes. 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.
At the time of the inspection 73 people received personal care.
The service can support older adults, people with learning disabilities, physical disabilities, younger adults and people with mental health conditions.
People’s experience of using this service and what we found
People were supported by staff who had received safeguarding training and had confidence to speak up if there were any concerns. Risk assessments were completed before care tasks were undertaken and contingency plans were in place for adverse weather conditions.
Staff were recruited following the application of robust recruitment procedures and there was enough staff to meet people’s needs.
People received their medicine by staff who had been trained and deemed competent to administer. Staff had access to personal protective equipment which they used when supporting people with personal care. Lessons were learnt when things went wrong.
People’s care needs were assessed in line with national guidance and contained enough information to ensure staff knew how people wanted to be supported.
Staff received the training they needed to ensure they were able to fulfil their role. This included food hygiene training which they needed to support people with meals. The environments in which staff worked were assessed to ensure staff safety and make sure the correct equipment was available.
Staff worked with other agencies to help provide consistent care and ensured people were supported during more difficult times. People were supported to access health appointments when needed and staff knew how to support people with any diagnosed health conditions.
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 were treated with kindness and respect and their protected characteristics were recorded in their care plan. People told us that they were involved in the care planning process and that they were always asked their opinion before any care tasks were completed. People’s privacy and dignity was respected, and their independence was promoted.
People received care that was reflective of their needs. Some people said they wished care times could be a little more consistent but confirmed they were told if staff were going to be late. People’s communication needs were assessed, and people were supported by staff who took time to talk with them and make sure they had all they needed before they left.
People had access to a complaints procedure and any complaints were investigated and feedback was shared.
No one was in receipt of end of life care at the time of inspection.
People were complimentary of the service they received and would recommend it to others. Staff felt well supported and listened to. The staff we asked, were aware of their duty of candour.
The management team were aware of their responsibilities and had effective governance systems in place which included monthly spot checks. People’s care was reviewed on a monthly basis to ensure people were happy with the service and any concerns were addressed.
The service could demonstrate partnership working and that it worked to continuously improve the care provided.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published 4 August 2017).
Why we inspected
The inspection was prompted in part due to concerns received about staffing and the recruitment checks in place. A decision was made for us to inspect and examine those risks.
We found no evidence during this inspection that people were at risk of harm from this concern.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.