Ultimate Independence Care Ltd

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 newly registered service. This key question has been rated good. This meant people were safe and protected from avoidable harm.

This service scored 72 (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 proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

The registered manager reviewed all accidents and incidents to ensure they were investigated and actioned to identify any themes or trends. Lessons learnt and reflective practices were discussed with staff. The registered manager agreed to improve documentation around lessons learnt and to apply a consistent approach to notifying CQC of incidents.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

The provider worked closely with stakeholders to assess whether their model of care and staffing capacity could accommodate potential care packages. A comprehensive assessment of people’s support requirements was completed to ensure the service could meet their needs. The provider was reviewing and updating their literature to ensure people received had the information they needed about the service in an accessible format.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately.

Systems were in place to safeguard people from abuse and harm. A safeguarding policy was in place and helped to inform the safeguarding lead and staff of their role and responsibilities around safeguarding. For example, financial management and oversight systems were in place to protect people from financial abuse. People and their relatives said they felt safe when being supported by staff.

Staff had been trained in safeguarding and felt confident to report any concerns of abuse. One staff member said, “It's part of my role to make sure people are safe.”

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

People’s physical and emotional needs were assessed, recorded and managed in accordance with their individual care needs. People’s care and risk management plans were detailed; however, we found some inconsistencies in the accuracy and completeness in certain areas of people’s record. The registered manager was responsive to our feedback and took action to address our concerns. We found no impact on people as staff demonstrated a good understanding of the people they supported and said they felt confident in managing people’s risks.

Where required, positive behaviour support plans provided staff with guidance and outlined support strategies and triggers for each person to help reduce people’s anxiety and to enhance their quality of life. Staff interventions had successfully enhanced the quality of people’s life by actively promoting inclusion, choice, participation, and equal opportunities.

Staff had access to a dedicated on-call system for guidance and support during out-of-hours periods.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

The registered manager worked collaboratively with health care professionals to ensure people lived in a safe environment. Staff were aware of the need to report any concerns about people’s safety or unmet needs relating to their environment and equipment.

The provider made sure there were enough qualified, skilled and experienced staff. However, records relating to the provider’s recruitment practices needed to improve. We reviewed 3 staff recruitment files and found there was limited evidence of the provider’s discussions with staff about their reasons for leaving and gaps in their previous employment. We were told staff’s previous employment was discussed during the interview process but not fully recorded. Following our feedback, the provider revised their recruitment policies and forms to ensure more consistent recording of employment gaps and reasons for leaving

New staff had received training and worked alongside experienced staff to develop their skills for their role. Staff told us they felt supported by the registered manager and well trained. We found staff knowledgeable and confident about their role. The registered manager told us staff received additional training and support during team meetings and supervisions. The provider had ensured staff had received training in how to interact appropriately with people with a learning disability and autistic people; however not all staff had received training appropriate to their role in accordance with ‘The Oliver McGowan Code of Practice’. This was raised with the registered manager who stated they would take immediate action to address this shortfall.

People and their relatives/representatives raised no concerns about staff training. One relative said, “They seem to be competent. We have not had any issues.” Another relative said, “They [staff] are kind, come with a smile and know what they are doing. They are well trained, they have a warm approach, we are grateful to them.”

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

Staff had access to the provider’s infection prevention and control (IPC) policy and were aware the importance of good personal protective equipment (PPE) and good hand hygiene. Their IPC practices were continually monitored by the team leaders and registered manager.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened.

People received their medicines in line with their prescription. Staff had received training in medicines management, and their competency was assessed before they were authorised to administer medicines. The registered manager was aware of the STOMP principles (Stopping Over Medication of People with a learning disability, autism, or both) and worked with people and staff to ensure people were not over prescribed with medicines which negatively affected their well-being.

Staff had access to the provider’s medicines policy which reflected national guidance and the principles of safe medicines management and STOMP.