Archived: Unique Care Services

Updated 7 December 2016

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 inspection took place on the 17 and 24 of October 2016 and was announced. 48 hours’ notice was given because the service is small and the registered manager is often out supporting staff or providing care. We needed to be sure that someone would be in to assist with the inspection process.

The inspection was carried out by an Adult Social Care Inspector.

Before the inspection, we asked the registered provider to complete a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. They did not return a PIR as requested and we took this into account when we made judgements in this report. We asked the registered manager to send us the Provider Information Return (PIR) after our visit. No response was received in relation to this request.

We contacted local authority commissioning group about information they held in respect of the registered provider. The registered provider does not currently have a contract with the Local Authority. We spoke with the finance team of the Local Authority in respect of direct payment auditing. Direct payment is a scheme that gives people money directly to pay for their own care, rather than the traditional route of a Local Government Authority providing care for them. They told us that the registered provider had not fully co-operated with this auditing process.

We reviewed all the information we had in relation to the service. This included notifications, comments, concerns and safeguarding information. Our visit involved looking at six care plans and other records such as five staff recruitment files, training records, policies and procedures, quality assurance audits and complaints files.

We spoke to five people who used the service. Discussions were held over the telephone or in one case, information was emailed to us. We spoke to five members of staff as well as the registered manager.

Updated 7 December 2016

We carried out an announced inspection of Unique Care on the 17 and 24 of October 2016.

Unique Care is registered to provide personal care for older people and younger adults. They currently provide support to 38 people within their own homes in Ellesmere Port, Neston and surrounding areas.

A registered manager was 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.

Our last inspection to Unique Care was on 26 September 2014. The registered provider was compliant with the regulations we used at that time.

We found a breach related to the management of the service. These included the registered provider not fully co-operating with a Local Authority in respect of direct payments, not completing and returning information we needed to assess the quality of the service when asked and issues relating to the registration of the location. While policies and procedures had been reviewed, these were found to contain inaccurate information. Audits were in place yet on occasions these had not been fully actioned as issues arose.

You can see what action we told the provider to take at the back of the full version of this report.

People told us they felt safe with the staff team. Staff demonstrated a good understanding of safeguarding and had received training. They were aware of the whistleblowing procedure and had been given a personal copy of this. However the safeguarding policy was out of date.

Recruitment demonstrated that checks had been completed prior to a member of staff coming to work for the service although the processes were not always robust. Systems were in place to ensure the safe management of medication.

People told us that they considered staff to be knowledgeable and training records demonstrated that staff had received training relating to the needs of the people who used the service.

Staff were supervised in their role and received an annual appraisal. Further support was provided through the provision of spot-checks made by the registered provider. The registered provider demonstrated that they took the capacity of people into account during in assessments and care planning. The nutritional needs of people were taken into account although a record keeping issue was noted on charts intended to monitor fluid intake.

People told us that they felt that their privacy and dignity had been maintained and that they were enabled to remain independent in those tasks that they could manage themselves.

The registered provider had a system of assessment which covered all the main health and social needs of people. This translated into a plan of care which was personalised in nature and was reviewed regularly. People were aware of their plan of care and had confirmed their agreement with its contents.

A complaints procedure was available. People knew how to make a complaint but had tended to do this informally rather than use the registered provider’s complaints procedure. Any complaints received were recorded although no complaints had been made since our last visit to the service.

During our visit we found that the registered provider did not always apply good governance to the running of the service. This included co-operation with the Local Authority in respect of financial audits which had not been fully complied with. The registration of the service needed to be updated yet this had not been completed by the registered provider and remained outstanding. The registered provider had not provided us with the information we asked for prior to our visit. This included the return of a Provider Information Return (PIR) which was not returned when we asked and had still not been returned despite requests to the registered provider during and after our visit. Polices and procedures were in place but were not always accurate. Audits took place but were not always robust.