Unity Care Solutions (Lewes) was rated Good across all five key questions at its first inspection, providing safe, personalised complex care to 12 people via a small, well-trained staff team. Minor concerns noted around staffing cover for sickness/leave, mental capacity assessment documentation, absence of end-of-life planning, and the registered manager needing additional office support.
Concerns (5)
minor
Staffing levels
: “it was not always possible to cover staffing if there was sickness or annual leave”
minorConsent / capacity: “We saw a mental capacity assessment for one person who did not have a legal representative. These were not individual and did not include information about how the decisions had been made.”
minorEnd-of-life care: “There was no information about people's end of life wishes. The registered manager and clinical lead told us these discussions would be held when appropriate to do so.”
minorLeadership: “The manager is a nice guy, but he works on his own, he needs staff.”
minorGovernance: “Provider had identified improvements were needed to the audit system. A new audit schedule had been developed which ensured regular audits across all services.”
Strengths
· Risks to people's complex health needs were well identified, assessed and managed with clear staff guidance
· Staff received person-specific training including seizures, tracheostomy, ventilators and PEG feeding
· Medicines managed safely with detailed guidance for 'as required' and rescue medicines
· Same small team of staff supported each person, ensuring continuity and strong relationships
· Safe recruitment with DBS, references, employment history and NMC checks for nurses
Quality-Statement breakdown (23)
safe: Systems and processes to safeguard people from the risk of abuseNot rated
safe: Assessing risk, safety monitoring and managementNot 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: 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: Promoting a positive culture that is person-centred, open, inclusive and empoweringNot rated
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsNot rated
well-led: Engaging and involving people using the service, the public and staffNot rated
well-led: Continuous learning and improving careNot rated
well-led: Working in partnership with othersNot rated