17 September 2014
During a routine inspection
' Is the service safe?
' Is the service effective?
' Is the service caring?
' Is the service responsive?
' Is the service well led?
Below is a summary of what we found. The summary describes what people using the service, their relatives told and the staff told us, what we observed and the records we looked at.
If you want to see the evidence that supports our summary please read the full report.
Is the service safe?
People were supported to have their health needs met. We saw that health monitoring charts were in place where people were at risk. These included monitoring of diet. We saw that when staff had concerns about people's health they contacted the office. We saw that action was taken as a result of any concerns raised. For example, early referral to their GP when a suspected infection presented, to allow the person to receive treatment promptly. This meant the service was responsive to people's changing needs.
The Registered Manager also confirmed how they managed emergencies around deterioration of health and end of life care; with advice sought from District Nurses and GPs when required. They explained the procedure to cope with staff sickness, to ensure all people received the planned daily care as agreed.
People who used the service told us they felt safe and well cared for by staff. All the people we spoke with described the staff as kind and felt secure with the care they received in their own home. One person told us "I've never had any concerns or cause to complain. But if I did I wouldn't hesitate to talk to staff." They added "I'm confident this would be dealt with and acknowledged promptly."
Is the service effective?
We saw that prior to using the service, people and or their representatives met with the provider to discuss care packages. Records showed that further information was gathered about the person's history, detailing their likes, dislikes and specific needs they had. This meant that the needs of the people using the service were fully assessed and ensured the provider could meet their needs. Care records we reviewed contained copies of these assessments.
People were supported to express their views and be involved as much as possible in making decisions about their care. People and their relatives told us they had been involved in the setting up of the care package. They told us that if there were any issues the service would contact them to let them know. People and relatives told us that they usually had the same group of care staff. This meant people could recognise staff and build relationships.
Is the service caring?
One person using the service told us "They have always treated me with respect and dignity; I've really appreciated that at times when I've been unable to do things for myself." They added "When family are not here, they are my substitute family. I couldn't thank them enough."
One person told us "Staff make suggestions how to make things easier for me, they are all very kind and caring. Giving me the support to remain independent."
Another person told us "I think Unicare are brilliant, I can't praise them enough for the help they have given me."
People who used the service were very complimentary about the management and the staff. One person said "I couldn't speak about the Manager and staff any higher. They are all very caring." Another person told us "The staff are excellent. They are lovely people and very good at caring for us."
We spoke with five care staff who demonstrated respect for the privacy and dignity of the people they visited. Staff told us they were mindful of the need to protect the dignity of the people they supported with personal care. Staff said that they prompted people to use towels for privacy when needed during personal care tasks. This meant the service recognised the importance of respecting people's dignity, diversity, values and human rights.
Is the service responsive?
From the care plans, we saw that the Registered Manager worked closely with other agencies and professionals for the best interests of the person using the service. The Registered Manager explained the process for changes in the mental health of a person using the service.
The Registered Manager said people's relatives and other professionals were consulted, where appropriate, when important decisions needed to be made about the care and treatment. We saw evidence in people's care plans of appointees to act in people's best interests.
There were arrangements in place to deal with foreseeable emergencies. The Registered Manager told us they operated an "on call" 24 hours a day system. For example, if a member of staff was taken unwell they could call the number to make arrangements for a replacement member of staff. This meant staff could contact the provider at any time for assistance to ensure people's care was not compromised.
Is the service well led?
The Registered Manager worked with staff to have an on-going review of the needs of those using the service. They worked closely with Social Services when a person's needs increased beyond what they could safely manage at home. This demonstrated that the service was able to identify that people were being supported in the best place for their needs to be met.
One staff member told us "When I first started I was made to feel very welcome and anything I didn't understand I could ask without feeling stupid." They added "'I've never known such a supportive company to work for, it's just like a family." Another told us that they felt confident if they approached the Registered Manager with any concerns, that these would be dealt with quickly and professionally.
One staff member told us "I once spoke with the Manager about a concern I had, I felt listened to and the action taken improved the safety of the person." They added "I would always encourage anyone to talk about any concerns for the safety of a person or the staff member."
We found that there were systems in place to regularly assess and monitor the quality of the service that people received. The Registered Manager told us that monthly audits were undertaken on medication records and daily logs. We looked at these audits and found they were completed regularly. The Registered Manger told us that spot checks were made on staff. This meant that the provider monitored the quality of service provided so they could make improvements.
As part of our inspection, we looked at the support which staff received to carry out their role. We spoke with five members of staff and the Registered Manager about this. Staff told us that they felt fully supported to carry out their role. They felt that the Registered Manager and all office staff were approachable, professional and supportive.