First Choice Home Care (Snetterton) is a domiciliary care agency providing personal care support to people living in their own homes. At the time of the assessment there were 56 people who were in receipt of the regulated activity of personal care. We had previously inspected the service on 12 August 2022 focusing on the key questions of safe and well-led. We rated the service requires improvement with a breach of Regulation 17 Good governance. We undertook our assessment because of a number of identified risks which could impact on the experiences of people using the service. Our assessment activity started on 9 January 2025 and ended on 5 February 2025. We visited the office location on 9 January 2025. We completed a full comprehensive assessment and looked at all the quality statements within the 5 key questions. At the time of our assessment the service manager was not registered with the Care Quality Commission. The onsite inspection was announced. This was because we needed to be sure that the provider or service manager would be available to support the inspection. The inspection was undertaken by two inspectors and one Expert by Experience. An Expert by Experience is a person who has personal experience of using this type of service. During our assessment, we identified concerns with how the service was being managed and found improvements were needed for new systems and ways of working to be firmly embedded. We identified issues relating to a lack of management oversight and poor governance. Additionally we found concerns around the systems and processes in place for handling complaints. The provider had previously been in breach of regulation 17: good governance and insufficient progress had been made which meant they were still in breach of this regulation. The provider was also found to be in breach of regulation 13: safeguarding service users from abuse and improper treatment. We have asked the provider for an action plan in response to concerns found.
PDF cached but not yet analysed by Claude; set ANTHROPIC_API_KEY and re-run npm run etl:reports -- --location 1-2579916184.
First Choice Home Care was rated Requires Improvement overall, with both Safe and Well-led downgraded from Good due to a breach of Regulation 17 (Good Governance). Quality assurance, medicines audits, recruitment checks, and staffing levels were not always robust, though people felt safe and praised infection control and personalised care.
Concerns (6)
criticalGovernance: “Some of the systems to assess, monitor and improve the quality of the service were not fully effective. This was a breach of regulation 17 (Good Governance)”
moderateStaffing levels: “There were not always enough staff on duty to meet people's needs. Staff vacancies and absence had led to low staffing levels on some occasions.”
moderateMedication management: “Medicines audits were not sufficient in fully identifying the circumstances behind identified errors.”
moderateOther: “Staff were not always recruited safely, we found gaps in completed application forms and some applications forms did not match staffs curriculum vitae (CV).”
moderateIncident learning: “Accidents and incidents were recorded. However, the management team were working to implement a new reporting system to gather more details and information, so lessons can be learnt”
minorComplaints handling: “the service had recorded cancelled calls and declined calls but had not recorded reasons for them. Some people had cancelled multiple calls in a month and there was no recording of alternative support offered”
Strengths
· People told us they felt safe with staff, and staff had received safeguarding training.
· Positive feedback about infection prevention and control processes; staff always wore PPE appropriately.
· Care files were personalised, shaped around people's preferences and support needs, with goals to support wishes.
· Management team understood and acted on duty of candour and CQC notification responsibilities.
· DBS checks and references were obtained for staff.
Quality-Statement breakdown (11)
safe: Staffing and recruitmentNot rated
safe: Using medicines safelyNot rated
safe: Learning lessons when things go wrongNot rated
safe: Assessing risk, safety monitoring and managementNot rated
safe: Systems and processes to safeguard people from the risk of abuseNot rated
safe: Preventing and controlling infectionNot rated
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsNot rated
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringNot rated
well-led: Engaging and involving people using the service, the public and staffNot rated
well-led: Continuous learning and improving careNot rated
well-led: Working in partnership with othersNot rated