Care Unique Limited

At our last inspection in September 2016, we rated the service 'good' overall and 'requires improvement' in the well-led domain, with one breach of Regulations relating to good governance. Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key question of 'is the service safe' to at least good. At this inspection we found the evidence continued to support the rating of good overall, the well domain had improved to good, with no breach of Regulations, and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Two registered managers were in position, one of whom was the registered provider and the other was employed as the care manager. 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.

Staff had a good understanding of systems in place to manage medicines, safeguarding matters and behaviours that are challenging to others. People's medicines were managed so that they received them safely.

Assessments were in place to reduce risks to people's health and welfare and any accidents/incidents were documented with outcomes and actions to prevent reoccurrence. Staff liaised with a range of health care professionals to ensure people's health care needs were supported.

There were sufficient staff available to ensure people's wellbeing, safety and security was protected. A robust recruitment and selection process was in place and staff received training and updates in a variety of subjects. This ensured staff had the right skills and were suitable to work with vulnerable people.

The service was working within the legal requirements of the Mental Capacity Act (2005). Staff had received training and the registered manager understood their legal responsibilities under the Act. People are

supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice.

People and their relatives confirmed most staff were caring and looked after people well, treating them with respect. Staff had a good understanding of people's needs. People were provided with the care, support and equipment they needed to stay as independent as possible.

People's needs were assessed and plans of care put in place which were reviewed regularly, including the person or their relatives wherever possible. People's preferences were considered when devising plans of care.

Staff we spoke with understood the importance of supporting people to have a good end of life as well as living life to full whilst they were fit and able to do so. The service liaised with health and social care professionals to develop plans of care to ensure their passing was comfortable, pain free and as peaceful as possible.

A complaints procedure was in place. Complaints were taken seriously and investigated. Less formal concerns were documented and actions taken as a result.

Staff spoke consistently about the service being a good place to work. The management team were constantly looking at ways to improve the service. The registered provider worked in partnership with other organisations and took part in good practice initiatives designed to further develop the quality of services in the local area.

Quality assurance systems were in place to monitor and drive improvements within the service. People's opinions of the service were sought through quality questionnaires and annual surveys. Regular staff meetings were held to share best practice and help improve the service provision.

As a result of our inspection, we concluded the service met all relevant fundamental standards.

Further information is in the detailed findings below.

The five questions we ask about services and what we found