Unique Personnel (UK) Limited

Updated 11 May 2023

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 Health and Social Care Act 2008.

Inspection team

The inspection was carried out by 2 inspectors on both days of the inspection, and 3 Experts by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service. The Expert by Experience’s made telephone calls to people and their relatives on the first day of the inspection.

Service and service type

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

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

We gave the service 48 hours' notice of the inspection. This was because we needed to be sure that the provider or registered manager would be in the office to support the inspection.

Inspection activity started on 16 February 2023 and ended on 21 February 2023. We visited the location's office on both of these days.

What we did before the inspection

We reviewed the information we held about the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We also gathered feedback from the local authority. We used all this information to plan our inspection.

During the inspection

We visited the office and spoke with the registered manager, director, operations manager, recruitment staff, 4 office staff and 5 care staff. We spoke with 31 people using the service and 10 relatives of people using the service to seek their feedback on the service they received. We reviewed records, including 14 people’s care plans and risk assessments, 5 staff recruitment and training records and a variety of records relating to the management of the service, including quality monitoring systems and audits.

Updated 11 May 2023

About the service

Unique Personnel (UK) Limited is a domiciliary care service providing personal care support to people living within their own homes. The service was providing care and support to 135 people at the time of the inspection. These included older people, people living with dementia, people with a physical disability and younger adults.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided.

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

Risks to people were not always identified, assessed, and documented. Staff did not always have access to detailed risk management information to ensure the support they provided was safe and appropriate to meet individuals needs and the actions they should take to safely mitigate and manage risks. The providers call monitoring system was ineffective. The electronic call monitoring (ECM) system to monitor call visits made to people was not operated effectively by staff placing people at risk of receiving late or missed call care visits. We received mixed feedback from people in relation to staffing levels and staff arriving at the agreed times to assist them with their care. The service was not well managed. Systems and processes in place for monitoring the quality and safety of the service were not effective in identifying and addressing issues and concerns we found at this inspection and for helping to drive service improvements.

The systems and processes in place for managing and administering people's medicines was not always safe. Systems in place to identify and take action in relation to concerns, safeguarding and poor practice was not always effective. The provider was not always working within the principles of the MCA. Care plans did not always identify and or reflect individual preferences in the way people wished to be supported or contain correct information about their needs, wishes and the support they needed. Care plans and records did not include information regarding people’s end of life care, wishes and preferences. Complaints were not always managed appropriately and in a timely manner and audits in place to learn from or identify themes and trends were not always effective.

We have made a recommendation to the provider that the provider refers to best practice and up to date guidance in relation to staff recruitment and ensures there are systems in place to monitor this.

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

Rating at last inspection

The last rating for this service was good (published 19 February 2018). This was the provider's first inspection since their registration at a new location in February 2023.

We have found evidence that the provider needs to make improvements. Please see the Safe, Effective, Caring, Responsive and Well Led sections of this full report. You can see what action we have asked the provider to take at the end of this full report.

Why we inspected

The inspection was prompted in part due to concerns received about the quality and safety of care provided, the management and oversight of the service, missed and late visits and medicine management. A decision was made for us to inspect and examine those risks.

Enforcement and Recommendations

We have identified breaches in relation to person-centred care, need for consent, safe care and treatment, receiving and acting on complaints, staffing and good governance. We have also made a recommendation about maintaining and monitoring robust systems to ensure fit and proper persons employed.

We served Warning Notice’s on the provider and registered manager requiring them to comply with three regulations by 12 June 2023. 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 standard 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.