First Choice Home Care

Safe- this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question requires improvement. At this assessment the rating has remained requires improvement. This meant some aspects of the service were not always safe and there was limited assurance about safety. There was an increased risk that people could be harmed. The service was in breach of legal regulation in relation to governance and safeguarding service users from abuse and improper treatment. We found actions taken were not the most effective. The management of complaints and safeguarding people from actual and or suspected abuse ‘did not protect people’. Complaints and safeguarding procedures were not always followed and where appropriate there was a lack of reporting of safeguarding concerns to the Care Quality Commission. There was also a lack of oversight and sharing of information more widely within the service meaning lessons were not learnt across the wider organisation. Staff had a knowledge of safeguarding and whom they would report any concerns to. When reviewing staff recruitment folders, we could not be sure all checks had been carried out appropriately which meant we could not be assured all staff had been safely recruited. We identified concerns around their, (staffs) knowledge of the Mental Capacity Act. Risks to people were not always appropriately captured or documented, and we had some concerns over appropriate risk assessments for people using the service. For example, people who had the same condition such as diabetes did not all consistently have a relevant risk assessment in relation to this. The service manager acknowledged that some improvements did need to be made to all of the issues above.

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence. At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

Caring- this means we looked for evidence that the provider involved people and treated them with compassion, kindness, dignity and respect. At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people were supported and treated with dignity and respect; and involved as partners in their care. People told us they felt their needs were being met.

Responsive – this means we looked for evidence that the provider met people’s needs. At our last assessment we rated this key question good. At this assessment the rating has remained good.

Well-led – this means we looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture. At our last ratings inspection we rated this key question requires improvement. At this assessment the rating has remained requires improvement. This meant there were shortfalls in service leadership. Leaders and the culture they created did not always assure the delivery of high-quality care. The service was in breach of the legal regulation in relation to the governance of the service. Governance procedures were not always effective. The provider had not identified all the quality or risk concerns we found. This meant prompt action had not been taken to address shortfalls. The provider had appropriate policies in place. Most staff felt supported by management and were aware of the values of the service. Management was keen to learn and make improvements to the service.