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Archived: United Home Care Limited Inadequate

This service was previously registered at a different address - see old profile

Inspection Summary


Overall summary & rating

Inadequate

Updated 17 May 2016

We undertook an announced inspection of United Home Care Limited on 8 December 2015. We told the provider two working days before our visit that we would be coming because the location provided a domiciliary care service for people living in their own homes and the service was small so we wanted to be sure the registered manager would be available.

The service had temporarily closed for approximately ten months from the end of 2014 as the registered provider (also the registered manager) had needed to shut the service during this period. The service had re-started operating again and supporting people in October 2015.

We last inspected the service in April 2013. At that inspection we found the service was meeting all the regulations that we assessed.

The service was family run and the registered manager’s wife and daughter also worked for the service as a care worker and assessor.

United Home Care Limited provides a range of services to people in their own home including personal care. People using the service had a range of needs such as physical disabilities and dementia. The service offered support to people over the age of 18 years old. At the time of our inspection 4 people were receiving personal care in their home.

There was a registered manager in post. 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.

Medicines were not always managed safely and we could not confirm people received their medicines as prescribed.

Risks to people and others were not well managed and people did not have the necessary risk assessments in place in relation to known risks to ensure staff safely supported them..

Recruitment systems were unsafe as the provider did not always ensure they obtained all the necessary checks before staff worked with people using the service.

There were concerns regarding how staff were being deployed in the service. The staff team was small and there were no contingency plans should a staff member not be available to work, thus potentially a person using the service might not receive all their home visits.

Our findings during the inspection showed that new staff did not receive an induction to the service or receive training in a timely manner on areas such as moving and handling and the administration of medicines, to prepare them for their roles.

Although there were systems in place to assess people's capacity and their ability to consent to the care and support they received, processes were not followed in working with the local authority to ensure people who needed a formal mental capacity assessment took place.

The provider had limited systems in place to monitor the quality of the care provided and these did not provide appropriate information to identify issues with the quality of the service. The registered manager had not been aware of their duties to act in accordance with the Mental Capacity Act 2005 and neither had they identified any of the issues we found during this inspection.

Feedback from a person using the service was positive. They spoke highly of the staff who visited them and said they felt safe receiving the service. A relative was also happy with the support their family member received.

People’s needs were assessed before they received a service and care plans identified their needs.

There was a complaints policy and procedure in place and people and their relatives knew to contact the service or the local authority if they had a concern.

Staff documented the drinks and meals people ate so that this could be monitored if a person was at risk of dehydration or malnutrition.

We have made a recommendation that the registered person should seek relevant current guidance and information on

Inspection areas

Safe

Inadequate

Updated 17 May 2016

The service was not safe.

Medicines management was unsafe and we could not always confirm people received their medicines as prescribed.

People were at risk of harm from poor risk assessment processes. The provider did not always assess people’s risks in relation to the provision of care to provide staff with guidance to ensure people were safely supported.

Recruitment practices were unsafe as suitable employment references to check performance of staff in previous roles were not always obtained and criminal record checks had not always been requested.

There were not enough staff deployed to support people using the service.

Staff and the registered manager were aware of how to respond if there was a safeguarding allegation.

Effective

Requires improvement

Updated 17 May 2016

The service was not always effective. There was no evidence of the support staff received, such as receiving an induction to working with people in the community.

Staff had not received training on important areas such as moving and handling and the administration and handling of medicines in a timely way.

There was no plan to provide one to one support and supervision to staff.

Staff encouraged people to make daily decisions. Capacity assessments had been carried out by the service and care staff were aware of their responsibilities in working with this legislation. However, the registered manager had not acted in accordance with the Mental Capacity Act 2005 in working with the local authority if they felt a person lacked capacity.

People received the necessary support in relation to their day to day health needs.

Staff supported people with their drinks and meals to ensure they did not become dehydrated or malnourished.

Caring

Good

Updated 17 May 2016

The service was caring. People were involved in planning their care.

People we spoke with were positive about the care they received and told us staff were kind and caring and treated them with dignity and respect.

Responsive

Good

Updated 17 May 2016

The service was responsive. People’s needs and wishes were assessed and care plans were in place to meet those needs.

People and relatives knew how to complain if they needed to.

Well-led

Inadequate

Updated 17 May 2016

The service was not well-led. There were inadequate systems in place to monitor the safety and quality of the service, so areas for improvement could not be identified and addressed. The lack of systems to monitor the quality of the service being provided had meant that the Registered Manager had not identified the concerns and poor practices that we found during this inspection.

Staff said the registered manager was approachable and supportive.