We conducted an inspection of First Option Healthcare on 2 May 2018. The inspection was announced. We gave 48 hours’ notice of our inspection as we wanted to be sure someone was available to speak with us. This was our first inspection of the service since it was registered in March 2017.

This service is a domiciliary care agency. It provides personal care for people living in their own houses and flats in the community. It provides a service to people of all ages. At the time of the inspection they were supporting eight people all of whom were under the age of 16. Not everyone using First Option Healthcare receives a regulated activity; CQC only inspects the service being received by people provided with ‘Personal Care’ or ‘Treatment of Disease, Disorder or Injury’. Where a person is in receipt of personal care CQC only inspects the service provided to people receiving help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided. First Option Healthcare also provided ‘Treatment of Disease, Disorder or Injury’. This meant they provided nursing assistance to people within their own homes in respect of long-term healthcare conditions.

There was no registered manager at 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. At the time of our inspection the provider had employed a manager who had submitted their application for registration to the CQC. The manager was being supported by a senior manager within the organisation who also assisted us during our inspection.

People’s care records contained detailed and comprehensive information related to their long-term medical conditions as well as clear instructions for nurses and care workers as to how they were expected to manage these conditions. Care records contained detailed instructions about people’s complex nutritional needs and records were kept of people’s nutritional intake.

The provider’s quality assurance systems supported the delivery of good care. The senior manager sought people’s feedback in relation to the care they were receiving during regular, unannounced spot checks of service delivery.

Care and nursing staff understood the principles of the Mental Capacity Act 2005 (MCA). Care records were signed by people’s relatives to indicate their consent to the care provided.

There was an up to date and comprehensive safeguarding policy and procedure in place. Nursing and care staff had a good understanding about their responsibilities to safeguard adults and children.

People’s relatives gave good feedback about staff. Staff ensured people’s privacy and dignity was respected.

Care records contained detailed risk assessments for both nursing and care staff. Risk assessments contained explanations of the known risks to people’s health and safety as well as clear guidelines for staff to follow in the event of an emergency.

Care plans contained details of people’s personal preferences in relation to their care and staff demonstrated a good understanding of these.

People’s families were involved in the creation and ongoing management of their care plan. Care records included information about how people’s families were involved in their care as well as information about the need to provide daily updates to family members about the care and support given.

The provider’s staff recruitment procedures ensured staff were suitable to work with people using the service. Staff records included evidence of comprehensive background checks to help ensure only suitably qualified and experienced staff were employed to care for people. The provider ensured there were a sufficient number of staff to meet people’s needs.