Background to this inspection
Updated
18 January 2020
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
Inspection team
The inspection was carried out by an inspector and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own homes.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.
What we did before the inspection
We sought feedback from two local authorities who work with the service. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all of this information to plan our inspection.
During the inspection-
We spoke with two people who used the service and four relatives about their experience of the care provided. We spoke with four members of staff including the deputy manager, and registered provider. We reviewed a range of records. This included three people’s care records and medication records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection –
We continued to seek clarification from the provider to validate evidence found. We looked at care plan information related to a persons’ medicines. We looked at information received from two local authorities who purchase care packages from the service.
Updated
18 January 2020
About the service
Unique Care Network Limited is a domiciliary care service providing personal care to people in their own homes. People may have needs related to dementia, physical disabilities and sensory impairments. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided. At the time of the inspection eight people were receiving personal care.
People’s experience of using this service and what we found
At our last inspection in March 2019, the provider was in beach of regulations 11, 12, 17 and 19 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Risks to people were not being managed to keep people safe. People had experienced late and missed care calls which impacted on their safety. People’s consent to care was not always sought and some decisions were made by the provider or people’s family and not in line with the law. People were not protected against the risks associated with unsafe staff recruitment practices. The provider had not ensured there were effective quality assurance checks in place to monitor the quality and safety of the service people received.
At this inspection we found that improvements had been made and breaches had been met. These improvements need to be embedded and sustained
The systems in place for monitoring the quality of the service had improved. Audits had been implemented but these still needed to be consistently undertaken and sustained, to ensure people received good outcomes.
Risks to people’s safety were identified with management plans in place to guide staff in supporting people safely. Staff understood how to recognise and report abuse to the appropriate safeguarding authorities. People were happy with the support they received to take their medicines. The numbers of people using the service had significantly decreased, care call scheduling and monitoring of care calls had improved so people did not experience missed calls. The provider had audited existing staff files, they have yet to demonstrate they can follow and sustain safe recruitment practices. People were satisfied that staff followed infection control procedures when in their home.
People were supported by staff who had training and support to meet people's needs. Improvements were noted in carrying out spot checks on staff to check their care practices. Improvements had been made in relation to seeking people’s consent before providing support. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
People had consistent support with their meals and staff were mindful of promoting drinks and snacks ensuring these were within reach of people. People maintained control over their health care arrangements and staff responded to changes in people's health conditions and followed the advice of health professionals.
People described staff as caring and considerate. People’s dignity and privacy was protected. The impact of having familiar staff and regular care calls had promoted people’s happiness with the service.
People's needs were assessed and their choices and preferences identified in their care plan. People’s wishes regarding their end of life care had not been discussed with them in case a sudden death occurred. The service was meeting the accessible information standard to provide information for people in a format relevant to them. People knew how to complain and complaints were responded to appropriately.
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 inadequate (published 09 April 2019) and there were multiple breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations. This service has been in Special Measures since 15 March 2019. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.
Why we inspected
This was a planned inspection based on the previous rating.
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.