Unite Highland Care

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• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

We identified a breach of the legal regulations in relation to person centred care. People's care plans were not person centred and missed important information. Care plans gave contradictory information and did not contain all of the information needed to inform staff how to support people in a safe and person-centred way. The provider had not proactively sought out ways to address any barriers to people to improve their experience of care and support provided.

This service scored 61 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Relatives told us care and communication needed to improve. Comments included, “The routine is obvious I shouldn’t have to tell these people every time. I don’t live there, (person) lives by themselves and they should know what (person) can do and what they can’t do.”, “They have a care plan but nothing is written about who came at what time and who did what which I got with the other agency.”, “I don’t know what's in (person’s) care plan.” and “Communication needs to improve.” Information in one person’s care plan stated they used communication aides. There was no information about how these should be used or in what context. A staff member said, “Sometimes we use photo cards to communicate with (Person). Like ‘are you happy? do you want to eat?’ At times (person) does and at times (person) doesn’t.” Some people were at the end of their life but there was no information about how staff should support people in a sensitive or thoughtful way.

There were no effective systems in place to ensure people’s care and support were person-centred. The registered manager gave us contradictory information about people’s care. Care plans missed important information and assessment of risk. Some staff were not aware of the significant risks associated with people and did not have a good awareness about important guidance which should be used to inform good care practice.

We did not look at Care provision, Integration and continuity during this assessment. The score for this quality statement is based on the previous rating for Responsive.

We did not look at Providing Information during this assessment. The score for this quality statement is based on the previous rating for Responsive.

We did not look at Listening to and involving people during this assessment. The score for this quality statement is based on the previous rating for Responsive.

We did not look at Equity in access during this assessment. The score for this quality statement is based on the previous rating for Responsive.

Some of the relatives we spoke with expressed concerns with how care was delivered, and our assessment found care did not meet the expected standards. People's packages of care were often terminated in the supported living provision if the provider felt they were too difficult to manage. People's care and treatment did not support equality or protect people's rights. People had not been involved in decision making about their care and support, and their home.

The registered manager who was a mental health nurse, did not have a good understating or people's conditions and applied labels to them which were inappropriate. For example, they referred to people with autism and attention-deficit/hyperactivity disorder (ADHD) as having ‘mental health conditions’. The registered manager and staff told us they considered and promoted equality, however we found evidence that human rights were not always considered for people. For example, people did not have choice and had unnecessary restrictions placed on them. Care plans did not fully assess and mitigate any potential barriers, such as communication.

The provider had not proactively sought out ways to address any barriers to people to improve their experience of care and support provided. Processes to ensure people's care plans fully reflected their physical, mental, emotional and social needs, including those related to protected characteristics under the Equality Act 2010 were not effective. For example, one person’s care plan detailed a potential communication barrier but provided no further detail on how staff would support them with this. People’s feedback was not always prioritised and when concerns were raised, action was not taken.

We did not look at Planning for the future during this assessment. The score for this quality statement is based on the previous rating for Responsive.