Archived: Unique Care Services

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 However the safeguarding policy was out of date.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.

Is the Service Safe?

The service was safe. The provider had addressed the concerns we found at a previous inspection and now had systems in place to ensure people were supported by staff of a suitable character.

We found that new staff members had been carefully recruited. The provider had followed the new recruitment policies and procedures they had recently introduced.

This is a summary of what we found.

Is the service safe?

All of the people we spoke with said they felt safe whilst being supported by their carer/s in their homes. Discussions with staff demonstrated they were knowledgeable about the different types of abuse that could occur and they knew what action to take if they recognised signs of abuse.

We had concerns in relation to the recruitment of two members of staff. We saw that Criminal Record Bureau (CRB) disclosure checks, and more recently Disclosure and Barring Service (DBS) checks were completed for all members of staff. However, the checks for two members of staff disclosed several criminal offences that had been committed and recorded against their name. We saw that no risk assessments were in place for either of these staff members. This meant that people who used the service could be at risk of harm.

Is the service effective?

People told us they were happy with the care provided and their needs had been met. Comments from them included; " There is nothing they could do better " and " They do more than I expected. They are very good ". Discussions with staff showed they were knowledgeable about the people they supported and what people's care needs were.

Is the service caring?

People told us that the staff who supported them were very kind and respectful towards them. People told us they were not rushed by their carers and were able to do things at their own pace. One person told us; "They are extremely supportive and very understanding". Another person told us; "I was always very independent and my carer has not taken that away from me. She is really good".

Is the service responsive?

We saw that before a person started to use the service, an assessment of their needs and abilities was undertaken, including any risks to their well-being. Care plans showed how their needs were to be met. This had been done with the involvement of the person where possible as well as their relatives. We found that when people's needs changed, a review of care was carried out and the appropriate changes were implemented.

Is the service well led?

We saw the service carried out monthly audits of various aspects of the its operations such as medication management, record keeping and care planning. Where concerns were identified, we saw there was evidence that learning from incidents / investigations took place and appropriate changes were implemented.

We noted that the current manager for the service had applied for a DBS (Disclosure and Baring Service) check. This is the start of the registration process. We discussed this with the provider who told us they would ensure the manager would apply to us once the check had been completed so that the service was not in breach of the conditions of its registration.

The people we spoke with said they felt safe whilst being supported by their carer/s in their homes. Staff knew what action to take if they recognised signs of abuse and were aware of the whistle blowing process should they have any concerns.

We found that staff were well supported and had the information they needed for their roles. From discussions with staff and examination of training records we saw that staff were supported by the company to gain National Vocational Qualifications (NVQ) in social care and National Certificate for Further Education (NCFE) in Dementia and end of life care. Comments from staff included: 'I feel I can approach the manager if there is training that needs refreshing.'

We found that people who used the service and their/or representatives were asked for their views about the care and treatment that was received.

We contacted the Local Authority and examined our records before our inspection. We had no concerns about the care that was provided by Unique Care Services.