Office

Updated 10 December 2021

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 one inspector.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own homes. The service did not have a manager registered with the Care Quality Commission. This means the provider is legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

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 would be in the office to support the inspection.

Inspection activity started on 24 November 2021 and ended on 29 November 2021. We visited the office location on 24 November 2021 and provided inspection feedback on 29 November 2021.

What we did before inspection

We reviewed information we had received about the service since the last inspection and reviewed the last inspection report. We sought feedback from the local authority and received feedback from two social workers. 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 one person who used the service about their experience of the care provided to themselves and their relative. We spoke with two members of care staff including the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We also spoke with a director for the service.

We reviewed a range of records. This included two people's care records and medicine records. We looked at several staff files in relation to recruitment and staff support. A variety of records relating to the management of the service, including quality assurance checks and training records were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. This included information relating to policies and procedures, communication procedures and audits and checks. We also received information on follow up actions taken by the provider. We invited additional care staff to provide feedback about working for the service.

Updated 10 December 2021

About the service

Office (Your Choice Care Ltd) is a domiciliary care agency providing personal care and support to people living in their own homes. 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 inspection there were two people who received personal care support.

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

Since our last inspection, the provider had taken action and made improvements in how the service was managed. New and improved systems and processes had been introduced and whilst these were working well, further time was required for them to become fully embedded and sustained.

Systems and processes to keep people safe were effective. Risks associated with people’s healthcare and support needs had been reviewed. Staff had up to date and detailed guidance of how to manage and mitigate risks.

Medicines management followed best practice guidance and new and improved medicines audits and monitoring systems had been introduced. Whilst there had be no accidents or incidents since the last inspection, the provider had implemented a new system that would enable a review and learning from any events that occurred.

Recruitment processes had been reviewed and a robust recruitment procedure introduced. All staff had pre-employment checks completed, this included a criminal record check to ensure they were suitable to work with vulnerable people.

Staff training and support had been improved upon. Staff had received mandatory training the provider had identified as required. Action were ongoing to ensure staff became fully compliant with all training requirements. Staff received opportunities to discuss their work, training, and development needs.

The staff rota confirmed how staff were deployed to meet people’s individual needs. Staff recruitment was ongoing, and staff shortfalls were covered by the management team.

Infection prevention and control practice did not fully reflect best practice guidance. Where shortfalls were identified, these were raised with the provider and immediate action was taken. Staff had access to sufficient stock of personal protective equipment to reduce the risk of infection spread. Staff undertook weekly testing for COVID-19 and the provider had a system to monitor this.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

This service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture. The provider’s new and improved systems and processes enabled a person using the service, to have choice and control of their care and support.

At the time of the inspection, there was not a registered manager in place. The day to day management and responsibility for the service was with the nominated person and a director.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update.

The last rating for this service was Inadequate (published 30 June 2021) and there were multiple breaches of regulation.

The provider completed an action plan after the last inspection to show what they would do and by when to improve.

At this inspection, we found improvements had been made and the provider was no longer in breach of regulations.

This service has been in Special Measures since the last inspection. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

We undertook this focused inspection to check the provider had followed their action plan and to confirm they now met legal requirements. 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 changed from Inadequate to 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 Office (Your Choice Care Ltd) 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.