Options Health Care Services remained rated Requires Improvement for a second consecutive inspection, with a confirmed breach of Regulation 17 (Good Governance) due to ineffective oversight systems failing to address persistent late calls and incomplete risk assessments. Strengths included safe medicines management and positive staff-client relationships, but ongoing governance failures and poor incident-learning processes continued to present risk.
Concerns (8)
criticalGovernance: “The lack of effective monitoring and oversight of the service was a breach of Regulation 17 of the Health and Social Care Act (Regulated Activities) Regulations 2014.”
moderateCare planning: “People did not always have completed risk assessments following a review of people's care needs. For example, where people were at risk of skin breakdown or had experienced a seizure.”
moderateMissed or late visits: “Call records confirmed that staff could be in excess of an hour late and arrived earlier than the agreed times.”
moderateIncident learning: “Analysis of themes, trends or patterns were not assessed. Staff were not always informed of the outcome from these incidents to enable them to reflect on their practise.”
moderateRecord keeping: “Care plans and risk assessments required further information to ensure these were complete...oversight and monitoring systems had not identified a lack of risk assessment or care plan.”
moderateSupervision / appraisal: “Staff meetings did not discuss staff views, suggestions or ideas, or review accidents or incidents, complaints, or share feedback from quality audits.”
minorInfection control: “People told us that staff did not always wear their masks when providing personal care to people which was their preference and they needed to remind staff.”
minorCommunication with families: “Changes within the staffing structure meant people and relatives found communication from the office was variable.”
Strengths
· People received their medicines as prescribed and regular audits were carried out to ensure safe management of medicines.
· People felt safe with the care provided and spoke positively about long-standing staff, describing them as like family.
· Staff knew how to recognise signs of abuse and how to report concerns internally and externally.
· The registered manager was accessible and responsive; people felt involved and informed.
· The provider responded immediately during and after the inspection, organising training and reassessing people's health needs.
Quality-Statement breakdown (8)
safe: Assessing risk, safety monitoring and managementRequires improvement
safe: Staffing and recruitmentRequires improvement
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Using medicines safelyGood
safe: Preventing and controlling infectionRequires improvement
well-led: Managers and staff being clear about their roles and understanding quality performance, risks and regulatory requirementsRequires improvement
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringGood