This announced comprehensive inspection was conducted on 24 May and 21 June 2018.Unite healthcare is a domiciliary care agency which offers care and support to people living in their own homes. The agency has an office based in Rainhill, Merseyside and employs 107 staff. The service was supporting 255 service users at the time of the inspection.
There was a registered manager in post. 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.
The last comprehensive inspection of Unite Healthcare was carried out in February and March 2017 and was rated Requires Improvement. We had found the registered provider was in breach of Regulations 12 and 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was because medicines were not managed safely and quality monitoring systems were not always effective. We asked the provider to complete an action plan telling us how they would address the issues. We found that improvements had been made and the provider was no longer in breach of regulations.
Individual risks to people were accurately assessed and reviewed regularly with measures in place to manage the risks identified and keep people safe from harm.
Staff were aware of different types of abuse and how to report safeguarding incidents. Those that were reported had been done so appropriately. Staff had received appropriate training in safeguarding and were able to explain how to keep people safe from abuse - Staff were also aware of the whistleblowing policy.
Sufficient numbers of suitably trained staff had been deployed to meet people’s needs and provide appropriate support. Staff had received training in areas such as infection control, manual handling, first aid, mental capacity act and food hygiene. Staff were supported in their role with regular supervision.
Accidents and incidents were reported and recorded appropriately. They showed evidence of analysis, review and action taken where needed.
Medicines were managed safely and staff had received appropriate training in order to safely administered medication. Those responsible for administering medication had their competency levels assessed regularly.
Consent for care was not always obtained in accordance with the Mental Capacity Act 2005. However, where issues had been identified around consent the registered manager had put measures in place to address this and provided evidence of these changes throughout the inspection period.
People were supported with their nutritional needs and had access to other health and social care professionals to help maintain their health and well-being.
People receive care and support specific to their needs; care plans were person centred and based on individual needs. However not all care plans provided detailed information regarding a person’s likes/dislikes and social background. The registered manager was aware of this issue and working to address this.
Care records provided detailed information regarding the support required and at what times. However, not all calls were made at the allocated times. There was no evidence that this impacted on the care and support being provided.
We have made a recommendation regarding call times.
People and their relatives had access to information about how to make a complaint if needed; people told us they felt confident making a complaint and those recorded had been dealt with appropriately.
There were systems in place to gather the feedback of people receiving support; feedback about the service was positive.
The service had implemented an electronic care record system that allowed for daily quality monitoring of the service being provided. This system was mostly effective however where calls had not been completed at the planned times these had not always been identified and addressed at the time.
We have made a recommendation regarding the quality monitoring systems.
The registered manager notified CQC of important incidents and events that occurred within the service.