16 March 2019
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 28 January 2018 and was announced. The provider was given 24 hours’ notice because the location is a small domiciliary care service and we needed to be sure somebody would be there. One inspector carried out this inspection.
Before the inspection, we looked at the evidence we already held about the service including notifications the provider had sent to us. A notification is information about important events which the service is required to send us by law. We used information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We contacted the local authority with responsibility for commissioning care from the service to seek their views about the service.
During the inspection we spoke with the deputy manager. We reviewed three people’s care records including risk assessments and care plans and reviewed four staff records including recruitment and supervision. We looked at records relating to how the service was managed including staff training, policies and procedures and quality assurance documentation. After the inspection we spoke with two care workers, two people who used the service, one relative and one friend.
16 March 2019
United Care (UK) Ltd is a domiciliary care agency. It provides personal care to older adults living in their own houses and flats. At the time of the inspection eleven people were receiving a service.
This inspection took place on the 28 January 2019. The inspection was announced. At the previous inspection which took place in December 2016 the service was rated as overall Good. However, the service was rated Requires Improvement in Well Led because there were no quality audits being carried out. At this inspection we found improvements had been made. The provider carried out staff observations and had developed a quality audit tool. Records showed issues identified were discussed with staff in supervision.
The service did not have a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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. The provider had recruited to the manager position and this person was in the process of becoming registered.
Staff knew how to report safeguarding concerns and knew about whistleblowing. People had risk assessments carried out to reduce the risks of harm they may face. Recruitment checks were carried out before new staff began working at the service. There were enough staff employed to meet people’s needs and keep them safe. People were protected from the risks associated with the spread of infection. The provider had systems in place to record and learn from accidents and incidents. People were supported with their medicines. However, records did not always contain a list of the medicines prescribed to people.
The provider assessed people’s needs before they began to use the service to ensure the right care could be provided. Staff were supported with training opportunities, regular supervision and annual appraisals. People were supported with their nutrition and to maintain their health. The provider and staff understood the requirements of the Mental Capacity Act (2005) and the need to obtain written and verbal consent before delivering care.
People and their representatives thought staff were caring. Staff knew how to support people with their care needs. The provider and staff involved people in care decisions. Staff knew about equality and diversity. People’s privacy, dignity and independence were promoted. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.
Staff understood how to deliver personalised care. Care plans were detailed and personalised. People’s communication needs were met. The provider had a system to record and handle complaints. The provider ensured they could provide end of life care should this be required.
The provider had a system to obtain feedback from people using the service and their representatives in order to identify areas for improvement. Staff had regular meetings to embed training and be updated on policy changes. The provider worked in partnership with other agencies to identify areas for improvement.
We have made one recommendation in relation to medicines management.