Choose 2 Care

Updated 3 June 2020

The inspection

We undertook this focused inspection to check whether the Warning Notice we previously served in relation to Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 had been met on the specific concerns we had about maintaining accurate records in respect of each service user, decisions taken in relation to the care and treatment provided for people, people being placed at risk due to unsafe staff recruitment processes, a failure to safeguard people, a failure to apply the principles of the Mental Capacity Act 2005 and the governance of the service and oversight of the service.

The overall rating for the service has not changed following this focused inspection and remains Requires Improvement.

Inspection team

This inspection was carried out by one inspector.

Service and service type

This service is a domiciliary care agency. It provides personal care to eight people living in their own houses and flats.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.

Inspection activity started on 23 February 2020 when the inspection was announced. We visited the office location on 25 February 2020.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We contacted Healthwatch for information held on their database about the service. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used all of this information to plan our inspection.

We reviewed a range of records. This included eight people’s care records and daily 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.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records.

Updated 3 June 2020

About the service

Choose 2 Care Choose is a domiciliary care agency. It provides personal care to people living in their own houses and flats across the Nottinghamshire area. It currently provides a service to nine adults. Not everyone using Choose 2 Care receives a regulated activity; CQC only inspects the service being received by people provided with 'personal care'; help with tasks related to personal hygiene and eating. Where they do, we also take into account any wider social care provided.

People’s experience of using this service and what we found

People's care plans were limited in the information provided. Risk assessments did not always include actions for staff to take to reduce the risk of potential harm to people.

The service needed to improve their implementation of the Mental Capacity Act 2005, we found people were not supported to have maximum choice and control of their lives and the staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.

We found people were safe from the risk of abuse. Safeguarding policies and procedures were being followed correctly by trained staff. Information was shared with the local authority safeguarding team and with us.

Recruitment processes were in place to make sure, that people were protected from staff being employed who were not suitable. Staff had been trained in areas which were deemed as essential by the registered manager.

Quality monitoring systems provided an oversight of the service to demonstrate the service was effectively managed and improving.

Rating at last inspection and update:

The last rating for this service was requires improvement (report published 9 January 2020) and there were multiple breaches of regulation. A warning notice was issued due to the breaches found. The provider completed an action plan following the warning notice to show what they would do to improve. At this inspection enough improvement had not been sustained and the provider was still in breach of the warning notice.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection. We carried out an announced comprehensive inspection of this service on 19 September 2019. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve in the areas of; ensuring people using the service gave their consent to treatment, safeguarding service users from abuse and improper treatment, ensuring the provider employed fit and proper persons to work with vulnerable adults.

We undertook this focused inspection to check whether the Warning Notice we previously served in relation to Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 had been met. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.

The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has remained Requires Improvement. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Choose 2 Care on our website at www.cqc.org.uk.

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.