Archived: Unique Care Services

Updated 20 February 2019

We carried out this inspection under section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014. This is not the full paragraph that should be inserted – please revisit the guidance

Before the inspection, we received concerns regarding the provision of care at the service. We therefore decided to bring forward our inspection. This inspection was carried out by four adult social care inspectors. The inspection took place over three days and was unannounced on the first day and announced on the following days.

During our inspection we spoke with four people who used the service by telephone and visited four people in their homes. We also spoke with two relatives, three care workers, three office staff and the registered manager. We looked at six people’s care records, four staff recruitment files and eight staff training records. We also looked at records relating to the management of the service.

Before the inspection we reviewed the information we held about the service. This included notifications received from the registered manager, safeguarding referrals, and other information from members of the public.

Updated 20 February 2019

We carried out our inspection on the 11, 21 and 27 September 2017. This was unannounced on the first day of inspection and announced on the following days. '24 hours' notice of the inspection was given because the registered manager is often out of the office supporting staff. We needed to be sure that they would be available in the office. Unique Care Services is a care agency based in Ellesmere Port. It offers care and support to approximately 50 people in their own homes including personal care. They employ 37 support and office staff.

The service had a registered manager who had been in post since September 2014. We were advised following our inspection that the registered manager had resigned and were working their notice period. 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 of the Health and Social Care Act 2008 and associated regulations about how the service is run.

We identified breaches of regulation 12, 17 and 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

The systems in place to protect people from the risk of harm were not effective. We found that risk assessments in place did not evidence that risks were mitigated. Clear guidance was not available within care plans to inform staff of the support they should be undertaking. This meant vulnerable people were at risk of harm.

The registered provider had not evidenced that staff had undertaken an induction or that all staff had completed training essential for their role. This meant staff may not have been up to date with skills and knowledge required for their role.

Staff had not received regular supervision and appraisal. This meant that the monitoring of staff performance was not effective and development opportunities were not considered.

The registered provider had audit systems in place for monitoring the quality of the service. These were not fully effective as they had not identified areas for development and improvement.

The registered provider had policies and procedures in place however, these were not all up-to-date and did not reflect current legislation and guidelines.

The registered provider had not notified the Care Quality Commission of all significant events that occurred at the service in line with their legal obligations. This meant that the registered provider was not complying with the law.

Staff were polite and respected people's privacy and dignity. People told us they had some regular staff that were kind and caring.

The Care Quality Commission is required by law to monitor the operation of the Mental Capacity Act (MCA) 2005 and to report on what we find. We saw the registered provider had policies and guidance available to staff in relation to the MCA. Staff were able to demonstrate a basic understanding of this.

People had access to information about how to complain. The registered provider had a complaints policy and procedure in place.

The overall rating for this service is ‘Inadequate’ and the service is therefore 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.