Care Unique Limited

Updated 13 July 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked 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.

The inspection took place between 18 and 21 June 2018 and was announced. We gave the service short notice of the inspection visit because the registered manager is often out of the office supporting staff or providing care. We needed to be sure that they would be in. We spoke with people who used the service on the telephone on 18 and 19 June 2018 and interviewed care staff on the telephone on 18 June. We visited the office location on 20 and 21 June 2018 to see the registered managers and office staff; and to review care records and policies and procedures.

The membership of the inspection team consisted of one adult social care inspector and an assistant inspector.

Before the inspection we reviewed the information we held about the service. This included contacting the local authority contracts and safeguarding teams and looking at information we had received about the service as well as any statutory notifications the registered manager had sent us. We usually request the provider completes 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. On this occasion we had not requested this from the provider.

During our visit to the provider's office we looked at elements of six people's care records, some in details and others to check specific information, six staff recruitment files, training records, medicines records and other records relating to the day to day running of the service, such as quality assurance checks.

During the inspection we spoke with the registered managers, company secretary, and care co-ordinator. We carried out telephone interviews with 18 people who either used the service or their relatives on 18 and 19 June 2018 and eight care staff on 18 June 2018.

Updated 13 July 2018

Care Unique Limited is a domiciliary care agency, providing services for people who require care and support in their own houses and flats in the community. It provides a service to older adults, younger disabled adults and children. Not everyone using Care Unique Limited receives regulated activity; CQC only inspects the service being received by people provided with 'personal care'; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided. Care Unique Limited specialises in providing care and support for people of South Asian, African Caribbean and Eastern European backgrounds. At the time of our inspection, the service was providing care and support for 59 people.

At our last inspection in September 2016, we rated the service ‘good’ overall and ‘requires improvement’ in the well-led domain, with one breach of Regulations relating to good governance. Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key question of ‘is the service safe’ to at least good. At this inspection we found the evidence continued to support the rating of good overall, the well domain had improved to good, with no breach of Regulations, and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Two registered managers were in position, one of whom was the registered provider and the other was employed as the care manager. 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.

Staff had a good understanding of systems in place to manage medicines, safeguarding matters and behaviours that are challenging to others. People's medicines were managed so that they received them safely.

Assessments were in place to reduce risks to people’s health and welfare and any accidents/incidents were documented with outcomes and actions to prevent reoccurrence. Staff liaised with a range of health care professionals to ensure people’s health care needs were supported.

There were sufficient staff available to ensure people's wellbeing, safety and security was protected. A robust recruitment and selection process was in place and staff received training and updates in a variety of subjects. This ensured staff had the right skills and were suitable to work with vulnerable people.

The service was working within the legal requirements of the Mental Capacity Act (2005). Staff had received training and the registered manager understood their legal responsibilities under the Act. People are supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice.

People and their relatives confirmed most staff were caring and looked after people well, treating them with respect. Staff had a good understanding of people's needs. People were provided with the care, support and equipment they needed to stay as independent as possible.

People’s needs were assessed and plans of care put in place which were reviewed regularly, including the person or their relatives wherever possible. People’s preferences were considered when devising plans of care.

Staff we spoke with understood the importance of supporting people to have a good end of life as well as living life to full whilst they were fit and able to do so. The service liaised with health and social care professionals to develop plans of care to ensure their passing was comfortable, pain free and as peaceful as possible.

A complaints procedure was in place. Complaints were taken seriously and investigated. Less formal concerns were documented and actions taken as a result.

Staff spoke consistently about the service being a good place to work. The management team were constantly looking at ways to improve the service. The registered provider worked in partnership with other organisations and took part in good practice initiatives designed to further develop the quality of services in the local area.

Quality assurance systems were in place to monitor and drive improvements within the service. People’s opinions of the service were sought through quality questionnaires and annual surveys. Regular staff meetings were held to share best practice and help improve the service provision.

As a result of our inspection, we concluded the service met all relevant fundamental standards.

Further information is in the detailed findings below.