We carried out a review of the data available to us about U&I Care Limited on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about U&I Care Limited, you can give feedback on this service.
U&I Care Limited is a domiciliary care agency providing personal care and support to people living in their own houses in the community or within the family home. It provides a service to adults. The service was supporting 5 people at the time of the inspection.
The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.
People’s experience of using this service and what we found
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 this practice.
The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.
Care and support was delivered on an individual basis as people either lived on their own or with family members. Care, support and activities were planned around individual likes and dislikes. People were encouraged to participate in activities that were meaningful to them and to experience new activities with varying degrees of success due to people’s general dislike of change.
We were told of several examples when the service had been exceptional in responding to people’s needs. For one individual their social worker told us it would have a life changing effect. People had opportunities to connect with other people using the U&I Care Limited services with attendance at social clubs, discos, dinner clubs and with the wider community. We saw that in some cases people had forged friendships with others.
During the inspection of the service we were told that some difficulties had arisen between family members and the service. A relative reported that this was usually around information sharing and activities. We were told that this had improved of late. We discussed with the manager ways to improve this aspect of the service. The possibility of working groups as a way forward to manage family’s expectations in line with legislation as people transitioned from children’s service to adult services.
People felt safe with the support from staff and showed us in their own individual ways that they were happy with their care. The service worked very hard to promote inclusivity and people’s diversity was embraced, staff demonstrated this with their knowledge of how people communicated and made their needs and wishes known.
Staff told us that they were proud to work for U&I Care Limited and we saw there was a genuine affection for the people they supported. There were processes in place for staff to access support at any time and we were told by staff that they felt supported by the management team. Records clearly showed that staff also received formal supervision, appraisal and regular training.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection (and update)
The last rating for this service was requires improvement (published 12 June 2018) and there were two breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
This service is a domiciliary care agency. It provides personal care to people living in their own houses in the community or within the family home. It provides a service to adults. The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.
Not all of the people using the service were able to verbally tell us their views on the care and support they received. People were able to indicate to us on occasions their thoughts by way of gesture and the use of facial expressions.
A registered manager was 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.
At the last inspection of this service in 2015 the service was rated good. During this inspection breaches of legal requirements were found and the service was rated 'Requires Improvement.'
During this inspection we found breaches in relation to the governance of the service and staff recruitment and selection processes You can see what action we told the provider to take at the back of the full version of the report.
Staff recruitment procedures were not always safe. Checks on recruitment records demonstrated that the service had not ensured that appropriate references had been sought and application forms had not always been completed. In addition, information relating to people’s Disclosure and Baring Service check had not always been discussed or recorded. This did not demonstrate that robust recruitment checks were being undertaken by the registered provider when recruiting new staff. We checked the provider’s policy with regards to the recruitment and selection of staff and found the provider was not always adhering to their own procedures.
Quality assurance systems were in place which included regular audits carried out by managers within the service. We found that these audits were not always effective. This was because the currently auditing systems had failed to identify that improvements were needed to ensure safer recruitment procedures were in place. In addition we found that the current auditing processes had failed to identify improvements needed to records relating to people’s care. Improvements were also needed to ensure that up to date information and guidance was available within the policies and procedures within the service.
We have made a recommendation in relation to reviewing the process for managing accidents and incidents.
We have made a recommendation in relation to the recording of people’s best interest decision made under the Mental Capacity Act.
We have made a recommendation in relation to the overall management of complaints.
We have made a recommendation about staff training in relation to autism.
Procedures were in place to safeguard people from harm. Staff were aware of the procedures in place and had received training in relation to safeguarding people.
People were generally supported to have maximum choice and control of their lives and staff generally supported them in the least restrictive way possible; the majority of policies and systems in the service supported this practice.
Staff supported people in a kind and caring manner and it was evident that positive relationships had been formed with the people they cared for.
Risk assessments contained sufficient detail to enable staff to keep people safe from harm. Consideration was given within the content of the risk assessments to people's diverse needs and behaviours.
Sufficient staff were available to ensure that people were supported with their assessed needs. We checked the numbers of staff against the rota and saw that each person was receiving the correct level of support from staff as planned.
A process was in place for assessing people’s needs and wishes prior to using the service. This assessment process helped ensure that U&I Care Ltd had the resources and skills to meet a person’s needs.
Staff received an induction into their role prior to them commencing work within the service. Staff told us that they had received suitable training for them to carry out their role safely. We spoke with the registered manager regarding the training provided regarding autism awareness. Due to the complexities of some of the people using the services of U&I Care Ltd the autism training offered to staff was not as thorough as expected. The registered manager was looking at introducing new more robust training.
Staff spoke positively about the support they received from registered manager. They told us that they were approachable and that they were always available to contact if they needed to.