First Choice Home Care (Halesworth) received an overall Good rating following a focused inspection of safe, effective, and well-led domains, with caring and responsive ratings carried forward from the previous 2019 inspection. The service demonstrated safe practices and positive outcomes for people, though supervision of staff had fallen behind and some staff reported concerns about management support following a branch merger.
Concerns (3)
moderate
Supervision / appraisal
: “Some staff told us that 1:1 and supervisions were not carried out regularly...some had not taken place and they had fallen behind.”
moderateLeadership: “Some care staff described a lack of support from the management team and office staff. A carer said, "People have literally been driven out by the way the company is being run."”
minorMissed or late visits: “Some people raised concerns that care staff did not always arrive at the agreed time.”
Strengths
· Over 97% of calls made within 15 minutes of agreed time according to electronic monitoring data
· Safe recruitment processes including DBS checks, references, and right to work verification
· People reported feeling safe; medicines managed safely with monthly audits and competency checks
· Staff trained in safeguarding and understood their reporting responsibilities
· Comprehensive risk assessments covering nutrition, moving and handling, medicines, and skin integrity
Quality-Statement breakdown (16)
safe: Staffing and recruitmentGood
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Assessing risk, safety monitoring and managementGood
safe: Using medicines safelyGood
safe: Preventing and controlling infectionGood
safe: Learning lessons when things go wrongGood
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawGood
effective: Staff support: induction, training, skills and experienceGood
effective: Supporting people to eat and drink enough to maintain a balanced dietGood
effective: Staff working with other agencies to provide consistent, effective, timely careGood
effective: Ensuring consent to care and treatment in line with law and guidanceGood
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringGood
well-led: How the provider understands and acts on the duty of candourGood
well-led: Engaging and involving people using the service, the public and staffGood
well-led: Continuous learning and improving careGood
First Choice Home Care (Halesworth) was rated Good across all five key questions at its first rated inspection in February 2019, with 58 people receiving personal care in their own homes. Key governance gaps included absence of a centralised accident/incident log, two missed statutory CQC notifications, and inconsistencies between the complaints policy and service user guide, though none had caused demonstrable harm to people.
Concerns (5)
moderateIncident learning: “there was no overall log of accidents and incidents for the service...a trend analysis of any accidents or incidents could take place and any lessons learned recorded”
moderateGovernance: “the provider had not sent in a statutory notification in relation to two incidents...It is a legal requirement to notify the CQC of serious incidents”
moderateGovernance: “There was no log of safeguarding referrals or accidents and incidents along with lessons learned as a result. Management oversight was therefore lacking in these areas”
minorRecord keeping: “staff did not always sign the medication administration charts (MAR) to confirm that people had been assisted with their medication”
minorComplaints handling: “the complaints policy was dated 2016 and contained different information to the service user guide...CQC does not investigate individual complaints”
Strengths
· People felt safe and staff understood safeguarding responsibilities, with positive feedback from people and relatives about staff conduct.
· Staff were well trained with an in-house trainer, received regular supervision, and demonstrated competency in specialist areas including dementia and diabetes care.
· Person-centred care plans were kept up to date with regular reviews and people felt involved in decisions about their care.
· Management team actively delivered care alongside staff, knew people well, and led by example with a strong caring ethos.
· The service was responsive to changing needs, with prompt care plan updates and flexible scheduling to accommodate people's requests.
Quality-Statement breakdown (23)
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Assessing risk, safety monitoring and managementGood
safe: Staffing and recruitmentGood
safe: Using medicines safelyGood
safe: Preventing and controlling infectionGood
safe: Learning lessons when things go wrongGood
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawGood
effective: Staff support: induction, training, skills and experienceGood
effective: Supporting people to eat and drink enough to maintain a balanced dietGood
effective: Staff working with other agencies to provide consistent, effective, timely careGood
effective: Supporting people to live healthier lives, access healthcare services and supportGood
effective: Ensuring consent to care and treatment in line with law and guidanceGood
caring: Ensuring people are well treated and supported; equality and diversityGood
caring: Supporting people to express their views and be involved in making decisions about their careGood
caring: Respecting and promoting people's privacy, dignity and independenceGood
responsive: Planning personalised care to meet people's needs, preferences, interests and give them choice and controlGood
responsive: Improving care quality in response to complaints or concernsGood
responsive: End of life care and supportGood
well-led: Planning and promoting person-centred, high-quality care and support; duty of candourGood
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsGood
well-led: Engaging and involving people using the service, the public and staffGood
well-led: Continuous learning and improving careGood