Uniq Health Care

Updated 21 March 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.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

One inspector and one Expert by Experience carried out the inspection. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

This service provides care and support to people living in 5 ‘supported living’ settings, so that they can live as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

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 it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection. This was also because people are often out and we wanted to be sure there would be people at home to speak with us.

Inspection activity started on 2 February 2023 and ended on 20 February 2023. We visited the location’s office on 6 and 7 February 2023 and people’s homes on 7 and 9 February 2023.

What we did before inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used all this information to plan our 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.

During the inspection

We met and spoke with 2 people in 2 different settings about their experience of the care provided. We observed staff interacting with 1 person who could not talk with us to help us understand their experience. We provided a questionnaire to 1 person who did not wish to speak with us, which they decided not to complete.

We spoke with 5 people’s relatives and 8 members of staff, including senior support workers, support workers, service coordinator, clinical lead, the registered manager and nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We received written feedback from a further 9 staff members, 3 people’s relatives and 8 health and social care professionals by email.

We reviewed parts of 5 people's care records. We reviewed 3 staff recruitment files and a number of management records such as policies and procedures and quality checks and audits.

Updated 21 March 2023

About the service

Uniq Health Care is a supported living service and domiciliary care agency providing care to people in their own homes. At the time of our inspection the service was not providing domiciliary care but intended to do so in future. The service specialises in providing care to adults under and over 65 years with a learning disability, autistic people and people with mental health conditions. 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. At the time of the inspection there were 6 people receiving personal care in 5 different shared supported living settings across Berkshire.

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

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

Right Support:

The leadership team were not fully clear about whether the service was a homecare agency or a supported living service. Management acted to resolve this during the inspection. National guidance for supported living services was understood and embedded.

Staff supported people with their medicines in a way that promoted safety. The service had not fully implemented procedures to manage controlled drugs safely. This was acted upon during our inspection. We have made a recommendation about this. The service did not consistently act to ensure people were supported in safe, clean and well-maintained environments. We have made a recommendation about fire safety.

The service worked with people to plan for when they experienced periods of distress so that their freedoms were restricted only if there was no alternative. We have made a recommendation about staff training standards about reducing restrictive practices. Staff supported people to play an active role in maintaining their own health and wellbeing.

Staff focused on people’s strengths and promoted what they could do, so people had a fulfilling and meaningful everyday life. People were supported by staff to pursue their interests and achieve their aspirations and goals. 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.

Right Care:

Staff understood how to protect people from poor care and abuse. The service worked well with other agencies to do so. One previous incident was not reported to CQC as required. Management acted to address this during the inspection. We were notified of all other events appropriately.

Staff recruitment checks were not consistently robust to promote safety. Management took immediate action to reduce any potential risk to people. The service had enough appropriately skilled staff to meet people’s needs and keep them safe. The service used training to help staff physically disengage from unwanted physical contact from people. National guidance recommends this type of training is usually for administrative staff who do not support people directly. We sign-posted the service to staff training standards.

Staff promoted equality and diversity in their support for people. They understood people’s cultural needs and provided culturally appropriate care. People received kind and compassionate care. Staff protected and respected people’s privacy and dignity. They understood and responded to their individual needs.

Right Culture:

People led inclusive and empowered lives because of the ethos, values, attitudes and behaviours of the management and staff. People received good quality care, support and treatment because trained staff and specialists could meet their needs and wishes.

People’s quality of life was enhanced by the service’s culture of improvement and inclusivity. Staff ensured risks of a closed culture were minimised so that people received support based on transparency, respect and inclusivity. People and those important to them, including advocates, were involved in planning their care.

Staff turnover was very low, which supported people to receive consistent care from staff who knew them well. Staff evaluated the quality of support provided to people, involving the person, their families and other professionals as appropriate.

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

Rating at last inspection

This service was registered with us on 12 November 2020 and this is the first inspection.

Why we inspected

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

We looked at infection prevention and control measures under the Safe key question. We look at this in all supported living inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Recommendations

We have made recommendations about the management of medicines, fire safety and staff training.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.