UBU - Harrogate

Updated 30 May 2019

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team

A team of eight inspectors carried out the inspection.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats and specialist housing.

This service provides care and support for people in supported living settings so that they can live as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

We informed the provider of our visit on 25 March 2019 because some of the people using it could not consent to a home visit from an inspector, which meant that we had to arrange for a ‘best interests’ decision about this. We gave notice of the inspection on 25 March and information including easy read documentation has been forwarded to them. We sent the registered manager information about the inspection and questionnaires in an easy read format to gain people’s views.

Inspection site visit activity started on 3 April 2019 and ended on 18 April 2019. Two inspectors visited the agency office on 3 and 4 April. Seven inspectors carried out visits to supported living services.

What we did before the inspection

We reviewed information we received about the service from the provider since the last inspection, such as safeguarding notifications. We sought feedback from the local authorities and professionals who worked with the service. We looked at feedback from a fire safety prevention officer. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections.

During the inspection

We spoke with the registered manager, chief executive officer and nominated individual, together with managers responsible for quality compliance, training, and the clinical team. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We held a focus group at which 20 staff attended.

We carried out observations during visits to each of the 12 supported living settings we visited. We spoke with people, managers and staff including area managers, regional development managers, scheme managers and support staff. We had more informal interactions with people who had limited verbal communication. We spoke with relatives on the telephone or in person during and after the inspection. We spoke with 12 relatives in total.

We reviewed a range of records. This included 12 people’s care records and associated medicine records. We looked at four staff files in relation to recruitment, supervision and training. Multiple records relating to the management of the service and policies and procedures were reviewed during and after the inspection. We observed care and support in communal areas. We looked at staff files, information received from the provider, staff rotas, quality assurance audits, staff training records, the complaints and compliments system and medication records.

After the inspection

We looked at information the provider sent us regarding complaints and safeguarding data and feedback from p

Updated 30 May 2019

About the service

This service provides care and support to people living in their own homes. The Harrogate office is the headquarters for support provided across the North East, East Midlands, the North West, and Yorkshire. People are supported in single occupancy houses, shared houses in multi occupancy or in individual flats in larger complexes. Not everyone using UBU – Harrogate receives regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided. At the time of the inspection 416 people were using the service. 143 people of who were receiving a regulated service.

People’s experience of using this service

The principles and values of Registering the Right Support other best practice guidance ensure people with a learning disability and or autism who use a service can live as full a life as possible and achieve the best outcomes that include control, choice and independence. At this inspection the provider had ensured they were applied.

The outcomes for people using the service reflected the principles and values of Registering the Right Support in the following ways. People’s care needs were holistically assessed, and care was mostly provided in line with current best practice guidance. Some relatives thought there could be a more consistent staff approach to enhance people’s quality of care. We have made a recommendation regarding the management of some medicines.

Staff worked together to provide people with seamless care when they accessed services and moved between services. Most people had support, which clearly focused on them having as many opportunities as possible to gain new skills and become more independent. They were supported to follow their interests and pursuits including in the wider community and accessed education and work opportunities. Relatives told us people with more complex health care needs did not always have the opportunities they would wish.

People were encouraged to develop and maintain relationships both within the service, with family and loved ones, and in the community. There were some inconsistencies about care delivery and the ability of staff to evidence effective, sustained improvements in some cases. We have made a recommendation regarding the management of complaints.

The provider and management had completed a range of monitoring visits and audits. When these had identified issues, action had been taken to resolve them. They had strong values of improving people’s support and providing high quality care.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. Many people using the service lacked capacity to make specific decisions and there were appropriate systems in place to make them. People had care plans which were personalised and provided a wealth of information for staff to use to support their needs and wishes.

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

Rating at last inspection

At the last inspection the service was rated Good (report published 14 October 2016).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.