We carried out a review of the data available to us about Unity House on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Unity House, you can give feedback on this service.
Unity House is a residential service providing personal care for up to 22 people with a learning disability. At the time of the inspection there were 11 people living at the service. Unity House provides accommodation over two floors across one large purpose-built house and some areas of the home have been converted to self-contained flats.
People’s experience of using this service and what we found
We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.
Right Support
People were regularly asked for their opinions and gave them freely. People were involved in discussions about their support and given information in a way they understood. Where people had support, they told us this was flexible, available when they needed it and to the level they needed. People were supported safely with medicines. Infection prevention and control practices reflected current guidance.
Right Care
Staff understood how to protect people from poor care and abuse. The service worked well with other agencies to do so. The service had enough appropriately skilled staff to meet people’s needs and keep them safe. Staff had training on how to recognise and report abuse and they knew how to apply it. The provider understood the new electronic assessment tool required further enhancement to ensure it fully covered people’s needs.
Right culture
The service was open to new ways of working and ongoing improvements were introduced to promote independence and inclusivity. Staff placed people’s wishes, needs and rights at the heart of everything they did. They sought advice and feedback from everyone involved in people's care. Staff were aware of and were working to best practice guidance for supporting people with a learning disability and/or autistic people.
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 3 September 2021).
Why we inspected
This inspection was prompted by a review of the information we held about this service.
This report only covers our findings in relation to the key questions safe and well-led. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Unity House on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
Unity House is a residential service providing personal care for up to 22 people with a learning disability. At the time of the inspection there were 13 people living at the service. Unity House provides accommodation over two floors across one large purpose-built house and some areas of the home have been converted to self-contained flats.
People’s experience of using this service and what we found
People were protected from harm as risks had been assessed and plans put in place to mitigate these. Support plans and positive behaviour support plans were in place however staff needed to ensure only current ones were kept in the file and they had always enough detail to support staff meet people’s needs.
The provider had reviewed the staffing model they used across their care homes and determined more flexibility was needed. The existing model did not enable staff to leave the service if someone needed additional support when in the community or provide flexibility for staff to rotate and take breaks. Additional staff were provided on both day and night shift to resolve these difficulties.
The provider was in the process of amending protocols for staff to follow when supporting people in the community to make it clear calling the police was to be used as a last resort rather than the first action when issues arose.
Throughout our visit we found staff work effectively with people to support them regulate their emotions and they created a very calming atmosphere. Staff effectively communicated with people. People were confident the service provided met individuals' needs.
Since January 2021 two successive managers had been appointed. The current manager was appointed to the post in June 2021 and they are yet to apply to become the registered manager.
Over the last year the provider and visiting professionals had identified improvements were needed. The provider had deployed a range of additional resources, such as area managers, the quality team and positive behavioural support team to the home to support staff make the necessary improvements. All reported this action had made positive improvements to the service and people’s quality of life.
Care staff, in general, adhered to COVID-19 guidance on working in a care setting. The provider needed to ensure the agency induction forms made it clear what was expected around their practice around adherence to current PPE guidance.
People were protected from abuse by staff who understood how to identify and report any concerns. The area manager was ensuring all appropriate referrals were made to the safeguarding team. Medicine management was effective. The environment and equipment were safe and well maintained.
The provider’s governance arrangements had identified improvements were needed in the home. Action had been taken to resolve these issues. The manager was in the process of learning how to use all aspects of the interactive electronic system.
We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.
This service was able to demonstrate how they were meeting some of the underpinning principles of Right Support, Right Care, Right Culture. Person-centred care was not however fully embedded into practice and outcomes for people’s independence and empowerment were at times inconsistent. We have made a recommendation about the need to improve person-centred care outcomes.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was requires improvement (published 12 January 2021).
Why we inspected
We carried out an unannounced focused inspection of this service in January 2021 and found two breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve infection control practices and governance arrangements. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
This report only covers our findings in relation to the Key Questions safe and well-led which contain those requirements. The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Unity House on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
Unity House is a residential service providing personal care for up to 22 people with a learning disability. At the time of the inspection there were 13 people living at the service. Unity House provides accommodation over two floors across one large purpose-built house and some areas of the home have been converted to self-contained flats.
People’s experience of using this service and what we found
On the first day of our visit, some staff were not following infection control processes. Records relating to medicines required improvement .The quality improvement processes at the service had not identified the deficits in practice and records that we found.
Processes to safeguard people from abuse were followed and risks were effectively reviewed and managed. Staffing levels were safe and the service was working on a recruitment and retention plan to reduce the current high levels of agency staff used at the home.
We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the guidance CQC follows to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.
The service was able to demonstrate how they were meeting some of the underpinning principles of the right support, right care, right culture.
Right support:
• Model of care and setting maximises people’s choice, control and independence
Right care:
• Care is person-centred and promotes people’s dignity, privacy and human rights
Right culture:
• Ethos, values, attitudes and behaviours of leaders and care staff ensure people using services lead confident, inclusive and empowered lives.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was Good (published 29 January 2020).
Why we inspected
The inspection was prompted in part due to concerns received about infection control practices and staffing levels. A decision was made for us to inspect and examine those risks.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to coronavirus and other infection outbreaks effectively.
The overall rating for the service has changed from Good to Requires Improvement. This is based on the findings at this inspection.
We have found evidence that the provider needs to make improvements. Please see the Safe and Well-Led sections of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Unity House on our website at www.cqc.org.uk.
Enforcement
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection.
We have identified breaches of regulation in relation to infection control practices and good governance at this inspection. Please see the action we have told the provider to take at the end of this report.
Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.
Follow up
We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and 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.
Unity House is a care home providing personal care for people living with a learning disability and people living with mental health needs. The service can provide support for up to 21 people in 15 residential beds and six individual flats. At the time of the inspection 16 people were using the service.
People’s experience of using this service and what we found
People were observed to be happy and had formed good working relationships with their care team. Staff knew the people they were supporting well and respected the choices they made about their care. People’s independence was encouraged. When people became distressed staff used various techniques to support people to regulate their emotions before physically intervening. However, the provider was in the process of working with staff to improve how they recorded information about incidents and ensuring the associated policies and procedures were robust.
Although care plans provided detail about how to work with people when they were distressed they did not provide staff with pictorial guidance on what holds to use for each person if they needed to physically intervene. At times, staff acted as a response team, but records did not show what this team were supposed to do in relation to each person or in their role as part of this intervention. Staff had received training around how to work with people when they became distressed and how to use physical interventions.
Throughout the home there were various keypads installed on corridor doors and some communal areas. The regional manager discussed how through their review of restrictive practices they had been looking to see that the number of keypads were reduced. We discussed new technology with staff and keypads that had sensors, which automatically release when people with a matching key-card approached. The deputy manager agreed to discuss this innovation with the provider.
Staff looked after people’s monies appropriately. Additional checks had been completed following concerns being raised around how staff handled people’s money. However, the provider recognised that their process for completing a monthly audit and check of account balances needed to recommence. The provider was in the process of setting up individual accounts for each person, as currently all the money was in one account.
Staff understood the procedures they needed to follow if they suspected abuse might be taking place and told us they were confident the management would act on any concerns.
Concerns had been raised that people were not supported to eat and drink enough. The provider had thoroughly investigated this matter. Although they found no evidence to support this concern they were introducing additional systems the registered manager could use to ensure people were not neglected.
People told us there were suitable numbers of staff on duty to ensure people’s needs were met. Each person had at least one staff member working with them throughout the day. This staffing level led to people being able to engage in any activities they liked both inside the home and within the community.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was Good (published 9 May 2018).
Why we inspected
This was a targeted inspection, based on concerns about risks raised with CQC in relation to the use of physical interventions and staff training in this area, finances, risk management and staff deployment. CQC are conducting trials of targeted inspections to measure their effectiveness in services where we have been alerted to potential risks.
We undertook this targeted inspection to check the service was meeting legal requirements. This report only covers our findings in relation to one key question - is the service Safe? The overall rating for the service has not changed following this targeted inspection and remains good. This is because we have not assessed all areas of the key questions.
The local authority and the provider had investigated the concerns raised and where required, had also acted to ensure people continued to receive safe care and treatment.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Unity House on our website at www.cqc.org.uk.
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.
Unity House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.
Unity House accommodates up to 21 people with a learning disability who require personal care. The service had 15 residential beds and six individual flats. At the time of our inspection, there were 15 people using the service, 11 people in residential beds and four people living in the flats.
The service had a registered manager in place. A registered manager is a person who has registered with the CQC to manage the service. Like 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.
This was the services first rated inspection under the new provider.
Accidents and incidents were appropriately recorded and investigated. Risk assessments were in place for people who used the service and described potential risks and the safeguards in place to mitigate these risks.
The registered manager understood their responsibilities with regard to safeguarding and staff had been trained in safeguarding vulnerable adults.
Medicines were stored safely and securely, and procedures were in place to ensure people received medicines as prescribed. Improvements with the counts of medicines were put in place on the day of inspection.
The home was clean and suitable for the people who used the service and appropriate health and safety checks had been carried out. At the time of the inspection fire drills were not taking place for all staff. The registered manager rectified this immediately and arranged two fire drills the day after the inspection. We have made a recommendation about fire drills.
There were enough staff available to provide individual care and support to each person. Staff upheld people's human rights and treated everyone with great respect and dignity. Robust recruitment and selection procedures were in place and appropriate checks had been undertaken before staff began work.
Staff were suitably trained and received supervision and a yearly appraisal.
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.
People were protected from the risk of poor nutrition and staff were aware of people’s nutritional needs. Care records contained evidence of people being supported during visits to and from external health care specialists.
The interactions between people and staff showed that staff knew the people really well. Staff spoken with had a good knowledge of people's needs and spoke with genuine affection about the people they supported.
People who used the service and family members were complimentary about the standard of care at Unity House. Staff helped to maintain people’s independence by encouraging them to care for themselves where possible.
Care records showed that people’s needs were assessed before they started using the service and support plans were written in a person-centred way. Person-centred is about ensuring the person is at the centre of any care or support plans and their individual wishes, needs and choices are taken into account.
Activities were arranged for people who used the service based on their likes and interests, and to help meet their social needs.
People who used the service and family members were aware of how to make a complaint; the service had received three complaints in the last year, which were fully investigated and acted upon.
The management team were approachable and they and the staff team worked in collaboration with external agencies to provide good outcomes for people. The provider continuously sought to make improvements to the service people received. The provider had quality assurance processes that included checks of the quality and safety of the service.