Unified Home Care Ltd

Updated 3 November 2022

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

This inspection was undertaken by one inspector.

Service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was announced. We gave 24 hours' notice of the inspection because some of the people using it could not consent to a telephone call from an inspector. This meant that we had to arrange for a ‘best interests’ decision about this. This was because some people needed a court appointed deputy to speak on their behalf.

Inspection activity started on 18 October 2022 and ended on 21 October 2022. We visited the office location on 20 October 2022.

What we did before the inspection

The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make.

We used information gathered as part of monitoring activity that took place on date 15 September 2022 to help plan the inspection and inform our judgements.

We reviewed information we had received about the service since it was registered. We sought feedback from the local authority safeguarding team.

We also reviewed incidents reported to us involving safeguarding. We used all this information to plan our inspection.

During the inspection

We spoke with two people, three other people's relatives, four staff including the registered manager, senior care staff and care staff. We received feedback from another relative by e-mail. We also spoke with a registered manager from another services where people's care and support was shared.

We reviewed a range of records. We looked at three people's care plans, various medicines administration records. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service were also reviewed, including training records, incident records, complaints, compliments, quality assurance processes and various policies and procedures.

Updated 3 November 2022

About the service

Unified Home Care Ltd is a domiciliary care service registered to provide personal care to people living in their own homes. The service supports older people some of whom were living with dementia and people with a physical disability. At the time of the inspection eight people were using the service, five of whom received personal care. Some people were also supported with live-in care. This is where staff stay in the person’s home for a large proportion of the day and were part of the person’s household.

People’s experience of using this service and what we found

Not all risks had been identified and this put people at risk of harm. Information for staff was limited in how to manage risks. People received their medicines as prescribed, although some records were not accurate or complete. This created a risk of harm.

Monitoring and oversight of the service was not effective. There were missed opportunities to improve the quality of service provided. Not all records had been completed or kept up to date. Staff did not always have accurate records they could rely on to provide good quality care.

Staff knew how to safeguard and support people to keep them safe. Enough suitably skilled staff had been safely recruited. People were supported by a consistent staff team who they felt comfortable with. Staff ensured they followed infection prevention guidance and good practise. The service and the staff team took on board learning when things went wrong.

People's needs were assessed before the service provided them with support. Staff knew people's needs well. Staff had received the required training and ongoing support to help them maintain and improve their skills to fulfil their role and responsibilities. Relatives and health professionals all confirmed staff had the skills necessary to care for people well.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Relatives told us staff were caring and knew people's needs and preferences well. Staff gave people privacy, treated them with dignity and respect and helped promote their independence.

People said they were involved when reviewing their care and felt staff were responsive to their changing needs. Complaints were used to help drive positive improvements. Procedures and policies were in place should any person suddenly become unwell or need end of life care.

The registered manager led by example and had fostered an open and honest staff team culture. People's views were sought, and this enabled them to have a say in how the service was provided. The provider worked well with other organisations, to provide people with joined up care.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating

This service was registered with us on 18 January 2022 and this is the first inspection.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

Enforcement and Recommendations

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to safe care and treatment and governance at this inspection. Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.