We carried out a focussed inspection of this service on 28 April 2017 and 02 May 2017.

When we last inspected the service on the 23 and 24 January 2017 the outcome of the inspection was Good in all areas and we had no concerns.

Choices Healthcare Limited provides care services to people within their own homes. Care services include personal care, a sitting service and domestic services. The service provided are either through private arrangement or social services funding. The service covers Southend on Sea and Essex.

The service had a registered manager who was also the registered provider of the service. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are 'registered persons'. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

In April 2017 we received some concerns around the service recruiting staff aged between 16-18 and not having appropriate safety measures in place when they are lone working. We found the service to have appropriate measures in place in regards to safe recruitment and in light of the concerns that had been raised the registered manager reviewed the recruitment process as to ensure additional support was made available for staff aged between16-18.

We also reviewed records relating to an incident whereby care staff had left a person's home without turning off the cooker. The registered manager has cascaded a message to all staff reminding them that staff are not to prepare a meal using a cooker unless a risk assessment has been completed.

Choices Healthcare Limited provides care services to people within their own homes. Care services include personal care, a sitting service and domestic services. The service provided are either through private arrangement or social services funding. The service covers Southend on Sea and Essex.

At the last inspection, the service was rated overall Requires Improvement as improvement needed to be made in the Safe and Well Led domains. At this inspection we found the service had made some improvement.

The service was safe. The service’s recruitment process ensured that appropriate checks were carried out before staff commenced employment. There were sufficient staff to meet the needs of people and keep them safe from potential harm or abuse. People’s health and wellbeing needs were assessed and reviewed to minimise risk to health. We found one record that needed to be addressed, the manager assured us this would be addressed immediately.

The service was effective. People were cared for and supported by staff who had received training to support people to meet their needs. The registered manager had a good understanding of their responsibilities in relation to the Mental Capacity Act 2005. People were supported to eat and drink enough as to ensure they maintained a balanced diet and referrals to health and social care services was made when required.

The service was caring. Staff cared for people in an empathetic and kind manner. Staff had a good understanding of people’s preferences of care. Staff always worked hard to promote people’s independence through encouraging and supporting people to make informed decisions.

The service was responsive. People and their relatives were involved in the planning and review of their care. Care plans were reviewed on a regular basis and also when there was a change in care needs. People were supported to follow their interests and participate in social activities. The service responded to complaints received in a timely manner.

The service was well-led. Staff, people and their relatives applauded the manager and informed us they were supportive and worked hard to provide a good service. The service had systems in place to monitor and provide good care and these were reviewed on a regular basis. The registered manager acknowledged that some of the systems and processes needed to be improved.

This inspection took place on the 13 April 2016 and 14 April 2016 which was unannounced, the inspection team consisted of one inspector on both days.

Choices Healthcare Limited provides care services to people within their own homes. Care services include personal care, a sitting service and domestic services. The service provided are either through private arrangement or social services funding. The service covers Southend on Sea and Essex.

The service has a registered manager. ‘A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.’

Medication practice required improvement to ensure that people received their medication as prescribed. The quality assurance system needed to be improved to ensure that it is effective in all areas of the service including medication management.

The manager had some systems in place to identify and monitor the safety and quality of the service however they had provided to be ineffective as they either did not recognise the shortfalls or when they did there was a lack of action to rectify them.

Suitable arrangements were in place to ensure that people received appropriate care and support to meet their needs. Staff knew the needs of the people they supported and they were treated with respect and dignity. People’s healthcare needs were well managed and they had access to a range of healthcare professionals.

People’s needs were met by sufficient numbers of staff. Suitable arrangements were in place to ensure that staff had been recruited safely; they received opportunities for training and supervision. People were safeguarded from harm; Staff had received training in Mental Capacity Act (MCA) 2005. People were supported to ensure they had sufficient amounts to eat and drink to ensure that their dietary and nutrition needs were being met was required.

People were provided with the opportunity to participate and engage in activities of their choice which met their needs. Relatives and people who used the service knew how to make a complaint and we felt reassured that all complaints would be dealt with and resolved efficiently and in a timely manner.

The service had a number of ways of gathering people’s views which included holding meetings with staff and carrying out annual service user surveys.

We carried out a responsive inspection of this service due to receiving some concerning information relating to staff being employed without proper recruitment checks being completed. Appropriate recruitment checks ensure that vulnerable people using the service are safe from inappropriate staff being employed.

Due to the nature of the concern we did not speak with people using the service as they did not have involvement in the recruitment process. We spoke with three care staff about the recruitment process and induction. We found that appropriate checks were completed prior to new staff being employed.

This inspection took place on 20 and 21 May and 12 June 2015.

Choices Healthcare Limited provides personal care and support to people within their own homes. They also provide domestic and sitting services.

There has been a registered manager in post since the service first registered on 6 November 2012. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Medication practice required improvement to ensure that people received their medication as prescribed.

The quality assurance system needed to be improved to ensure that it is effective in all areas of the service including medication management.

Staff had a good understanding of how to protect people from the risk of abuse; they had been trained and had access to guidance and information to support them with the process. Risks to people’s health and safety had been identified and there were plans in place to manage them.

People had mixed views about the timing of their visits.

Staff were safely recruited because the recruitment processes were thorough and the service was actively recruiting new staff. Staff were well trained, supervised and supported.

People received personalised care that was responsive to their needs. The care plans met people’s needs and preferences and provided them with good support.

People were treated respectfully and staff listened to what they had to say, their views and opinions were taken into account and people felt involved.

Complaints and concerns were dealt with appropriately.