Unite Care Ltd improved from Requires Improvement to Good across all inspected key questions (Safe, Responsive, Well-led), having remediated prior breaches of Regulations 9, 12, and 17. The service demonstrated safe medicines management, robust risk assessments, no missed visits, and strong person-centred care, with only a minor recommendation to formalise lessons-learned dissemination.
Concerns (1)
minorIncident learning: “we found the process for disseminating information on lessons learnt could be further developed. We have made a recommendation for implementation of formal systems”
Strengths
· No missed or late calls recorded over the past three months via electronic monitoring system
· Detailed and clear risk assessments developed since previous inspection, accessible to care workers via app
· Medicines managed safely with electronic MAR system and automatic alerts for missed medicines
· Robust quality assurance monitoring system with regular spot-checks and care plan audits
· Person-centred electronic care planning system implemented since last inspection
Quality-Statement breakdown (15)
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Assessing risk, safety monitoring and managementGood
safe: Staffing and recruitmentGood
safe: Using medicines safelyGood
safe: Preventing and controlling infectionGood
safe: Learning lessons when things go wrongGood
responsive: Planning personalised care to ensure people have choice and control and to meet their needs and preferencesGood
responsive: Meeting people's communication needsGood
responsive: Improving care quality in response to complaints or concernsGood
responsive: End of life care and supportGood
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsGood
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringGood
well-led: How the provider understands and acts on the duty of candourGood
well-led: Continuous learning and improving careGood
Unite Care Ltd, a small domiciliary care agency in Brent, received an overall rating of Requires Improvement at its first inspection, with breaches of Regulations 9, 12 and 17 identified in relation to unsafe medicines management, inadequate risk assessments and ineffective governance systems. People and relatives were consistently positive about the caring, respectful attitude of staff, and the service demonstrated good practice in safeguarding, infection control, consent and partnership working.
Concerns (5)
criticalMedication management: “we were not able to find information about the medicines, a medicines risk assessment and medicines administration record sheet (MARs) in the person's care folder.”
criticalCare planning: “we saw in one care plan that there was a different name recorded. It was therefore not clear who this care plan was for.”
criticalGovernance: “the quality audit system had failed to identify the issues we found in respect of medicines management and risk management and person-centred care planning.”
moderateRecord keeping: “Care records at times contained conflicting information and didn't reflect the assessed needs of people who used the service.”
moderatePerson-centred care: “Care plans viewed were found to be not always personalised and did not always reflect the person's needs and preferences.”
Strengths
· People and relatives consistently reported feeling safe and expressed satisfaction with the caring, respectful attitude of care workers.
· Robust safeguarding adults procedure in place with staff trained to identify and report abuse concerns.
· Safe recruitment practices followed, including DBS checks prior to employment.
· Appropriate infection prevention and control measures in place, including COVID-19 PPE provision and testing.
· Systems in place to record accidents and incidents with lessons learned used to improve quality.
Quality-Statement breakdown (23)
safe: Assessing risk, safety monitoring and managementRequires improvement
safe: Using medicines safelyRequires improvement
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Staffing and recruitmentGood
safe: Preventing and controlling infectionGood
safe: Learning lessons when things go wrongGood
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawGood
effective: Staff support: induction, training, skills and experienceGood
effective: Supporting people to eat and drink enough to maintain a balanced dietGood
effective: Staff working with other agencies to provide consistent, effective, timely careGood
effective: Supporting people to live healthier lives, access healthcare services and supportGood
effective: Ensuring consent to care and treatment in line with law and guidanceGood
caring: Ensuring people are well treated and supported; respecting equality and diversityGood
caring: Supporting people to express their views and be involved in making decisions about their careGood
caring: Respecting and promoting people's privacy, dignity and independenceGood
responsive: Planning personalised care to ensure people have choice and control and to meet their needs and preferencesRequires improvement
responsive: Meeting people's communication needsGood
responsive: Improving care quality in response to complaints or concernsGood
responsive: End of life care and supportGood
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsRequires improvement
well-led: How the provider understands and acts on the duty of candourGood
well-led: Engaging and involving people using the service, the public and staff, fully considering their equality characteristicsGood
well-led: Continuous learning and improving care; Working in partnership with othersGood