Unite Highland Care

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• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

We identified a breach of the legal regulations in relation to dignity and respect. People's human rights were not upheld, because people had not been supported to make decisions in line with the Mental Capacity Act. People were not supported to be as independent as possible, or to have goals and aspirations to work towards. Some of the language used to describe people or how their care should be delivered was not dignified or respectful. Peoples feedback was not acted on when they raised concerns about their care. The registered manager could not demonstrate how people were involved with planning their care or their care reviews.

This service scored 55 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We did not look at Kindness, compassion and dignity during this assessment. The score for this quality statement is based on the previous rating for Caring.

People were not empowered or included in all of their care and support. Relatives commented, “They are ok but nothing to write home about”, “Some are nice and some I don’t like. Some of them are kind.” and “They try to do less and they are not very practical. (Loved one) can’t hang up their clothes and they don’t offer to support with that.” The information staff had to support people missed important detail or was inaccurate. Some of the language used to describe the support people received was not respectful. For example, one person’s care plan stated the person needed a wheelchair ‘when out in the community and is assisted with pushing them around.’ This is not a dignified way of describing supporting a person to mobilise. Another person’s care plan stated they had ‘challenging behaviour’ and went on to describe them walking around being ‘challenging behaviour’, and ‘attempting to abscond’. This was not a respectful way to describe the person. Another person’s care plan stated they did not have any communication problems although English was their second language. Other parts of the person's care plan stated they required an interpreter for appointments.

Some staff appeared to be kind and caring and tried to support people well. However, they did not have all of the support from the provider they needed to be able to provide a service to people which ensured they were treated as individuals and respected. The registered manager told us they relied a lot on other individuals such as district nurses, relatives and other carers who did not work for Unite Highland Care to ensure the support people received was safe and met their individual needs. For example, one person had complex health conditions including a catheter (a flexible tube used to empty the bladder and collect urine in a drainage bag). Staff had not been given any training or guidance to support the person with this. The provider told us the person’s live in carer instructed staff what to do. We would expect providers to provide staff all of the information required to support people safely.

The provider did not have robust processes in place to ensure people were treated as individuals or their views on their care listened and responded to. The provider issued surveys to people but there was no information about how their feedback was listened to or acted on so the service and the care they received improved. For example, one person said they would like to have more male staff to talk to at night to have better conversations. There was no information to understand what action had been take in response to this. Another person said they would like to do more shopping and buy more soft drinks. There was no information about how this had been responded to. Where people had fed back, they were not satisfied with the care they received and there was no information about how this had been responded to.

While some people and relatives we spoke with expressed that they were generally happy with their care, our assessment found care did not meet the expected standards. People were not empowered to have as much independence, choice or control over their lives as they possibly could. People were restricted in ways that were not the least restrictive. A relative told us they have raised several concerns with the provider about the care and treatment their loved one received, but no action had been taken in response. In the weekly house meeting minutes, it was recorded ‘(Person) must continue going into the community daily for some exercise’ However, the registered manager informed us this person had capacity to make their own choices.

Staff did not have adequate guidance or training to support people with their independence or choice. When people became ‘too difficult’ they were given notice and had to leave their home even though they had their own tenancy agreements in place. Staff told us people had no choice over who they lived with. The registered manager could not demonstrate how people were involved with planning their care or their care reviews. Staff had no understanding of the principles of Right support, right care, right culture.

The registered manager had not ensured people had choice and control over their own care and to make decisions about their care, treatment and wellbeing. Care plans did not contain any life skills that people wanted to develop or meaningful goals and aspirations. Some people’s care plans stated staff should ‘Promote relaxation and stress relief’ but there was no information about how or what could cause the person stress or how staff should support the person to relax. A person’s care plan stated ‘I want to be able to enjoy the basic things of life. I want to remain as sociable as much as possible.’ There was no information about how staff supported this or what this specifically meant for the person. The person was restricted in how often they could go out due to staffing numbers.

We did not look at Responding to people’s immediate needs during this assessment. The score for this quality statement is based on the previous rating for Caring.

We did not look at Workforce wellbeing and enablement during this assessment. The score for this quality statement is based on the previous rating for Caring.