Unique Domiciliary Care Ltd Head Office

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• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

Well-led – this means we looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture.

This is the first assessment for this service. This question has been rated requires improvement. This meant the management and leadership was inconsistent. Leaders and the culture they created did not always support the delivery of high-quality, person-centred care.

The service was in breach of legal regulation in relation to how well the service was governed.

This service scored 62 (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 shared vision, strategy and culture that was understood and embedded across the service. This was based on delivering person-centred care, dignity and respect, and promoting independence. Leaders clearly defined organisational values, including openness, collaboration and professionalism, and outlined a strategy focused on delivering flexible care in people’s homes and improving outcomes through feedback and monitoring.

Staff were supported to understand and apply these values through recruitment processes, induction, supervision and ongoing training. Leaders reinforced expectations through regular oversight, team communication and observations of practice.

There was evidence of a positive and transparent culture where feedback was encouraged from staff and people using the service. Systems such as supervision and spot checks were used to promote consistency in practice and ensure care reflected organisational values.

The provider had capable and compassionate leadership, and staff spoke positively about the management approach. There was evidence that leaders were approachable, supportive and promoted an inclusive culture within the team. Staff described feeling supported in their roles and able to approach the manager for guidance. This indicated that leaders had established trusting relationships with staff and were visible within the service.

Relatives gave good feedback about the registered manager. One relative told us the registered manager was “very helpful, friendly and easy to reach. Whenever I have a question, need to change a visit, or have a small query, she answers the phone quickly and sorts it out straight away. I feel supported by the whole team.”

Leaders demonstrated an understanding of their responsibilities and the requirements of the role, including oversight of care delivery, recruitment and support for staff. They led by example and promoted person-centred care and respect in line with the organisation’s values.

The provider promoted a culture where people and staff felt able to speak up and raise concerns. Clear processes were in place for providing feedback, raising concerns and making complaints, and these were communicated in accessible ways. People using the service and staff were supported through a range of mechanisms, including feedback forms, telephone contact, care reviews and direct communication with management. Leaders ensured concerns were recorded, reviewed and responded to in a timely way.

Staff feedback confirmed they felt confident raising concerns and believed that the manager would take action. One member of staff told us they felt comfortable speaking up if needed and trusted that issues would be addressed. There was no evidence of a blame culture, and leaders promoted reassurance that raising concerns would not lead to negative consequences. This supported an open and transparent working environment.

The provider promoted equality, diversity and inclusion within the workforce and demonstrated a commitment to fair and inclusive practices. Recruitment processes were described as fair and based on skills, values and suitability for the role.

Staff received training in equality, diversity and human rights, and leaders promoted a culture where differences were respected and valued. The service encouraged staff to express their views and individuality and addressed any discriminatory behaviour appropriately. One care worker told us the registered manager “does respect us all- we all respect different religions and different cultures”.

Feedback from staff confirmed that diversity was respected within the team and that the manager promoted an inclusive working environment. Although formal documentation such as job descriptions was limited, overall the service demonstrated a positive approach to equality and inclusion, supporting staff to work in a respectful and person-centred way.

The provider did not always have effective governance systems in place to ensure high-quality and sustainable care. While roles and responsibilities were understood within the small team structure, there were gaps in formal systems and oversight.

Leaders described a clear structure and responsibilities and there was an organisational chart in place. However,, the registered manager was not always clear about the need for detailed record keeping in care plans and risk assessments. This was reflected in wider findings across the assessment. Risk assessments and care plans often lacked detailed documentation, with only conclusions recorded rather than full assessments.

There were gaps in governance processes, as audits did not identify the issues we found with care plans and risk assessments. Although the provider showed willingness to improve and had begun reviewing documentation and processes, governance systems were not yet fully embedded or consistently effective in monitoring quality and mitigating risks.

This was a breach of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

The provider worked in partnership with others to support people and understood the importance of collaboration. Leaders recognised their responsibility to liaise with external professionals, such as healthcare services, when required.

The registered manager demonstrated awareness of how to engage with partners to ensure people received coordinated care. Other areas of the assessment showed examples of communication with professionals, such as GPs and hospital teams, and sharing information to support continuity of care. Overall, the service was able to work collaboratively with others to meet people’s needs and support positive outcomes.

The provider did not always have robust systems in place to support continuous learning, improvement and innovation. While the registered manager described a range of checks and reviews, these had not identified the wider concerns we found with record- keeping. Furthermore, there was no evidence of wider independent checks of the systems in place thereby minimising the opportunity to independently identify issues.

Although there was a clear intention to improve and some learning processes in place, these were not yet sufficiently developed to ensure consistent and effective improvement across the service. After our assessment, we noted that some changes had been made to auditing procedures as required.