United Care (UK) Ltd is a domiciliary care agency. It provides personal care to older adults living in their own houses and flats. At the time of the inspection eleven people were receiving a service.

This inspection took place on the 28 January 2019. The inspection was announced. At the previous inspection which took place in December 2016 the service was rated as overall Good. However, the service was rated Requires Improvement in Well Led because there were no quality audits being carried out. At this inspection we found improvements had been made. The provider carried out staff observations and had developed a quality audit tool. Records showed issues identified were discussed with staff in supervision.

The service did not have a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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. The provider had recruited to the manager position and this person was in the process of becoming registered.

Staff knew how to report safeguarding concerns and knew about whistleblowing. People had risk assessments carried out to reduce the risks of harm they may face. Recruitment checks were carried out before new staff began working at the service. There were enough staff employed to meet people’s needs and keep them safe. People were protected from the risks associated with the spread of infection. The provider had systems in place to record and learn from accidents and incidents. People were supported with their medicines. However, records did not always contain a list of the medicines prescribed to people.

The provider assessed people’s needs before they began to use the service to ensure the right care could be provided. Staff were supported with training opportunities, regular supervision and annual appraisals. People were supported with their nutrition and to maintain their health. The provider and staff understood the requirements of the Mental Capacity Act (2005) and the need to obtain written and verbal consent before delivering care.

People and their representatives thought staff were caring. Staff knew how to support people with their care needs. The provider and staff involved people in care decisions. Staff knew about equality and diversity. People’s privacy, dignity and independence were promoted. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

Staff understood how to deliver personalised care. Care plans were detailed and personalised. People’s communication needs were met. The provider had a system to record and handle complaints. The provider ensured they could provide end of life care should this be required.

The provider had a system to obtain feedback from people using the service and their representatives in order to identify areas for improvement. Staff had regular meetings to embed training and be updated on policy changes. The provider worked in partnership with other agencies to identify areas for improvement.

We have made one recommendation in relation to medicines management.

We undertook this announced inspection on 21 December 2016. United Care is registered to provide Personal Care services to people in their own homes. The services they provide include personal care, housework and assistance with medicines. The service has a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are registered persons’. Registered persons have legal responsibility for meeting the requirements of the Health and Social Care Act and associated Regulations about how the service is run.

People and their relatives informed us that they were satisfied with the care and services provided. They informed us that people had been treated with respect and they were safe when cared for by the service. There was a safeguarding adult’s policy. Care workers knew what action to take if they were aware that people who used the service were being abused.

Risk assessments had been carried out and these contained guidance for care workers for minimising potential risks to people. There was a record of accidents. Where an accident was preventable, guidance to care workers on prevention had been provided. The service had a policy and procedure for the administration of medicines. Medicine administration records (MAR) examined had been properly completed and no gaps were noted.

Care workers were caring in their approach and knowledgeable regarding the individual choices and preferences of people. People’s care needs and potential risks to them were assessed and guidance provided to care workers on how to care for people. Care workers prepared appropriate and up to date care plans which involved people and their representatives.

Care workers had been carefully recruited. The necessary checks had been undertaken prior to them starting work. The service had a training programme to ensure care workers were competent and able to care effectively for people. They had the necessary support, supervision and appraisals from management staff. Teamwork and communication within the service was good. Newly appointed care workers had been provided with a period of induction and signed to evidence this.

There were arrangements for encouraging people and their representatives to express their views and make suggestions regarding the care provided and the management of the service. Reviews of care had been carried out to ensure that people received appropriate care.

The service had a complaints procedure and people and their representatives knew who to contact if they had concerns. No complaints were recorded. The registered manager stated that none had been received.

People and their representatives expressed confidence in the management of the service. They stated that care workers communicated well with them and understood their needs. Care workers were aware of the values and aims of the service and this included treating people with respect and dignity and providing a high quality care.

The service had a system of checks to ensure people received the care they needed. We were provided with evidence of spot checks on care workers and reviews of care which had been carried out. Audits of the service had not been carried out. The registered manager explained that the service had been slow in attracting contracts and they had only a few people using the service. He responded promptly and carried out an audit of the service. Documented evidence was provided soon after the inspection. This audit was not sufficiently comprehensive and a recommendation is being made accordingly.