Care Unique Limited

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.

The service is an independent home care company, based in Bradford, West Yorkshire, providing services for people who require care and support in their own home, including child care. Care Unique Limited also specialises in providing care and support for people of South Asian, African Caribbean and Eastern European backgrounds. At the time of our inspection, Care Unique was providing services for 35 people.

There was a registered manager in position. 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.

Appropriate safeguarding mechanisms were in place and staff understood how to keep people safe from harm or abuse. Risk assessments had been undertaken to mitigate risks.

Accidents and injuries were documented with outcomes and actions put in place to prevent reoccurrence.

Staffing levels were safe. People told us they generally saw the same staff who understood their needs, stayed the allocated time and completed all required care and support tasks.

A robust recruitment process was in place and staff had the necessary training to carry out their duties. A system of staff supervisions, appraisals and spot checks was in place.

The service was working within the legal framework of the Mental Capacity Act 2005 (MCA). Staff had received MCA training and the registered manager understood their legal responsibilities under the Act.

People's needs were assessed and a plan of care implemented which was reviewed regularly. People and their relatives told us they were involved in this process and their preferences were taken into account wherever possible.

A complaints procedure was in place, complaints were taken seriously and investigated thoroughly.

People were supported to consume a varied diet according to their cultural needs and requirements. Staff communicated with people in their own language.

Staff knew people well and treated them with dignity and respect. People told us they were supported in a kind and caring manner, their healthcare needs were met and appropriate referrals made where required.

The registered manager was respected and considered approachable by staff and most people. The management team were willing to look at ways to help improve the service.

Regular staff meetings were held and quality questionnaires and surveys were sent out annually to staff and people who used the service.

Although some quality assurance was in place, there was a lack of audit of care records or daily records of care.

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

We found there were reasonable risk assessments in place to establish people's key risks and we also found people's plans of care provided adequate information to care staff. On occasion, some care plans could have been more person-centred and the registered manager acknowledged this.

We found there were reasonable and proportionate infection control measures in place to reduce the risk of cross infection between people and the spot checks performed by the registered manager provided a way of checking staff compliance, particularly with hand hygiene and uniform.

We also found the provider had an accurate Statement of Purpose and it contained the necessary information including aim and objectives, the kinds of services provided, names of key individuals working for the service, legal status of the provider and details of the office address.

After the inspection, the following week, we called several people who used the service and/or their relative. One person's relative said, "People are polite, it is a good service and there's no problems." A person who used the service said they were, "Happy with the service, staff are polite and things are fine." Another person said they, "Do a good job and will call if running a bit late".

People told us they had been given written information about the services the provider offered. One person said, 'I was visited by the manager before the agency started to provide my support and they left me details about the services the agency provided. They also explained everything to me and listened to what I had to say.' Another person said "I feel very lucky, I receive good quality care from staff that are caring and professional."

We spoke with four staff and they told us they enjoyed working for the agency and always respected people's rights to privacy and dignity when providing care and support. They also told us they helped and encouraged people to retain their independence and provided care and support in line with their agreed support plan.