Background to this inspection
Updated
3 October 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 was carried out by a single inspector.
Service and service type
This service is a domiciliary care agency that provides personal care and support to people living in their own homes or flats.
Notice of inspection
We gave a short period notice of the inspection because we wanted to try to gain consent to visit people in their homes, and to be sure that the registered manager would be in the office to support the inspection.
What we did before the inspection
We checked the information we had about the provider and location including documents provided during their registration with CQC. 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 asked the local authority for any information they had about the service. We used this information to help plan our inspection.
During the inspection-
We received consent to visit one person using the service and their relative. We spoke with two care workers, the operations manager, the HR advisor and the registered manager. We reviewed a range of records. This included three care plans, medicines records, three staff recruitment and training records and records related to running the service such as audits and meeting minutes.
After the inspection
The registered manager sent us further information including some updated risk assessments.
Updated
3 October 2019
About the service
Right Choice Home Care is a domiciliary care service in the London Borough of Bromley providing personal care and support to people living in their own homes. The service was supporting three people at the time of this inspection.
People’s experience of using this service and what we found
We found concerns in relation to aspects of the management and governance of the service. The monitoring of the quality and safety of the service was not always effective. The complaints process had also not been provided to people and their relatives. Staff recruitment processes failed to fully follow legal requirements to ensure staff had an appropriate criminal record check before they started work or check on staff conduct in previous employment in health and social care
Other areas needed improvement. People and their relatives were not provided with adequate information about the service to refer to. Staff training needed some improvement to ensure staff new to health and social care received training to a recognised standard and that staff received training to meet the full range of people’s needs. Staff had training on administering medicines; however, their competency had not been assessed in line with the provider’s policy. Some risk assessment records were not sufficiently detailed to provide an accurate record of care and support, although this issue was addressed following the inspection.
We were only able to gather feedback from one person and their relative and they were very complimentary about the care and support they received. They told us they felt very safe and had the same consistent care workers who were reliable and stayed the full length of the call. Staff had safeguarding training and understood their roles in relation to safeguarding. Risks to people were identified and assessed and guidance was provided to staff to manage risks. There were systems to administer medicines as prescribed Staff understood how to reduce the risk of infection.
People’s needs were assessed before they started to use the service and their nutritional needs were identified and met. The service worked with health care professionals and relatives to ensure people’s health care needs were met. Staff sought people’s consent when offering them support. 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 and their relative said staff treated them with care and kindness and they were consulted about the support they received. Staff treated people with dignity and respected their privacy.
People had a personalised plan for their care that reflected their needs. People’s needs in respect of their protected characteristics were assessed and supported. The service had matched people with staff from the same cultural back ground. They understood people’s cultural and religious needs and how to support them to meet these needs as required.
There were some systems to monitor the quality and safety of the service through checks on medicines records and spot checks on staff. Staff told us there was a supportive working culture at the service and the management team were approachable and available. Meetings were held to promote effective communication. The service had links with local voluntary agencies they could sign post people to if this was appropriate.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
This service was registered with us on 28 October 2017 and this is the first inspection as it had only started to provide personal care since April 2019.
Why we inspected
This was a planned inspection based on our inspection scheduling for new services.
We have found evidence that the provider needs to make improvements. Please see the safe, effective, responsive and well led sections of this full report.
You can see what action we have asked the provider to take at the end of this full report.
Follow up
We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.