Archived: Unique Home Care Limited

During this inspection, the inspector answered five key questions; is the service safe, effective, caring, responsive and well-led? We found improvements had been made.

Below is a summary of what we found. The summary describes what we observed, the records we looked at and what the staff told us. Due to the nature of this inspection we did not seek the views of service users. If you want to see the evidence that supports our summary please read the full report.

Is the service safe?

People were properly safeguarded by the agency. This was because staff reported adult protection incidents to the local authority safeguarding team. The staff that we spoke to understood the procedures they needed to follow to ensure that people were safe. They were able to describe the different ways that people might experience abuse and the correct steps to take if they were concerned that abuse had taken place.

Systems were in place to make sure that the manager and staff learned from events such as accidents and serious incidents, complaints, concerns and investigations. This was because there was follow up action or outcomes to investigations.

Staff recruitment practice was safe and thorough. This meant people who were suitable, were employed by the agency and worked in positions of trust with vulnerable people. Care plans reflected people's current needs with respect to managing their medicines.

Is the Service Effective?

People's health and care needs were assessed with them by their social worker. Where people who had very complex needs, we found there was detailed information to guide staff about how to meet these needs safely. We also found systems were in place to make sure staff turned up and were on time for their calls.

Is the service caring?

Due to the nature e of this inspection we did not obtain people's views about the service.

Is the service responsive?

The agency had an effective complaints procedure. We looked at how complaints had been dealt with and found that responses had been thorough. People could therefore be assured that their complaints would be investigated and action taken as necessary.

Is the service well-led?

Since the last inspection the provider had appointed an acting manager who had implemented significant changes and improvements in the way that the service operated. The service now had an effective quality assurance system. Records we looked at showed where shortfalls were identified these were promptly addressed and the provider learned lessons from mistakes and took measures to avoid them in future. This helped to ensure that people received a good quality service at all times.

We found records could be promptly located. All essential records we looked at, such as people's care records and staff recruitment records were up to date and accurately completed.

Below is a summary of what we found. The summary is based on our observations during the inspection, talking with people who use services, speaking with the staff supporting them and from looking at records.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

Systems were not in place to make sure that the registered manager and staff learned from events such as accidents and serious incidents, complaints, concerns and investigations. This was because there was no evidence of follow up action or outcomes to investigations.

Staff recruitment practice was not safe and thorough. This meant people who were unsuitable, were employed by the agency and worked in positions of trust with vulnerable people.

People were not properly safeguarded by the agency. This was because staff did not report adult protection incidents to the local authority safeguarding team.

Care plans did not always reflect people's current needs with respect to managing their medicines.

Is the service effective?

People's health and care needs were assessed with them by their social worker. However, where people who had very complex needs, we found there was very little information to guide staff about how to meet these needs safely. We also found sometimes care staff turned up late for their calls or not at all. We found on one occasion staff had 'forgotten' to give someone their medication and meal. On another occasion a member of staff had not reported that they had smelled gas in a person's home.

Is the service caring?

People were supported mostly by kind staff. People told us 'They are alright. They are very nice. They do very well they do,' 'I am quite happy. They are champions and I really appreciate them.'

Is the service responsive?

The agency did not have an effective complaints procedure. We looked at how complaints had been dealt with and found that responses had not been thorough. People could therefore not be assured that their complaints would be investigated and action taken as necessary.

Is the service well-led?

The service had a quality assurance system. However, records we looked at showed shortfalls were not addressed. There were gaps in key areas of the agency's performance which should have been monitored and in some areas, checks of how the service was performing did not take place at all. This did not help to ensure that people received a good quality service at all times.

We found records could not always be promptly located and both a paper and computerised system were in operation, which caused confusion. Some essential records were incomplete such as people's care records and staff recruitment records.

We saw people were fully involved in decisions about their care. One person said 'Someone came out to visit me and asked me what help I needed.'

People described how their care and welfare needs were met. Comments included 'I couldn't manage without them now. They make my breakfast and tea and make me something for supper. They have increased my care as I have needed it.' Another person said 'They increased my calls when I came out of hospital. They are absolutely fantastic.'

The manager had made suitable arrangements to protect vulnerable people and respond appropriately to any allegation of abuse. One person said 'I can say anything to Janet (supervisor). She would listen to me.'

We saw appropriate records were kept of peoples' medicines so staff were clear about the support each person needed.

We found there were enough staff to meet people's needs. People who used the service told us the correct number of staff always turned up and that they were generally on time.

We saw the provider had a system to regularly assess and monitor the quality of the service people received.