Unite Highland Care Limited

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. At our last assessment we rated this key question Inadequate. At this assessment the rating has changed to Good. This meant people were safe and protected from avoidable harm.

At this assessment we identified that the provider had improved systems and processes to keep people safe. There were some areas that improvements were still needed, such as medicines management, and ensuring that care plans and risk assessments contained sufficient person-centred guidance. However, other areas had improved including safeguarding processes, the safe allocation and recruitment of staff and infection prevention and control strategies.

This service scored 69 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Since our last assessment, the provider had implemented a new process to ensure that all incidents were documented. All incidents were collated on a matrix, which the provider reviewed to ensure that appropriate action had been taken. For example, when a person had an unwitnessed fall action was taken to refer them for support from other healthcare professionals. This included ensuring that appropriate authorities were informed about events as required.

Since our last assessment, 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, including for example when people went into hospital. People were now involved in their care and treatment, through care reviews and regular calls with staff. Following reviews of care, risk assessments and care plans were updated appropriately.

The provider had implemented new processes and systems to ensure that safeguarding concerns were documented, reported and reviewed for analysis. All incidents were now documented, and concerns escalated to the provider to share with the local authority safeguarding team. The provider had implemented a new safeguarding log that captured all incidents, and actions taken to address the incidents, and learn and improve. Concerns were now being shared appropriately with the local authority safeguarding team.

Since our last assessment, the provider had reviewed and improved people’s care plans and risk assessments. There was now mostly guidance in place to inform staff how best to support people with complex health conditions, and how to escalate concerns about these, for example diabetes. The provider had worked with people where possible to involve them in creating their care plans. However, there were still some areas where care plans and risk assessments needed to be improved or needed more clarity. For example, where people were supported by other organisations or providers it was not always clear within the guidance who was responsible for parts of care and support. People we spoke with, and staff knew the remits of each organisation. We discussed this with the provider, who agreed that improvements could be made. People and relatives told us they felt safe, and that their loved one was safe.

Since our last assessment, the provider now detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. Following our last assessment, the provider removed CCTV that was in place in some people’s houses. The provider supported people to raise concerns about their accommodation when needed, for example, when one person’s house needed some improvements the provider raised this with the landlord and these were completed.

Since our last assessment, the provider had made improvements with the arrangements of staff. We saw that staff travel time was allocated to staff to ensure they had time to travel between care calls. Staff told us that since our assessment, the allocation of work had improved, and that staff were given notice in relation to rotas. Staff also told us that the opportunity to take annual leave had improved, which increased their well-being.

We found that the provider followed safe systems and processes to recruit staff. Staff had received a mixture of online training and face to face training, and following this the provider had assessed their competency in areas including medicines management and supporting people with epilepsy.

People and relatives fed back positively about staffing. A relative told us, “We’ve never had missed call. I generally get a phone call when they’re going to be late.” Another relative told us, “They (staff) are very pleasant people. They have 2 carers who alternate, they are brilliant.”

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. People and the relatives we spoke with told us that staff used appropriate personal protective equipment (PPE). Comments included, “They always wear gloves, aprons and masks,” and “They always wear PPE.” The provider completed ‘spot checks’ regularly to check that staff were following good infection prevention and control procedures including washing their hands.

Since our last assessment, the provider had made improvements with their medicines administration and management. There was now a safe system in place to support people if they needed to take their medicines out with them. People’s capacity around medicines administration was assessed, and people had been supported to have medicines reviews to ensure that the medicine prescribed to them was still necessary. Where people were supported with medicated creams, staff documented this to ensure there was a clear record of the support the person received. However, when staff administered medicines to people, there was no count down sheet to inform them how many medicines remained in stock to ensure that people had received the medicine as prescribed. We discussed this with the provider who informed us they would implement this to support their medicines audits.