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Universal Care Agency Ltd Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 10 June 2017

This inspection was carried out on 4 and 8 May 2017 and was announced.

Universal Care Agency Ltd is a domiciliary care service which provides care and support to adults and older persons; some of whom are living with dementia, who live in their own homes. At the time of the inspection 18 were receiving support with their personal care. There were 17 care staff which included one senior care worker, one recruitment co-ordinator and one staff member that planned people’s care. There was a manager who was overseeing the day to day management of the service and a director who was also the nominated individual.

There was not a registered manager at the time of the inspection. A registered manager had not been in post since July 2016. The provider had recruited a manager who would be applying to the Commission to become the registered manager when they commenced their employment for the provider on 16 May 2017. 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 in December 2016, the service was placed into Special Measures as it was Inadequate overall.

The overall rating for this service is ‘Requires improvement’. However, the service will remain in 'special measures'. We do this when services have been rated as 'Inadequate' in any key question over two consecutive comprehensive inspections. The ‘Inadequate’ rating does not need to be in the same question at each of these inspections for us to place or keep services in special measures.

Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the provider’s registration of the service, will be inspected again within six months.

The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe.

If not enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. This service will continue to be kept under review and, if needed, could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement so there is still a rating of inadequate for any key question or overall, we will take action to prevent the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration.

For adult social care services the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.

At our last inspection in December 2016 we found the provider did not always follow safe recruitment processes. At this inspection we found the provider continued to not follow safe recruitment practices.

At the last inspection in December 2016 we found risk assessments were completed but not always dated and did not contain all the information on how risks to people could be minimised. At this inspection we did not find an improvement with this concern.

At the last inspection in December 2016 we found staff did not receive an induction programme and did not always receive training from the provider or have their competencies checked. At this inspection we did not find any improvement with this concern and we found staff did not always receive training which was specific to people’s needs.

At the last inspection in December 2016 we found systems to assess the overall quality and safety of the service were not in place. At this inspection we found quality and safety audits were in place but they were ineffective.

At the last inspection in December 2016 we found people’s personal information was not always kept private. At this inspection we found a person’s personal care plan had been shared with a relative of another person who was in receipt of personal care.

At the last inspection in December 2016 we found there was a lack of communication between the management team, people, staff and external professionals and this had an effect on the care people received. At this inspection we found communication between the manager, staff, people and external professionals had improved but required further improvement.

At the last inspection in December 2016 we found staff and management had a limited understanding of the Mental Capacity Act 2005. People did not always receive timely support from an external health care professional. Care records were mostly personalised although inconsistent with detailing how people would like to receive their care. Complaints received had not always been identified as a complaint, investigated and followed up. The provider and manager had not notified the Commission of two safeguarding concerns and had not investigated these concerns appropriately and staff did notify external health care professionals or receive a supervision. At this inspection we found improvements had been made in these areas.

There were enough staff to meet people’s needs and there was good continuity of care workers. There were no concerns with medicine practices. People received support with food and fluids when required. Staff felt when the manager made themselves available, they were approachable and had a caring nature and felt confident in raising concerns to the manager and felt supported to question practice.

We found three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Full information about CQC’s regulatory response to any concerns found during inspections is added to reports after any representations and appeals have been concluded.

Inspection areas

Safe

Requires improvement

Updated 10 June 2017

The service was not always safe

Safe recruitment practices were not always followed

Risk assessments were completed but not always dated and lacked sufficient detail on how risks to people could be managed.

There were enough staff to meet people’s needs. People were supported to receive their medicines safely.

Safeguarding concerns had not been received but systems were in place to investigate allegations of potential abuse.

Effective

Requires improvement

Updated 10 June 2017

The service was not always effective

Staff did not always receive an induction programme, ongoing training or person specific training from the provider.

Staff received a supervision and demonstrated a clearer understanding of the Mental Capacity Act 2005.

People’s nutrition and hydration needs were met and people were supported to have access to Health care professionals

Caring

Requires improvement

Updated 10 June 2017

The service was not always caring

People’s personal information was not always kept private. However care staff promoted their independence and respected people’s dignity and privacy.

People were involved with their care and received support in line with their preferences. Risk assessments did not contain sufficient detail to ensure risks to people could be managed.

Responsive

Requires improvement

Updated 10 June 2017

The service was not always responsive

Care records were accurate but risk information was limited in how staff should manage risks to people. People did not always receive support from care staff who had the required training to respond to their needs.

People were involved in their care planning and had choice and control over the care they received.

Complaints were received, investigated and followed up.

Well-led

Inadequate

Updated 10 June 2017

The service was not well led.

The service had been without a registered manager since July 2016 and the governance and leadership of the service was inadequate.

Effective systems were not in place to assess the overall safety and quality of the service and peoples care records were not always kept private.

Communication continued to require improvement.

Staff had not had a team meeting but felt the manager was supportive and would support them to question practice and raise concerns.