Top Option Healthcare Limited provides personal care and support to people who require assistance in their own home. This service is a domiciliary care agency. At the time of our assessment 10 people were being supported by the service. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided. We carried out our on-site responsive assessment on 05 February 2025, offsite activity started on 1 February 2025 and ended on 7 February 2025. The assessment was completed to follow up on the last assessment to see if improvements had been made. We found the service had made improvements and are no longer in breach of regulations. The registered manager now had systems in place to monitor the service, which provided good oversight to monitor and improve outcomes for people. This assessment was announced.
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Top Option Healthcare Limited provides personal care and support to people who require assistance in their own home. This service is a domiciliary care agency. At the time of our assessment 10 people were being supported by the service. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided. We carried out our on-site responsive assessment on 3 July 2024, offsite activity started on 01 July 2024 and ended on 10 July 2024. We looked at 8 quality statements; Learning culture; Safeguarding; Involving people to manage risks; Safe and effective staffing; Medicines optimisation; Capable, compassionate and inclusive leaders; Freedom to speak up; Governance, management and sustainability. This assessment was announced. We found 3 breaches of the legal regulations in relation to safe and effective staffing, good governance and the notification of incidents. We have made a recommendation about end of life wishes.
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Top Option Healthcare Limited, a small domiciliary care agency in Southend-on-Sea, received an overall rating of Requires Improvement at its first inspection in October 2022, with breaches of Regulation 17 (Good Governance) identified due to ineffective audits, gaps in staff recruitment records, missing PRN medication protocols, and absence of formal supervision records. People and relatives praised the caring, compassionate staff and reported no missed calls, with Good ratings awarded for caring and responsive domains.
Concerns (6)
criticalGovernance: “Due to the lack of formal governance, lack of oversight with elements of medicines management, staff training and formal support for staff this placed people at risk of receiving poor quality of care.”
moderateRecord keeping: “gaps in staff recruitment files, such as not having a full employment history and staff were employed before relevant references were obtained. References received were not verified.”
moderateMedication management: “We found protocols missing in some records for medicines prescribed as required (PRN). Protocols are important as they help staff understand when it is appropriate to offer PRN.”
moderateSupervision / appraisal: “there were no formal supervision records kept on staff files and we there were only two completed spot checks.”
moderateGovernance: “Audits were ineffective and not reviewed regularly. We found these to be mostly tick box audits, without action plans attached or with timescales for completion.”
minorStaff training: “Staff had not started the Care Certificate. The registered manager told us they are in the process of starting The Care Certificate.”
Strengths
· People felt safe and staff knew how to protect them from abuse; no open safeguarding incidents at time of inspection.
· Sufficient staffing levels; no missed or late calls reported by people using the service.
· Detailed, personalised support plans reflecting people's needs, likes, dislikes and health conditions.
· Positive feedback from people and relatives about compassionate, respectful and attentive care.
· Staff received mandatory training and appropriate induction including shadow shifts.
Quality-Statement breakdown (22)
safe: Staffing and recruitmentRequires improvement
safe: Using medicines safelyRequires improvement
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Assessing risk, safety monitoring and managementGood
safe: Preventing and controlling infectionGood
safe: Learning lessons when things go wrongGood
effective: Staff support: induction, training, skills and experienceRequires improvement
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawGood
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
caring: Ensuring people are well treated and supported; respecting 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 ensure people have choice and control and to meet their needs and preferencesGood
responsive: Meeting people's communication needsGood
responsive: Improving care quality in response to complaints or concernsGood
responsive: End of life care and supportNot rated
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsRequires improvement
well-led: Engaging and involving people using the service, the public and staff, fully considering their equality characteristicsRequires improvement
well-led: How the provider understands and acts on the duty of candour; Promoting a positive cultureGood
well-led: Continuous learning and improving care; Working in partnership with othersGood