Universal Care Services Hinckley

Universal Care Services Hinckley is a domiciliary care service providing personal care to 251 younger adults and older people with dementia, physical disabilities, mental health needs, sensory impairments and learning disability or autistic spectrum disorder.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

People’s experience of using this service and what we found

There was no registered manager in post. The provider had appointed an acting manager that had applied to be registered with the CQC. They supported the provider to monitor the quality of the service and ensure the regulatory requirements were met. Quality assurance systems and processes identified where improvements were needed and action was taken to address these. However, we found further improvements were required to improve call times, prevent missed calls, respond to calls to the office and the recording of medicines.

People told us they received their medicines as prescribed. However, staff did not always record medicines administration on the correct documentation. The service had identified this and acted to address it. However, further improvements were required including the implementation of an electronic Medicines Administration Record (MAR) whereby office staff would be alerted if medicines were not administered.

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. Staff offered people choice’s when delivering their care.

Staff knew how to recognise, and report suspected abuse. They had been safely recruited and had access to the training they needed to meet people’s individual care needs. Staff had a good knowledge of people’s moving and handling needs. Staff had access to personal protective equipment to minimise and control the spread of infection. Staff felt well supported by the management team.

People were supported to eat and drink enough by staff that knew their preferences and wishes, they ensured people had snacks and drinks available before they left their home. Staff contacted health professionals as needed and had received specific training to meet people’s individual needs.

People were supported by staff that were kind and caring. Staff respected people’s privacy and dignity and involved them in decisions about their care. Staff knew people’s hobbies, interests, preferences and wishes.

There had been improvements in the management of complaints. These were managed in line with the providers complaints policy. Some people found it difficult to contact the office to discuss their day to day care needs or raise concerns.

Staff knew how to provide person centred care, and the information included in people’s care plans about their likes, dislikes, hobbies and interests assisted with this. Staff enjoyed spending time with people.

The service understood their requirements in relation to duty of candour and were open and honest with us during our inspection. They worked with partner agencies such as commissioners and healthcare professionals to meet the needs of the people receiving care from the service.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (Published 29 October 2018) and there were breaches of regulation. Since this rating was awarded the service has moved premises and changed its name from Universal Care Services Nuneaton to Universal Care Services Hinckley.

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 regulation.

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

There was a registered manager in post. 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.

At the last inspection, during March 2017, the service was rated ‘Requires Improvement’ overall. We found the service was not consistently responsive to people’s needs because they had not ensured staff always had the information they needed to support people in a way they wanted. Quality monitoring systems were not always effective and the service was not consistently well led.

At this inspection we found some areas of improvement had been made. However, the overall quality of services provided had not been sufficiently improved and some previously good areas had not been sustained. We found two breaches of the regulations. The overall rating given to the service continued to be Requires Improvement.

People, relatives and care staff felt some improvements had started to be made from February 2018 onwards, when a new management structure was put into place by Clece Care. However, people felt further improvements were needed. Prior to our inspection visit, the provider had recognised improvements in the service delivery were required to ensure people received a safe, effective, caring and responsive service.

The provider had appointed a business consultant who was supporting them to introduce more effective systems to check the quality of the service provided and identify actions needed to help it improve. Many of these were ‘work in progress’ or planned for; with timescales for implementation.

People’s health, safety and wellbeing was not consistently maintained because, on occasions, some people experienced missed or late calls. Risk management plans did not always contain the information needed so that staff knew how to safely move and handle people using equipment. Staff were trained and, overall, had the skills and knowledge they needed. The effectiveness of moving and handling needed to be improved upon. Staff did not always ensure they wore their identity badge when undertaking call visits to people in their homes.

People knew how to make a complaint about the services they received when these fell short of their expectations. However, complaints were not always recorded, investigated or responded to.

The provider undertook pre-employment checks prior to staff starting work, to ensure their suitability to provide care and support to people. Staff were trained to protect people from the risks of abuse.

Staff had received training in the Mental Capacity Act 2005 and, overall, worked in line with this to promote people’s best interests. Staff gained consent before, for example, supporting people with personal care.

There were enough staff employed to undertake care calls to people and meet their individual needs, although rota care call scheduling meant care calls did not always take place at the times arranged.

People were supported to eat and drink enough and care staff left people with drinks when needed.

We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

You can see what action we told the provider to take at the back of the full version of the report.

Universal Care Services Nuneaton provides domiciliary care to people in their own homes. At the time of our inspection, 177 people were supported with care.

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.

The home was last inspected on 19 May 2015, when we found the provider was compliant with the fundamental standards described in the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The service was rated ‘good’ overall.

People and their relatives told us they felt safe with the staff who supported them. Staff received training to safeguard people from abuse. They were supported by the provider, who acted on concerns raised and ensured staff followed safeguarding policies and procedures. Staff understood what action they should take in order to protect people from abuse. Risks to people’s safety were identified and staff were aware of current risks, and how they should be managed.

People told us they were administered medicines by staff safely and as prescribed. However, there were some gaps in medicine records.

There were enough staff to meet people’s needs effectively. The provider conducted pre-employment checks prior to staff starting work, to ensure their suitability to support people who lived in their homes.

People told us staff asked their consent before undertaking any care tasks. Where people were able to make their own decisions, staff respected their right to do so. People’s care records did not always include information on the support they needed with decision making. However, staff and the registered manager had a good understanding of the Mental Capacity Act (2005).

People and relatives told us staff were respectful and treated people with dignity, kindness and respect. People’s privacy was maintained. People were supported to make choices about their day to day lives.

People saw health professionals when needed and the care and support provided was in line with what they had recommended.

People’s care records were not always up to date and did not always give staff key information they needed to respond to people’s needs consistently. People were not always supported by regular staff, and were not always informed if staff were going to be late.

People and relatives told us they felt able to raise any concerns with the registered manager. They felt these would be listened to and responded to effectively and in a timely way. Staff told us the registered manager and senior staff were approachable and responsive to their ideas and suggestions.

Systems in place to check the quality of the service provided and to help it improve were not effective. The provider did not ensure staff had the opportunity to meet to share good practice, and did not ensure staff performance was assessed regularly to check they remained competent in their roles.