About the service: Universal Care Services provides a domiciliary care service to people in a shared living environment. Four people with learning disabilities share a living space and the service provide support with activities of daily living 24 hours a day. At the time of our inspection, the service was providing personal care to four people.

At the time of registration, the care service had not been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice and independence. People using the service receive planned and coordinated person-centred support that is appropriate and inclusive for them. The service is now working towards developing the service in line with these principles, ensuring people with learning disabilities can live as ordinary a life as any citizen.

People’s experience of using this service:

Relatives told us their family member was safe. Risks to people were assessed and how to reduce risks and how to respond to possible harm recorded. The management of medicines was safe and staff had completed training. Staff followed infection prevention and control guidance when supporting people.

There were enough skilled and experienced staff to meet people’s needs. An induction was completed by new staff. Staff received appropriate training and support to enable them to perform their roles effectively. Recruitment processes were in place and followed.

Staff involved healthcare professionals to support people's health care needs were required. People received support, with eating and drinking, when needed. 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 gained people's consent before providing personal care and support.

Relatives said and people’s satisfaction surveys told us staff were kind and caring. The staff described how individual people preferred their care and support delivered and the importance of treating people with dignity and respect. Care plans showed people were involved in their care and they contained sufficient detail for staff to provide effective care and support.

People, relatives and staff had the opportunity to provide feedback about the service. Information was provided so people knew who to speak with if they had concerns. There was a system in place to respond to any complaints. The provider worked in partnership with other services to support people’s when needed. Systems were in place to monitor the quality of service but the provider was in the process of reviewing the quality checks to make these more robust.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk.

Rating at last inspection: At the last inspection the service was rated Good. (published 2 August 2016). The overall rating has remained the same.

Why we inspected: This was a planned inspection based on the previous rating of Good.

Follow up: We will continue to monitor the service through information we receive. Further inspections will be planned for future dates as per our re-inspection programme. If any concerning information is received we may inspect sooner.

This inspection took place on 8 June 2016. This was an unannounced inspection.

At the time of our last inspection in December 2013, Universal Care Services was found to be meeting all of the essential standards relating to the quality and safety of care.

Universal Care Services provides a domiciliary care service to four people in a shared living environment.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission 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 service was safe because people were protected from the risk of abuse and avoidable harm and staff were aware of the processes they needed to follow. People were supported by enough members of staff who knew them well enough to ensure their needs were met. We also found that people received their prescribed medicines as required.

The service was effective because people received care from staff who had received adequate training and had the knowledge and skills they required to do their job effectively. People received care and support with their consent, where possible and people’s rights were protected because key processes had been fully followed to ensure people were not unlawfully restricted.

People’s nutritional needs were assessed and monitored to identify any risks associated with nutrition and hydration and they had food they enjoyed. People were also supported to maintain good health because staff worked closely with other health and social care professionals when necessary.

The service was caring because people were supported by staff that were very kind and caring. People received the care they wanted based on their personal preferences and likes and dislikes because staff were dedicated and committed to getting to know people well. People were also cared for by staff who protected their privacy and dignity.

People were encouraged to be as independent as possible and were supported to express their views in all aspects of their lives including the care and support that was provided to them, as far as reasonably possible.

The service was responsive because people and their relatives felt involved in the planning and review of their care because staff communicated with them in ways they could understand. People were also encouraged to offer feedback on the quality of the service and knew how to complain.

People were actively encouraged and supported by staff to engage in group and individual activities that were of interest and important to them. People were also supported to maintain positive relationships with their friends and relatives.

The service was not always well led because quality monitoring processes had not always identified areas for improvement such as record keeping. However, this was not found to have had a negative impact on the people that were receiving a service and everyone we spoke with were complimentary about the registered manager.

Staff felt supported and appreciated in their work and reported Universal Care Services to have an open and honest leadership culture.

There were four people being supported by the service when we inspected. People lived in ‘supported living’.This means all four people lived in one house and had individual tenancy agreements. During our inspection we spoke with the manager/ provider three staff and four relatives. People using the service were not able to speak with us because they had limited verbal communication skills.

Relatives spoken with were very complementary about the care their relatives received. One relative told us, “I cannot believe the difference in X we looked for a long time before using the service. I am so pleased with his progress’’. Another relative told us,“He is clean, well presented and very happy''.

People’s care and health needs were planned and met in a personalised way. All staff spoken with told us they had the information they needed to care for people safely.

Staffs were clear about the action to take should they become aware of an allegation of abuse. All relatives spoken with told us they felt that their relative was safe and secure.

Staff were supported, supervised and trained to provide safe and effective care. All staff spoken with told us that they had the support they needed to ensure people’s care needs were met.

There were systems in place to monitor how the service was run, and action was taken where feedback from relatives and people using the service said things could improve.

We told the provider we were visiting as the provider also carried out visits to people in their homes and when we visited unannounced, there was no one available to assist us.

The agency provided a service to four people living in supported accommodation (people living in the same house with independent tenancies). We spoke with the manager during our visit, three relatives, three staff and one person using the serivce on the telephone following our visit .

People were encouraged to express their views about their care and how they wanted staff to support them.

All relatives spoken with were happy with the service provided to their relatives. People had individual care plans detailing what care they needed. One relative told us,” Staff are very good kind and respectful to X and I can see X feels comfortable in their presence when they bring X to visit me.” Another relative told us, “I don’t worry so much now because I know my relative is being cared for’’.

Staff received a range of training so that they had up to date knowledge and skills in order to support the people receiving a service.

The provider had clear procedures in place to identify and respond to suspicions of abuse to ensure people were protected against abuse.

There were systems in place to monitor the quality of the service provided. Improvements were made by listening to the views of people using the service, their relatives and taking the appropriate actions.