Archived: United Response - Derwent DCA

Updated 9 August 2018

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.

This comprehensive inspection took place on 22 June 2018 and was announced. The provider was given two working days’ notice because the location provides a domiciliary care service and we needed to be sure that someone would be available at the office. We also needed to arrange to speak to people who used the service and their relatives as part of this inspection and to the staff that supported people. The inspection team consisted of one inspector.

We used information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make.

The inspection was also informed by other information we had received from and about the service. This included statutory notifications. A notification is information about important events, which the provider is required to send us by law. We also received feedback from the local authority who commission services from the provider.

We visited three people at their home, however due to their needs they were unable to talk with us about the support they received. To enable us to understand the experiences of people, we observed the support provided to people and how the staff interacted with them.

During the inspection, we spoke with the registered manager, two team managers, one senior support worker and two support staff. Following the inspection, we spoke on the telephone with one person’s relative.

We looked at two people’s care records to check that the care they received matched the information in their records. We reviewed two staff files to see how staff were recruited, supported and trained. We looked at the systems the provider had in place to ensure the quality of the service was continuously monitored and reviewed to drive improvement.

We asked the registered manager to email copies of their audits so that we could see how the provider monitored the service to drive improvements. The manager sent this to us within the required timeframe.

Updated 9 August 2018

United Response Derwent DCA is a domiciliary care agency that provides personal care to adults with a learning disability living in their own homes. Some people lived alone and others with one or two other people that were also receiving a service from United Response Derwent DCA. Not everyone using the service received a regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

The service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. The aim of the guidance is to assist services in enabling people with learning disabilities and autism using the service to live as ordinary a life as any citizen.

We inspected this service on 22 June 2018. This inspection was announced. This meant the provider and staff knew we would be visiting the service’s office before we arrived. There were nine people in receipt of personal care support at the time of this inspection visit.

The service had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission 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.

At our previous inspection on 7 and 23 February 2017 although the service was not in breach of any regulations; the overall rating given was ‘requires improvement’. This was because not all staff were able to effectively communicate with people using their preferred method of communication. We had received mixed views from people’s families and the staff team regarding how approachable local managers were and some staff reported a lack of confidence in their line managers. Some staff did not know who the registered manager was or that they were an additional person they could raise their concerns with. At this inspection visit we saw improvements had been made.

Staff had a good understanding of people’ communication methods and received training in Makaton sign language when they supported people that used this method of communication. Makaton uses signs and symbols and is used to support hearing people with learning or communication difficulties.

The registered manager had sent out information to staff, people that used the service and their family representatives to remind them of their role and contact details. A logbook had been put in place to enhance the communication received by the registered manager.

People were supported to understand how to keep safe and staff were clear on their role on protecting people from the risk of harm. Staff understood their responsibilities to raise concerns and record safety incidents. These were reviewed and analysed to ensure actions could be taken to reduce risks and promote a safe environment.

Individual risks to people were identified and people were supported to take reasonable risks to promote independent living. Environmental risks within people’s homes were also undertaken and people were supported to raise any concerns regarding improvements with their landlord, to ensure they were protected by the prevention and control of infection and reduce the risk of trips and falls.

People were protected against the risk of abuse, as checks were made to confirm staff were of good character. There were sufficient staff to support people and the skill mix of staff ensured people’s needs were met. Medicines were managed safely and people were supported as needed to take their medicine as prescribed.

People were consulted regarding their preferences and interests and these were incorporated into their support plan to ensure they were supported to lead the life they wanted to. People were supported to be as independent as they could. The staff team knew people well and were provided with the right training and support to enable them to promote people’s independence and autonomy.

People were supported with their dietary needs and to access healthcare services to maintain good health. A period of transition was provided to support people when they moved home to ensure the person received support that met their needs and preferences.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. The importance of gaining people’s consent to the support they received was understood by the staff team.

Staff knew about people’s individual capacity to make decisions and supported them to make their own decisions. Where people were unable to make certain decisions, the staff ensured that best interest decisions were made in accordance with legislation.

People were supported develop and maintain interests and be part of the local community to promote equality and integration. The registered manager actively sought and included people and their representatives in the planning of care.

There were processes in place for people to raise any complaints and support provided when needed to enable people to raise concerns. People and their representatives were encouraged to express their views and opinions about the service provided.

A positive culture was in place that promoted good outcomes for people. People who used the service, their relatives and the staff team were all involved in developing the service; which promoted an open and inclusive culture.

Staff had a clear understanding of their roles and responsibilities. The registered manager and provider understood their responsibilities of registration. There were systems in place to monitor the quality of the service to enable the registered manager and provider to drive improvement.