First Choice Medical Solutions Ltd

Safe - this means we looked for evidence that people were protected from abuse and avoidable harm. We assessed a total of eight quality statements from this key question. This key question has been rated requires inadequate at the previous assessment on 28 November 2022. This meant some aspects of the service were not always safe and there was limited assurance about safety. During our current assessment of this key question, we found people were kept safe. The registered manager had robust systems in place to assess and manage risk. People participated in the management of risk and provided with information to help support them to make informed decisions about any risk they choose to take. For example, if a person wanted to participate in a particular activity, a risk assessment would be completed along with the person, so the person would be able to make an informed decision considering any potential risks. People were protected from potential harm and abuse. There were effective infection control measures in place. Accident, incidents, and events were recorded and reviewed, and any lessons learnt shared with staff. People were supported to take their medications regularly by staff who had completed medication training and had their competencies checked. There were robust recruitment measures in place to ensure all pre-employment checks were completed in advance of staff starting work. Staff received training, supervision and support which provided them with the skills and knowledge to support people safely. The culture of the service was one of learning and staff and the management team were resourceful in being receptive to any learning and sharing of best practice. People were supported to transition through services safely.

Effective - this means we looked for evidence that people’s physical, mental health and social needs were holistically assessed, and that their care, treatment and support delivered in line with legislation. We check standards and evidence-based guidance to make sure people received care that was person centred. We assessed a total of eight quality statements from this key question. This key question has been rated requires improvement at the previous assessment on 28/11/2022. This meant some aspects of the service were not always effective.

During our current assessment of this key question, we found people received effective care. People had their individual needs assessed and their care plans were regularly reviewed and updated. People were involved in discussions about their care and support and had choices about how their care was provided. People were asked to consent to their care and support. Consent was recorded and reviewed.

The service had anti discriminatory processes in place to ensure there is no discrimination, including in relation to protected characteristics under the Equality Act, when making care and support decisions. Technology and or equipment was used where appropriate to help people retain their independence.

Caring – this means we looked for evidence that the service involved people and treated them with compassion, kindness, dignity and respect. People were supported and treated with dignity and respect; and involved as partners in their care.

People and relatives told us staff were kind to them. Professionals we spoke with said staff showed kindness and respect to people and their families as well. A social care professional said, “My experience of [the service] has been that they [staff] have a ‘can do’ attitude to not only supporting [people] but also their families. They are receptive to new and different ideas but are also clear in their comments if they think something is not in [people’s] best interests. Supporting people to express their views and be involved in making decisions about their care People were involved in their care. They told us staff listened to them and their opinion mattered.

For people who could not express their wishes and needs verbally, staff recorded their behaviour and body language when they received support or were engaged in different activities. This helped them identify what people liked and disliked.

People told us they felt at ease with staff and their dignity and privacy were promoted. Relatives confirmed this and that wherever possible independence was promoted.

Staff told us how they closed curtains and doors when they supported people with personal care. They used respectful language when talking about people and ensured they only disclosed personal information about people to authorised professionals or relatives if appropriate.

Responsive – this means we looked for evidence that the service met people’s needs. This key question has been rated good. This meant people’s needs were met through good organisation and delivery. Planning personalised care to ensure people have choice and control and to meet their needs and preferences

People received support in a way that suited them by a staff team who knew them well. People’s care plans were detailed with likes and dislikes in every area of their support. Guidance was place for staff on how to support people in a personalised way. People achieved positive outcomes due to the personalised care and support they received. We found many examples where people’s well-being, behaviour and health improved due to the personalised support they received. There were various communication methods in place to support people and comply with the Accessible Information Standard. People’s communication needs were assessed, and staff had guidance how to effectively communicate with them. For example, staff used pictorial social stories to aid a person’s understanding when talking to them.

Care plans gave staff clear guidance and examples of what communication people used and what this meant. This helped people feel included in their care as staff knew how to effectively communicate with them. Supporting people to develop and maintain relationships to avoid social isolation; support to follow interests and to take part in activities that are socially and culturally relevant to them.

People who received support from staff in a supported living setting were engaged in different activities. Staff encouraged them to try out activities based on their hobbies and interest. Improving care quality in response to complaints or concerns. People and relatives told us they knew how to raise concerns. One relative told us they had no cause for concerns for the care their family member received.

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. This key question has been rated good. This meant the service was consistently managed and well-led.

Leaders and the culture they created promoted high-quality, person-centred care. Promoting a positive culture that is person-centred, open, inclusive and empowering, which achieves good outcomes for people; People, relatives and professionals we spoke with were happy how the service was managed. One professional told us, “The staff team have excellent leadership from [registered manager] who I have regular contact with in informal and formal meetings.”

Staff were positive about the management of the service. The registered manager was committed to ongoing development for the whole staff team. In addition to the training considered mandatory by the provider, the registered manager ensure staff received bespoke training to understand people’s specific needs. One staff member told us, “ The provider had effective and robust quality assurance systems in place which enabled them to closely monitor the quality of the service they provided. Checks were completed daily, weekly and monthly by staff and managers to identify areas to improve and to maintain the health and well bein of staff and people. The registered manager completed regular audits and checked medicine administration records, care plans, missed or late visits and observed staff competencies when supporting people. This was done by visiting people when staff were present for a ‘spot check’. People had continuous opportunities to provide feedback about the service they received