People’s Choice provides personal care to people who live in their own homes. At the time of our inspection 31 people were receiving personal care. The inspection was unannounced and took place on 16, 17 and 18 November 2016.

The service had a registered manager in post. 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 and associated Regulations about how the service is run.

People were protected from harm or abuse by staff that were aware of the principles of safeguarding and reporting procedures. Risk assessments were in place and risks to people were managed appropriately. Accidents and incidents were recorded should these arise, and the cause analysed, so that preventative action could be taken to reduce the risk of reoccurrence. Staffing levels were sufficient to meet people’s needs and keep them safe. Robust recruitment processes were in place. Safe arrangements were in place for the administration, recording and management of medicines.

There was regular staff training and supervision to ensure that staff had the right skills and knowledge for their roles. The CQC is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) Deprivation of Liberty Safeguards (DoLS) and to report on what we find. We found that people who used the service had capacity to make day-to-day decisions and gave consent before any support was provided by staff. People were provided with nutritional support if this was an assessed part of their package of care.

People were content with the care they received from staff. They were treated with kindness and compassion. Staff understood people’s privacy and dignity needs. They were respectful of the decisions people made.

People had their support needs assessed and reviewed on a regular basis, so that staff knew how to support them to maintain their independence. Care plans contained person centred information. The service had systems to obtain people’s feedback and provide them with opportunities to raise concerns.

There was an open and positive culture at the service, with a clear set of values which people, staff and the management all worked towards. Quality control systems were in place to ensure care was delivered to a high standard and identify areas for development.

We carried out an announced comprehensive inspection of this service on 19 November 2015, during which breaches of legal requirements were found. We found that risk assessments were not robust and did not provide staff with the information they needed to ensure that they could take steps to keep people safe. Those risk assessments that had been completed had not been reviewed on a regular basis to ensure they were an accurate reflection of the risks that were posed to people.

We also found that the provider had failed to ensure that people had accurate and up-to-date person-centred care plans in place. Staff did not have the information they needed to provide people with individualised care and records were accurately maintained. Care plans and daily notes were not reviewed regularly to ensure they were an accurate reflection of people's care and support needs.

We asked the provider to submit an action plan to tell us how they would meet these regulations in the future; they stated that they would be meeting them by 30 March 2016. During this inspection we returned to see if the service had made the improvements they stated in their action plan. We found that the provider was now meeting these regulations.

We undertook this focused inspection on 12 April 2016 to check that they had followed their plan and to confirm that they now met legal requirements. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for People's Choice UK on our website at www.cqc.org.uk.

During our previous inspection on 19 November 2015

People's Choice UK is registered to provide personal care to people in their own homes in and around the town of Bedford. When we inspected the service was providing 22 people with care and support.

The service had 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 legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Improvements had been made to the risk assessments carried out by the service. Risk assessments had been carried out for each person and showed how risk levels had been calculated. They also provided staff with control measures which detailed how they could work to reduce the impact of risks on people's health, safety and well-being.

There had also been improvements made regarding people's care plans and records. Care plans were more person-centred and were reviewed and updated regularly to ensure they were accurate. Records such as daily notes were collected regularly and reviewed to identify trends and update care plans if necessary.

People’s Choice UK provides care and support for adults in their own homes, in and around the town of Bedford. On the day of our visit the service provided support for 12 people.

This inspection was announced and took place on 18 November 2015.

The service had 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 legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People’s risk assessments were not comprehensive and failed to cover areas of potential harm to specific individuals. Risk assessments that were in place had not been regularly reviewed and failed to provide staff with sufficient information about the risks and control measures to reduce them.

Care plans lacked information about people’s specific needs regarding medication. They failed to provide staff with robust procedures regarding medication administration, and as a result, records were not always completed in full.

Staffing levels at the service were such that, at times, staff were late for people’s calls. The provider had identified this area of concern and was in the process of introducing procedures to address it.

People felt they had been involved in planning their own care, along with their family members, however care plans did not evidence this involvement.

The service had not carried out regular reviews of people’s care plans, to ensure they were reflective of people’s current needs and wishes.

People felt safe when receiving care from the service. They were protected from harm or abuse by staff who were knowledgeable about the signs of abuse, as well as procedures for reporting it.

Staff received regular training and support from the provider to ensure they had the required skills and knowledge to meet people’s needs. New staff benefitted from a comprehensive induction and all staff received on-going training and refresher sessions. Staff received regular supervisions to help them discuss their roles and performance and to support their development.

People were supported to prepare food and drink, if they needed help in this area. Staff ensured people had enough to eat and drink and left them with access to drinks and snacks between calls.

The service was able to support people to have access to healthcare professionals, should they require that support.

People were treated with kindness and compassion by staff. They saw regular staff members who had worked hard to develop positive and meaningful relationships with people and their families.

Throughout their care, people were treated with dignity and respect and staff were sensitive to their privacy and independence.

Feedback from people and their family members was welcomed by the service. Feedback which was provided was used to drive improvements to the service, and complaints were handled appropriately.

There was a positive and open culture at the service. Staff worked with the registered manager to ensure people received the care they needed and had a positive experience with the service.

The registered manager had worked to ensure their own ethos and values were evident throughout the service. They were committed to developing an effective service which met people’s needs.

Quality assurance systems were in place to identify areas for improvement and to help develop the service.

We identified that the provider was not meeting regulatory requirements and was in breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.