We carried out a review of the data available to us about Unicare Devon on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Unicare Devon, you can give feedback on this service.
Unicare Devon is a domiciliary care service. At the time of this inspection they provided personal care to 80 people.
Not everyone using the service received a regulated activity; CQC only inspects the service received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do, we also take into account any wider social care provided.
People’s experience of using this service and what we found
Since the last inspection there had been a number of changes and improvements to the service. A new registered manager had been appointed and they were supported by a new office-based team. At the last inspection we found there were some aspects of the service that were not fully safe, effective, responsive or well-led. At this inspection all issues had been addressed satisfactorily. Comments from people who used the service included, “I have no complaints whatsoever. They are ‘top notch’. I am so happy with them”, and “I give them 10 out of 10”.
Care plans and risk assessments had been improved. There was a new secure electronic communication system for staff which meant care staff were kept up to date and informed promptly. Care staff told us this was very successful and had made a big difference to the service. The electronic care plans provided detailed information about all aspects of each person’s needs. Any changes to the person’s needs were reviewed promptly and care plans were kept updated.
Safe recruitment procedures were followed. New staff received training at the start of their employment on all topics relevant to their jobs. There was regular updated training and opportunities to gain relevant qualifications. People received their medicines safely. Staff had the equipment and training to protect people from infection.
There were sufficient staff employed to meet people’s needs. The service was in the process of streamlining rotas to give care workers more consistent visits. This was resulting in people having smaller teams of care workers who they knew and trusted. Care workers were positive about their jobs and told us they were willing to do extra hours to cover for vacant shifts when colleagues were off sick or on leave. People told us care workers usually arrived on time and stayed for the correct length of time.
People told us the care workers were always kind and treated them with respect. Comments included, “All the staff are caring - absolutely!” and "The carers are fantastic”. Care workers were observant and noticed when additional assistance may be needed with tasks.
People who used the service and care workers told us the service was well-led. Comments included, “The management team are brilliant! If I ever need them, they are always happy to talk” and “It's a good organisation to work for”. The providers had improved their monitoring systems to enable them to quickly identify any areas where improvements were needed and ensure actions were taken to address these.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was Requires Improvement (published 1 March 2019).
The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
This was a planned inspection based on the previous rating.
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
People’s experience of using this service:
Risks associated with people’s care needs were not always appropriately assessed and risks that staff may have faced were not documented.
The service did not have up to date assessments of care needs and information for staff on how to provide support to people using the service.
Quality assurance systems to assess, monitor and improve the quality and safety of the service were not in place.
Some care files lacked personalised information on how people wanted to have their care delivered. Staff knew people well and reflected what people told us about themselves.
Information was available to people in accessible formats if they needed it. The service treated people with dignity and respect and staff had training in equality and diversity.
People told us that occasionally staff were late but they stayed for the duration of the visit and met their needs.
The service had a caring, person centred ethos, there were several examples where staff had gone over and above what had been expected of them. People and relatives told us staff were kind and caring.
People were offered choice, in how they had their personal care delivered, what food staff prepared for them and what clothes they wore.
People were supported by staff who had been through a robust recruitment process that checked they were safe to work with people who may be vulnerable.
Staff and the registered manager knew how to spot signs of abuse and how to report them. Staff had attended safeguarding adults training.
Staff felt supported by the registered manager and listened to when they gave feedback.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practise. People told us staff asked them for consent before supporting with care tasks.
We found the service was in breach of two regulations relating to safe care and treatment and good governance.
Further information is in the detailed findings below.
Rating at last inspection: Unicare Devon was rated good at its last inspection on 14 July 2016, the report was published on 3 August 2016.
Why we inspected: This was a scheduled inspection based on the previous rating.
Follow up: We will ask the provider to send a report of actions to us within a specific timeframe relating to the breaches of regulation we have identified in this report. We will continue to monitor the intelligence we receive about the service, and invite the provider and registered manager to meet with us regarding how they plan to make improvements to the service.
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.
We visited the office on 14 July 2016. We carried out phone calls to people and their relatives on 18 July 2016. We carried out a home visit on 19 July 2016. At the time of this announced inspection 78 people were receiving personal care from the service. The service had moved offices and this was the first inspection at this location.
People were really pleased with the way staff treated them. Each person we spoke with told us their care workers were kind, caring and compassionate. Comments included “I’m so glad I decided to have care; I’m delighted with them. I have a whole new group of friends”; “The staff are marvellous” and “They’re very helpful and kind, I only have to ask”. Several relatives told us that staff always offered to help them as well. Staff spoke about the people they cared for with compassion and concern. People told us staff were respectful and polite. We saw staff and people interact in a friendly way. People were pleased to see the staff. The staff knew people well and chatted with them with warmth. Staff checked if they could do anything else for people before leaving.
People told us they felt safe and comfortable when staff were in their home and when they received care. People told us "I feel very safe” and “I feel comfortable with them". Staff knew how to recognise signs of potential abuse and understood how to report any concerns in line with the service's safeguarding policy. Safe staff recruitment procedures were in place. This helped reduce the risk of the provider employing a person who may be a risk to vulnerable people.
People told us staff knew how to meet their needs. Comments included "They know my routine” and “They are competent”. Staff told us they were happy with the training they received. Staff told us they felt well supported and had regular opportunities to discuss their work.
Care plans were developed with each person. They described the support the person
needed to manage their day to day health needs. Staff knew people well and were able to tell us how they supported people. We saw staff responded to people's requests, met their needs appropriately, and knew how they liked things to be done.
People told us staff were usually on time and had time to meet their needs in the way they wanted. People were provided with a copy of the staff rota so they knew who was due to visit them. The registered manager told us they tried to ring people with any changes, and the majority of people confirmed this happened. Staff told us they had enough time to travel between visits.
Risk assessments had been undertaken for each person. These included information about action to be taken to minimise the chance of harm occurring to people. We saw risk assessments had been carried out in relation to nutrition, skin care, and mobility. Risk assessments relating to each person's home environment had been completed. Where concerns were identified, action had been taken. A healthcare professional fed back that the care staff had managed one person’s complex needs very well and this had reduced risks for them. The service reviewed incidents and accidents to minimise the risk of them happening again.
People were supported safely with their medicines and told us they were happy with the support they received. Staff completed medication administration record (MAR) sheets after giving people their medicines. The MAR sheets were audited to ensure people had received their medicines as prescribed to promote good health.
The service sought regular feedback. People told us they were asked for feedback over the phone, and during visits and care plan reviews. Some people who lived in the Dawlish area had commented that the office in Newton Abbot was too far away. The service had opened a small office in Dawlish so people could call in and speak with a staff member. One person had recently enjoyed calling in for a cup of tea as they were passing. The provider had received an award for the positive feedback received from people and their relatives. People had submitted their feedback to a website and this resulted in a ‘Top 10 Award’. We saw all reviewers had rated the overall standard as ‘excellent’.
People and their relatives felt able to raise concerns or make a complaint. They were confident their concerns would be taken seriously. People told us they didn't have any complaints. Comments included “I can’t fault them in any way. They do everything” and “No complaints at all”. Where complaints had been received they had been managed in line with the company policy.
People told us the management were approachable and they were happy with the service. Comments included “They’re very approachable and work hard to keep you in the picture”; “I’m very happy with Unicare, I’d recommend them to anyone” and “It’s going extremely well”. Staff told us there was open culture. Staff said “Nothing could be better, the door is always open”; and “It’s open and transparent, I can’t speak highly enough of them”. Staff told us they were able to make suggestions for improvements. For example, staff had identified an issue at weekends. They had not been able to contact senior staff on call if they were carrying out visits. The registered manager cleared the senior’s visits to make sure they were available to take calls.
The registered manager was keen to develop and improve the service. They kept up-to-date with best practice and met up with other care providers to share good practice. Records were clear, well organised and up-to-date. An audit system was in place to monitor the quality of the service. Unannounced checks to observe staff’s competency were carried out on a regular basis.