CQC report explained · a residential care home
What the CQC found at U&I Care Limited
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found suitable staff recruitment checks, safe medicines systems, safeguarding training and risk assessments. The home was clean and incidents were reviewed to reduce the chance of them happening again.
- Effective?
- Good
- People's needs and choices were assessed and care plans aimed to build independence. Staff received induction, training and supervision, and the home worked with health and social care professionals.
- Caring?
- Good
- Staff knew the person's preferences and communication style and treated them with kindness, dignity and respect. The person was involved in planning their care and was supported to make choices.
- Responsive?
- Good
- Support and activities were organised around the person's interests, choices and communication needs. Inspectors suggested clearer recording of complaints, particularly where someone could not communicate verbally.
- Well-led?
- Good
- Changes to the management structure created clearer accountability and improved monitoring. Audits and incident reviews were in place, although inspectors said these needed time to become consistent.
What inspectors found, August 2019
Rated Good; inspectors found safe, kind and personalised care, with some recording and transition arrangements to improve.
This was a planned inspection because the previous rating was Requires Improvement. The inspection activity took place on 14 May, 26 June and 01 July 2019, with an office visit on 08 May 2019.
The home was registered for three adults with a learning disability and autism. One person lived there at the time. Inspectors visited the home, met the person, reviewed care and medicine records, and spoke with staff, managers and professionals involved in the person's support.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. Inspectors found improvements since the previous inspection, including stronger recruitment checks and better management oversight. The home was no longer in breach of the two regulations identified at the previous inspection.
Care built around the person
The person helped decide daily routines, activities and how support was provided. Staff used detailed knowledge of their likes, dislikes and communication.
“Care and support was delivered on an individual basis and the occupant of the home decided the daily routines.” from the report
Kind and respectful staff
Inspectors saw staff treating the person compassionately and supporting their dignity, independence and choices.
“We observed staff consistently treating people with a very kind and compassionate manner.” from the report
Staff checks and training
Recruitment, induction, training and supervision processes were in place to help ensure staff had the right skills and were suitable for the work.
“Thorough recruitment and induction processes were in place to ensure staff were suitable and received appropriate training to deliver care and support.” from the report
Activities and independence
The person was supported to take part in education, work placements, clubs, social activities and interests, while deciding whether to participate.
“The person led their own activities programme and decided whether to participate or not.” from the report
Improved management oversight
A changed management structure and audits gave the service clearer lines of accountability and better oversight of incidents and quality.
“Recent changes to the management structure of the organisation were seen as positive in supporting clear lines of accountability.” from the report
Transition arrangements
needs fixingThe service needed to review how it explained support choices when people moved from children's services to adult services. This was to help families understand what adult services could legally provide.
“This aspect of people's care across all U&I Care services needs to be reviewed, to be able to manage family's expectations in line with legislation as people transitioned from children's service and receive support in adult services.” from the report
Complaint records
needs fixingInspectors suggested making clearer records of complaints and concerns, especially when a person could not communicate verbally.
“We suggested the service improved the quality of recording any complaints made by people using the service.” from the report
Evidence of follow-up
needs fixingThe service was asked to keep evidence showing that it had followed up applications concerning possible restrictions on a person's liberty.
“We asked the service to keep evidence of when they had followed up on progress of DoLS applications with the local authority.” from the report
- 01How would you explain the choices and limits of support to our family member when moving from children's services to adult services?
- 02How do you record complaints or concerns when a person cannot communicate verbally?
- 03What evidence do you keep to show that applications concerning restrictions on liberty have been followed up?
- 04How will you make sure care plans contain information that is relevant to the individual rather than standard information?
- 05How do you involve the person and their family in regular reviews of care, activities and health appointments?
This was a planned inspection covering all five CQC questions, with the home visit focused on one person and records about staff working across the provider's services. This explanation was written from the published report of 9 August 2019 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, May 2018
U&I Care Limited rated Requires Improvement; inspectors found kind, individualised care but weaknesses in recruitment, consent, health access and management checks.
This was a comprehensive inspection carried out earlier than planned because CQC had received information about possible risks and concerns. There was an unannounced visit on 22 January 2018 and an announced visit on 26 January 2018. Inspectors spoke with staff and relatives and reviewed care records, recruitment files, medicines records and quality checks.
The home was caring, with staff described as kind, patient and respectful. People had individual care plans, choices and a wide range of activities. Medicines were managed safely, staffing levels met people's needs, and risks were usually assessed and reviewed.
The home was rated Requires Improvement overall. CQC found unsafe recruitment checks, incomplete records about decisions made for people who lacked capacity, delays in accessing some medical care, weak complaints records and quality checks that had not found these problems. The provider was in breach of Regulations 17 and 19.
Kind and respectful care
Inspectors saw staff being calm, patient and positive with people. Relatives also described staff as kind and caring.
“We observed staff to be calm and patient with people when providing support.” from the report
Safe medicines support
Medicines were stored securely and records checked by inspectors were completed correctly. Staff had medication training and regular competency checks.
“Staff had received appropriate training in the safe administration of medication and had their competency assessed regularly.” from the report
Personalised support
Care records reflected people's individual needs, preferences, communication and behaviour. Plans were reviewed regularly and gave staff detailed guidance.
“Care records and support plans were based on individual needs and requirements and were reviewed regularly.” from the report
Recruitment checks
seriousSome staff files did not show that proper references and employment histories had been checked before staff started work. This was a breach of Regulation 19.
“Some recruitment files did not contain appropriate references prior to staff commencing employment and those that did contain references had not always been obtained from previous employers as detailed in the provider's policy.” from the report
Emergency evacuation plans
seriousPersonal Emergency Evacuation Plans did not explain clearly how staff should communicate with people or safely evacuate them in an emergency.
“The PEEP forms did not provide guidance for staff on how to communicate effectively to people and safely remove them during an emergency.” from the report
Consent records
needs fixingThe home did not consistently record capacity assessments or who was involved in best-interest decisions. One relative had consented to medical treatment without having the legal authority to do so.
“We did not see evidence of staff recording when a decision had been made and who was involved in that decision.” from the report
Access to medical care
needs fixingRelatives said medical treatment was not always requested promptly when people were injured or needed help. They reported some improvement after new senior staff joined.
“However relatives told us people were not always supported to access medical care in an appropriate time scale.” from the report
Autism training
needs fixingAutism training was an introduction delivered by the provider and was not accredited. Relatives felt some staff did not have enough autism-specific knowledge to manage behaviour effectively in the community.
“Staff had received training in most areas relevant to their role, however training provided for autism was an 'introduction to autism' delivered by the registered provider and not an accredited training program.” from the report
Weak management checks
seriousAudits and reviews did not identify several problems found during the inspection. This included recruitment, best-interest records, incident reviews, complaints records and some medicines errors. This was a breach of Regulation 17.
“This showed that systems in place to check the quality and safety of the service were not effective.” from the report
- 01What has changed in recruitment since the inspection, and are references, employment histories and gaps checked before staff start?
- 02How are capacity assessments and best-interest decisions now recorded and made available at the home?
- 03How do you make sure injuries and other health concerns are referred for medical advice without delay?
- 04Have the Personal Emergency Evacuation Plans been rewritten to explain how each person will be supported safely?
- 05What accredited autism training do staff now receive, and how is their competence checked?
This was an early comprehensive inspection covering all five CQC questions; it followed information about risk or concern, and the previous September 2015 rating was Good. This explanation was written from the published report of 17 May 2018 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of U&I Care Limited
3 rated inspections over 4 years: the service has held its Good rating throughout.
- August 2019Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2018Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- November 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- October 2014
Report published without a new overall rating.
- February 2014
Report published without a new overall rating.
- December 2012
Report published without a new overall rating.
- March 2011
Registered with the Care Quality Commission on 22 March 2011.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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At least 100 live-in carers within about an hour of Warrington
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £980 to £1,260 a week. 90 can care for a couple. 10 years' experience on average.
“He developed a close affinity with Terence, spending time talking with him before he retired to bed and looking after his needs during the night.”
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