United Response - York DCA

Updated 26 July 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

The inspection took place on the 5, 7, and 10 July 2017 and was announced. The provider was given 48 hours' notice because the location provides a domiciliary care service and we needed to be sure that someone would be in the main office.

One adult social care inspector undertook the inspection and they were assisted by an expert by experience. The expert by experience had previous knowledge of experiences of people with learning disabilities in a similar setting.

Before this inspection, we reviewed the information we held about the service, such as notifications we had received from the provider. Notifications are when providers send us information about certain changes, events or incidents that occur.

The provider submitted a provider information return (PIR) prior to the inspection. This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.

During the inspection, we spent time visiting people in their own home and spoke with four people receiving a service. We interviewed six care workers and we spoke with three service managers and the registered manager. After the second day of the inspection we spoke with four relatives of people receiving a service over the telephone.

We looked at records, which related to people's individual care; this included the care planning documentation for six people and other records associated with running a community care service. We also looked at eight care workers recruitment and training records, records of audits, policies and procedures and records of meetings and other documentation involved in the running of a domiciliary care agency.

Updated 26 July 2017

This inspection carried out on the 5, 7 and 10 July 2017 and was announced. The provider was given 48 hours' notice because the location provides a domiciliary care service and we needed to be sure that someone would be in the main office.

York DCA is owned by United Response and provides services to people with a wide range of complex needs in community settings, such as people's own homes and supported living houses. The service provides domiciliary care and support services from the registered office location in the centre of York.

At the time of this inspection, the provider was providing personal care and support for twenty seven people in villages outside the City of York who had a learning disability or autistic spectrum disorder.

The provider is required to have a registered manager in post and on this inspection, there was a registered manager registered with the Care Quality Commission (CQC). A registered manager is a person who has registered with the CQC to manage the service. Like registered providers, they are 'registered persons'. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the service is run. The registered manager will be referred to as 'manager' throughout the report.

At the last inspection in May 2016 the provider was rated as required improvement. This was because they were in breach of two Regulations under the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The breaches were in Regulation 12 Safe care and treatment and Regulation 17 Good governance.

We asked the provider to submit an action plan regarding the breaches identified and during this inspection the actions were met. No further breaches were identified during this inspection.

Systems and processes were in place that helped keep people safe from harm and abuse. Staff had completed safeguarding training and knew the signs of abuse to look out for and how to raise any concerns.

The provider ensured there were sufficient skilled and qualified staff to meet people's individual needs and preferences. People received their care and support from regular staff that ensured continuity and consistency.

People received their medicines as prescribed and safe systems were in place to manage people's medicines. Staff were trained in medication administration and their competency was checked regularly.

People were supported to pursue a wide and diverse variety of social activities relevant to their needs, wishes, culture and interests. Arrangements were in place for people to maintain links with the local community, friends and family.

The provider had systems and processes to record and learn from accidents and incidents that identified trends and helped prevent re-occurrence.

People were supported to have maximum choice and control of their lives and care workers supported them in the least restrictive way possible; the policies and systems in the service support this practice.

People and relatives were encouraged to be involved in their care planning as much or as little as they wanted or were able to be. People's records of their care were reviewed and included up to date information that reflected their current needs.

Care workers had a good understanding of people's needs and were kind and caring. They understood the importance of respecting people's dignity and upholding their right to privacy.

There was an effective complaints procedure for people to raise their concerns and these were responded to.

There were systems of audit in place to check, monitor and improve the quality of the service. Associated outcomes and actions were recorded with timely outcomes and these were reviewed for their effectiveness.

The provider worked effectively with external agencies and health and social care professionals to provide consistent care.

Everybody spoke positively about the way the service was managed. Staff understood their levels of responsibility and knew when to escalate any concerns. The manager had a clear understanding of their role and responsibilities and requirements in regards to their registration with CQC.