Choice Independent Living Limited

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Relatives said people felt safe being supported by Choice Independent Living staff. They said they had been involved in agreeing people’s care and support needs when people had been discharged from hospital. Staff knew people’s needs and how to support them. Care plans contained guidance for the support people needed and how to manage identified risks. Staff knew what needed to be recorded as an incident. Incident reports were reviewed by the registered manager to ensure appropriate actions had been taken. Relatives said staff were usually on time for the support calls and completed all agreed tasks. Most staff said they were able to travel between calls and be on time, although some said the travel time was sometimes not taken into account on their rota. People received their medicines as prescribed. Additional details on how people communicated they needed an as required medicines, for example pain relief, needed to be recorded. Staff said they asked people if they needed an as required medicine and they were able to communicate if they did. The registered manager told us they would introduce a tool for staff to recognise if people were in pain. Staff had access to personal protective equipment. People’s capacity to make decisions was assessed by the commissioners prior to the service starting their support. Staff recruitment procedures ensured checks were made prior to the staff member starting work. However, references weren’t always verified. Staff received the training for their role. Team leaders were being trained as trainers in 3 key areas so they would be able to train the staff team. Staff had regular supervision meetings, staff meetings and the team leaders completed observations of their practice.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People said they felt safe being supported by Choice Independent Living staff members. Where staff had concerns about people’s safety when providing support, they had raised these with the management team. A relative said, “They seem to take a responsible approach to safety.”

Staff knew what to report and how to record any incidents through the mobile app. They said the management team reviewed the incidents and would contact them for further information if needed. Team leaders said staff were encouraged to record any situation that is not usual for the person’s care plan. Team leaders and the registered manager reviewed these and ensured any actions needed to reduce the risk of a recurrence had been taken.

All incidents were recorded by staff on an app on their phone. The team leader and registered manager were alerted there was a new incident for them to review. They reviewed the incident and signed off any actions required.

People and their relatives said they had been involved in agreeing the support needed when Choice Independent Living started to provide their support. People and relatives said the care staff knew peoples support needs well.

Staff said they were able to read the care plans for new people they were supporting and knew the support they needed before their first support call. Staff often also received a phone call to discuss the new person’s support needs before they visited.

The commissioning manager said Choice Independent Living were responsive to new support packages and their care plans captured people’s needs.

The team leaders reviewed the person’s discharge plan and where possible arranged to meet their family prior to discharge to discuss the person’s needs and what the families wishes were. A care plan was written and made available to the staff team. The care coordinator rang the staff who were going to provide the support to inform them they had a new person to support and give a verbal overview of their needs.

People and relatives spoke positively about the care and support they received. They felt confident that people were kept safe. They said they were able to contact the office if they had any concerns and these concerns were then resolved. One person said, “They’re definitely trained on keeping me safe.”

Staff knew how to report any safeguarding concerns and what they needed to report. They said the registered manager would listen and respond to their concerns. Staff explained how they asked people what support they wanted before providing it and explained what they were going to do.

Systems were in place to safeguard people. The registered manager knew when to refer an incident or allegation to the safeguarding team. People’s capacity was assessed by the commissioning team prior to the service supporting them.

People and relatives said they were involved in agreeing and reviewing the support they needed. They said staff knew how to manage risks around moving and handling and skin integrity. One person said, “I’m washed twice a day, carer checks my skin, thoroughly applies the cream and I am re positioned every visit, I’ve had no sores.”

Staff knew people’s support needs and the risks they may face. They said all the relevant information is available from the care plans through the mobile app. If staff were due to support a new person, the office would often ring them to brief them on the person’s support needs before the first call.

Care plans identified potential risks and provided brief guidance to manage these risks. The risk assessments did not always capture the hazard and how to mitigate the risk, however this was included in the care plans. Risks were reviewed and updated if people’s needs changed. Environmental risks were identified for all properties staff visited.

People did not comment as the care takes place in their own homes.

Staff had the information that they needed and checked for risks when they entered the property.

A Risk Assessment was completed for every home that the staff visited.

People and relatives were positive about the staff supporting them. They said they were generally on time for calls, apologised if they were late and stayed the full length of calls. A relative said, “We've had no problems with staff not turning up or not being on time.” They mainly had regular staff visiting them who knew their needs well. A relative said, “They all seem experienced and able to deal with the situation they face.” One person said, “Staff don't rush me, stay as long as I need them, and always tidy up before they leave.”

The majority of staff said their rotas were fine, although some staff said they did not get enough travel time on their rotas to ensure they could arrive to calls on time. We discussed this with the registered manager, who said they monitored call times. All staff said they had the training for their role and felt supported. They had regular supervision meetings, staff meetings and the team leaders completed observations of their practice. A member of staff said, “A supervisor comes unannounced once or twice a month for a spot check. They observe our uniform and how give care.”

Pre-employment checks were completed prior to staff starting work at the service. However, references had not always been verified. We discussed this with the registered manager, who had rewritten the staff recruitment checklist to include details of the references received. A team leader was identified as being on supervisory duty each week. They completed spot checks and supported staff where needed. Team leaders and the registered manager had completed train the trainer courses for moving and handling and medicines, with basic life support being completed in September 2024. This would mean these courses could be delivered face to face in house. Online training was completed. The system highlighted when training needed to be refreshed. There was a high level of compliance with training. New staff completed all training before completing shadow shifts. They then worked alongside a supervisor for 2 to 3 weeks so they could be supported, and their competencies observed.

People and relatives said staff used appropriate personal protective equipment (PPE) when providing personal care

Staff said they were able to collect any PPE they needed from the office.

PPE was available in the office for staff to collect when they needed it.

People and relatives said staff administered medicines safely and as prescribed. One relative said staff had contacted them when the person had told staff they were having a side effect from a newly prescribed medicine so they could discuss this with the GP.

Staff said all the information about the medicines people needed at each call was on the app. They said they would ask people if they needed any pain relief where prescribed and people were able to communicate whether they did or not. Staff said they had received training in medicines administration. We saw 1 person had refused their pain medicines for 2 months. The registered manager said the person would say if they needed this medicine or not, but due to their medical diagnosis did not want it discontinued. We discussed if this should be an as required medicine instead of a regular dose

The support people needed with heir medicines was identified in their care plans. An electronic medicines administration record (EMAR) was used as well as a paper MARs in each property. This ensured other visiting professionals could see what medicines had been administered by staff. An alert was seen by the management team if medicines had not been administered and they could contact the staff members on the call to establish if there was an issue. Protocols were in place for any as required medicines (PRNs), however they did not state how the person would communicate they needed the PRN. Staff said they asked people if they wanted the PRN, and they would say if they did or not. The registered manager told us they were introducing a procedure for recognising pain through facial expressions to guide staff.