Unique Domiciliary Care Ltd Head Office

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. This is the first assessment for this service. This key question has been rated required improvement. This meant some aspects of the service were not always safe and there was limited assurance about safety. There was an increased risk that people could be harmed.

The service was in breach of legal regulation in relation to the safety of care provided.

This service scored 59 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a positive culture of safety where incidents were reported and reviewed, but full records were not always kept to improve ongoing practice. Records showed accidents and incidents were documented with actions taken and follow-up actions identified. However, people’s risk assessments and care plans did not always contain full details about the risks to people’s care so staff had clear records for ongoing management of their needs.

Care staff understood the procedure they were required to follow when things went wrong. One care worker told us, “We have policies for when things go wrong. You’re supposed to report things to the manager”. The registered manager described how learning was shared through handovers, team meetings and supervision, using anonymised examples to support staff understanding.

The provider worked with people and partners to ensure safe transitions between services. Processes were in place to gather relevant information before care commenced, including care plans, risk assessments and input from professionals, supporting continuity of care. Records showed care plans and risk assessments were updated following hospital admissions to reflect changes in need. The registered manager explained that, “We gather as much information as possible beforehand… so we fully understand the person’s needs before we start.”

The provider had systems and processes in place to keep people safe from abuse and avoidable harm. Clear safeguarding and whistleblowing policies were in place and understood. The registered manager confirmed there had been no safeguarding incidents since the service began operating, but both the registered manager and staff demonstrated a good understanding of their responsibilities. People’s relatives told us they felt safe using the service. One relative told us their family member was “completely safe and confident” with their care worker.

The provider involved people in assessing risks, however, recording systems were not always sufficiently detailed. The registered manager described asking a full set of questions when assessing risks, but documented risk assessments only included brief summaries rather than full detail of the risks to people’s health and safety. Records did not clearly evidence what questions had been asked when conducting risk assessments, so it was not clear whether risk assessments had fully explored all the potential risks to people’s health and safety. We therefore could not be assured full risk assessment had been conducted.

There was no evidence this had negatively impacted people, but the lack of detail limited oversight of how risks were assessed and managed.

This was a breach of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

The provider completed environmental risk assessments, however, these lacked sufficient detail. Records showed that general home risk assessments were undertaken, including checks for trip hazards, fire safety and access. However, documentation recorded conclusions rather than clearly evidencing what was assessed. Despite this, a relative reported the manager completed a thorough pre-assessment of the home environment.

Systems were in place to recruit and support staff, but improvements were required in record keeping and oversight. Pre-employment checks, including Disclosure and Barring Service (DBS) checks and references, were completed, and staff received induction and training. However, original reference verification emails were not available, so their authenticity could not be confirmed at the time of inspection.

The provider had systems in place to assess and manage the risk of infection. An infection control policy was in place and understood. The registered manager completed regular spot checks, including checks on cleanliness within people’s homes. These checks helped monitor standards and identify any areas for improvement. Inspection findings confirmed that appropriate policies and processes were in place to support safe infection prevention and control practices.

The provider had systems in place to manage medicines safely, although they were not currently supporting people with medicines administration at the time of the inspection. There was a clear medicines policy and process, and a Medication Administration Records (MAR) charts system was prepared for future use. The registered manager confirmed that systems and staff training were in place should medicines support be required. This demonstrated preparedness to safely manage medicines in line with people’s needs as the service develops.