Unicorn Healthcare Services

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

The provider did not have an effective audit and governance system in place to provide oversight of the service. There were no action plans in place to improve the quality and safety of the service. This is a breach of regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) 2014. The provider did not share their vision and strategy for the service and staff lacked knowledge and understanding of the values of the service and how they could achieve them. The provider and registered manager lacked knowledge around the issues and priorities for the service and did not have access to appropriate support and development. People did not always feel they could speak up and it would remain confidential. There was no opportunity to learn lessons from accidents and incidents, there was a lack of trust between the managers and staff and staff were not encouraged to speak up with their ideas around improvements or innovations.

This service scored 29 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

There was not a shared vision for the service. Staff including the registered manager had not had an appraisal, some staff told us there was a lack of opportunities for them to develop. One staff member said, “I have no idea, they never speak to you or involve you in anything.”

Feedback was not sought from people who use the service, their relatives, staff, or professionals to enable the service to engage them in developments and be part of future planning.

Staff we spoke to told us they had not met any of the managers and had never attended a team meeting. Comments from staff included “They don’t have anything to do with us,” “Don’t’ know them saw the registered manager at interview and that was it,” and “I have seen photographs of them but never met them, we got interviewed over the phone”.

There was a lack of robust systems in place to ensure effective oversight of the service including the relevant checks to ensure safe recruitment. Health decelerations were not completed by staff which meant the provider was unable to consider the physical and mental health of the staff employed and support them.

Some staff did not feel confident in raising their concerns and felt there would be a negative response from some of the management team, comments from staff included, “I would not feel confident to tell them [Managers] anything,” and “I might say something to the Registered Manager but no one else and I would be worried about any emails I got because I had said something.”

The provider had a whistle blowing policy, however some staff lacked understanding of what whistle blowing was. There was no forum for staff to speak up and be confident they would remain anonymous.

Some staff told us they felt ‘pushed out’ and not included in the workforce. Staff told us there was little support given to ethnic minority groups who required further training.

The provider had a policy for equality and diversion and staff had received their training. However, there was little action from the management team to address culture and bullying within the organisation.

The managers within the organisation lacked understanding of their roles and responsibilities. Information was not provided or was not accessible to the inspectors when completing their assessment. Action plan requested for concerns identified on the assessment were not delivered within the time frame requested.

There were no systems and processes in place to monitor the service. Effective audits did not take place to improve the quality of the service. There was no analysis of accidents or incidents to identify themes, trends, and lessons learnt. Medication audits were sporadic and did not identify any of the concerns we found on our assessment. The provider did not identify any of the shortfalls we found in the service.

People told us they had access to a GP if they needed it and district nurses visited if required.

Staff told us if people required to be seen by a GP they would contact family and inform them or support the person to contact their GP. Some Staff would attend care meetings if they were required, however they were unable to tell us how the information would then be transferred onto people’s support plans.

Professional had little involvement with the service and care was not always joined up.

The provider did not have a system in place to review information from other professionals, care staff told us they attended reviews, and the managers never requested any feedback. Information and guidance from reviews was not always transferred into care plans and the registered manager lacked up to date knowledge about the support people required.

We found no evidence lessons had been learned from safeguarding’s or incidents within the service. Staff told us they had not been involved in any lessons learned. There was no strategy in place for staff development.

There was no process in place for learning, innovations and improvement in the service. People and their families had not been involved with the development of the service. Professionals and staff had not been asked for ideas on improvements in the service.