Unique Homecare Services (Lincoln) Ltd was rated Good across all five key questions at this first inspection, with exceptionally caring, person-centred practice and innovative approaches to wellbeing. Some weaknesses were identified in care plan risk recording, whistleblowing knowledge, MCA documentation, end of life planning and governance audits, all of which the registered manager addressed promptly during the inspection.
Concerns (9)
moderate
Care planning
: “Risks to people were assessed and documented, but we identified two people being at risk of falls where this was not included in their care plans.”
moderateMedication management: “in the days prior to the inspection one person had not received their pain relief patch. The management team were not aware of this, as the month's medicines administration record audit had not yet been completed”
moderateGovernance: “some of these systems could have been more robust such as the accidents and incidents audit.”
minorSafeguarding: “Some staff members were unsure on aspects of whistleblowing procedures, but they understood the need to raise concerns about poor practice to keep people safe.”
minorRecord keeping: “we found some unexplained gaps in staff's employment history in their recruitment files.”
minorConsent / capacity: “The provider had completed mental capacity assessments for people when needed but these could have included more information around the questions used and answers given.”
minorCommunication with families: “Care plans included information on people's communication needs but could have included more specific information.”
minorEnd-of-life care: “We found limited information in people's end of life care plan information.”
minorIncident learning: “There were a small number of accidents and incidents recorded with some evidence of learning lessons when things went wrong.”
Strengths
· Exceptionally kind and caring staff who went above and beyond, e.g. printing a poem for a person and taking photos abroad to share personal memories
· Strong person-centred culture with minimum 45-minute care calls to support social interaction and wellbeing
· Innovative approaches such as a no-uniform policy to reduce stigma and a care planning app for people and relatives to review their care
· Comprehensive staff induction, Care Certificate support, regular supervisions and access to additional training
· Safe recruitment with DBS checks and references, and appropriate staffing levels
Quality-Statement breakdown (21)
safe: Assessing risk, safety monitoring and management; Systems and processes to safeguard people from the risk of abuseNot rated
safe: Staffing and recruitmentNot rated
safe: Using medicines safelyNot rated
safe: Preventing and controlling infectionNot rated
safe: Learning lessons when things go wrongNot rated
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawNot rated
effective: Staff support: induction, training, skills and experienceNot rated
effective: Staff working with other agencies to provide consistent, effective, timely careNot rated
effective: Supporting people to eat and drink enough to maintain a balanced dietNot rated
effective: Supporting people to live healthier lives, access healthcare services and supportNot rated
effective: Ensuring consent to care and treatment in line with law and guidanceNot rated
caring: Ensuring people are well treated and supported; respecting equality and diversityNot rated
caring: Supporting people to express their views and be involved in making decisions about their careNot rated
caring: Respecting and promoting people's privacy, dignity and independenceNot rated
responsive: Planning personalised care to ensure people have choice and control and to meet their needs and preferencesNot rated
responsive: Meeting people's communication needsNot rated
responsive: Improving care quality in response to complaints or concernsNot rated
responsive: End of life care and supportNot rated
well-led: Continuous learning and improving care; Working in partnership with othersNot rated
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringNot rated
well-led: Engaging and involving people using the service, the public and staffNot rated