About the serviceUnity House is a residential service providing personal care for up to 22 people with a learning disability. At the time of the inspection there were 13 people living at the service. Unity House provides accommodation over two floors across one large purpose-built house and some areas of the home have been converted to self-contained flats.
People’s experience of using this service and what we found
People were protected from harm as risks had been assessed and plans put in place to mitigate these. Support plans and positive behaviour support plans were in place however staff needed to ensure only current ones were kept in the file and they had always enough detail to support staff meet people’s needs.
The provider had reviewed the staffing model they used across their care homes and determined more flexibility was needed. The existing model did not enable staff to leave the service if someone needed additional support when in the community or provide flexibility for staff to rotate and take breaks. Additional staff were provided on both day and night shift to resolve these difficulties.
The provider was in the process of amending protocols for staff to follow when supporting people in the community to make it clear calling the police was to be used as a last resort rather than the first action when issues arose.
Throughout our visit we found staff work effectively with people to support them regulate their emotions and they created a very calming atmosphere. Staff effectively communicated with people. People were confident the service provided met individuals' needs.
Since January 2021 two successive managers had been appointed. The current manager was appointed to the post in June 2021 and they are yet to apply to become the registered manager.
Over the last year the provider and visiting professionals had identified improvements were needed. The provider had deployed a range of additional resources, such as area managers, the quality team and positive behavioural support team to the home to support staff make the necessary improvements. All reported this action had made positive improvements to the service and people’s quality of life.
Care staff, in general, adhered to COVID-19 guidance on working in a care setting. The provider needed to ensure the agency induction forms made it clear what was expected around their practice around adherence to current PPE guidance.
People were protected from abuse by staff who understood how to identify and report any concerns. The area manager was ensuring all appropriate referrals were made to the safeguarding team. Medicine management was effective. The environment and equipment were safe and well maintained.
The provider’s governance arrangements had identified improvements were needed in the home. Action had been taken to resolve these issues. The manager was in the process of learning how to use all aspects of the interactive electronic system.
We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.
This service was able to demonstrate how they were meeting some of the underpinning principles of Right Support, Right Care, Right Culture. Person-centred care was not however fully embedded into practice and outcomes for people’s independence and empowerment were at times inconsistent. We have made a recommendation about the need to improve person-centred care outcomes.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was requires improvement (published 12 January 2021).
Why we inspected
We carried out an unannounced focused inspection of this service in January 2021 and found two breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve infection control practices and governance arrangements. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
This report only covers our findings in relation to the Key Questions safe and well-led which contain those requirements. The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Unity House on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.