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Unique Care Network Limited Inadequate

Inspection Summary


Overall summary & rating

Inadequate

Updated 10 April 2019

About the service: Unique Care Network Limited is registered to provide the regulated activity of personal care. This service is a domiciliary care agency. It provides personal care to people living in their own houses in the community. It provides a service to older adults and younger adults. People had needs that related to old age and could include dementia, health conditions, and/or a physical disability. There were 43 people using this service at the time of our inspection.

People’s experience of using this service:

The provider had not progressed to ensuring everyone's care plan and risk assessment had been reviewed. This meant not everyone had an accurate and up to date care plan with guidance to ensure people were safe. There had been some improvements since our last inspection in putting management plans in place to reduce risks to some people. However, this did not provide assurance that risk management processes would ensure everyone received safe and appropriate care.

At our previous inspection the provider lacked knowledge about safeguarding procedures. At this inspection we saw they still did not understood their responsibilities for keeping people safe, or for sharing information with other agencies. Staff were up to date with safeguarding training and knew how to report any concerns about people’s safety.

Improvements had not been made in the recruitment of staff. The provider had not ensured safe processes were followed. Two staff had been recruited without reference checks to determine their suitability.

Some improvement had been made in relation to scheduling care call times. The provider had implemented an electronic scheduling system which we saw planned call times and monitored the duration. This also included travel time for staff between calls. However, this was in the early stages and only in place in one geographical area. Some people told us they continued to have late calls.

Quality assurance continued to be ineffective and did not pick up on the issues identified at this inspection. These included concerns with sharing potential safeguarding incidents and recruitment checks. Systems and processes were not yet in place to show how the provider was assessing, monitoring and mitigating risks. Whilst records were being reviewed, the provider did not have a system for auditing these. Leadership within the service remained unclear, roles and responsibilities were not defined. Management meetings were not recorded and there was no recorded agenda of the improvements needed or the progress being made.

The registered provider continued to lack knowledge around the regulations and legislation. They had not notified us of two incidents which they are required to do. Post inspection they used the wrong notification reports.

Rating at last inspection: The service was last rated Inadequate on 18 and 21 January 2019 and placed in special measures.

Why we inspected: This was a planned focused inspection based on previous rating of inadequate and the requirement to re inspect services placed in special measures.

Enforcement

We identified a continued breaches of the Health and Social Care Act (Regulated Activities) Regulations 2014 around safe care and treatment and governance. We judged that the breach in safe care and treatment remains as at this inspection there was evidence that sufficient progress had been made with regard to risk management processes within the service. In addition we identified a breach in relation to staff recruitment. The provider has also a breach in relation to seeking people's consent to care and support which was not assessed at this focused inspection.

Details of action we have asked the provider to take can be found at the end of this report.

Follow up: We will continue to monitor the service as per our inspection programme.

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

Inspection report


Inspection areas

Safe

Requires improvement

Updated 10 April 2019

The service was not always safe

Details are in our Safe findings below.

Inspection report


Effective

Requires improvement

Updated 16 March 2019

The service was not effective.

People were not consistently supported by staff who had the skills or support and understood how to meet their needs effectively.

People’s consent to care was sought however, improvements were required to ensure their rights were protected.

Some people’s meals had been affected by call times. Plans did not always identify people’s nutritional needs. There had been some delay in referring people to health professionals when required.

Caring

Requires improvement

Updated 16 March 2019

The service was not consistently caring.

People did not feel listened to and described being distressed by the experiences of missed calls and lack of management action in this area.

Some people found it difficult to build a report with different staff undertaking care calls.

Some people described language barriers affected their care. They described a lack of respect from some staff.

People did not feel involved in decisions about their care.

People were complimentary about their regular staff and described them as caring.

Responsive

Requires improvement

Updated 16 March 2019

The service was not responsive.

People did not receive consistent support that met with their needs

and preferences. People did not receive support at the times they needed in response to their needs.

People’s support plans were not up to date or reflective of their needs.

People were not confident that their complaints had been listened to and had not always received a response. The provider had not ensured that people’s complaints were used to drive improvements.

Well-led

Inadequate

Updated 10 April 2019

The service was not well-led.

Details are in our Well-Led findings below.

Inspection report