United Response - Durham and Darlington DCA

United Response - Durham and Darlington DCA is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to older and younger adults with physical and learning disabilities and mental health conditions.

Not everyone using United Response – Durham and Darlington DCA receives a regulated activity. The Care Quality Commission (CQC) only inspects the service being received by people provided with ‘personal care’, which includes help with tasks related to personal hygiene and eating. Where they do, we also take into account any wider social care provided. At the time of our inspection, 27 people were receiving personal care from the service.

People’s experience of the service and what we found:

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. We considered this guidance as there were people using the service who have a learning disability and or who are autistic.

Right Support

Staff supported people to have the maximum possible choice, control and independence and they had control over their own lives. People had an active life which incorporated activities in their local community. Where people had shared interests, they went out together. Staff focused on people’s strengths and promoted what they could do, so people had a fulfilling and meaningful everyday life. The service made reasonable adjustments for people so they could be fully involved in discussions. People received their medicines as required and staff worked in-line with recommendations from health professionals. Staff supported people to make decisions following best practice in decision-making. Staff communicated with people in ways that met their needs. The service gave people care and support in a safe, clean, well equipped, well-furnished and well-maintained environment that met their sensory and physical needs.

Right Care

Staff understood how to protect people from poor care and abuse. Staff had training on how to recognise and report abuse and they knew how to apply it. Staff promoted equality and diversity in their support for people. They understood people's cultural needs and provided appropriate care and emotional support. There were enough staff on duty to provide safe care to people. The registered manager had a flexible approach to staffing levels to ensure activities, hobbies, individual interests, and outings were catered for. People were support by a stable staff team who knew them really well. Staff and people cooperated to assess risks people might face. Where appropriate, staff encouraged and enabled people to take positive risks.

Right Culture

People received compassionate care that was tailored to their individual needs. Staff spoke highly of people and went 'above and beyond' for them to live the best lives possible. People led inclusive and empowered lives because of the ethos, values, attitudes and behaviours of the management and staff. Management led by example and staff empowered people to do all that they wanted to do safely.

The service was committed to a culture of improvement and regularly sought feedback from people, staff and professionals. People were at the centre of the service and staff valued and acted upon people's views.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was Good (published 15 June 2018).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

We undertook a focused inspection to review the key questions of safe and well-led only. For those key question not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

You can read the report from our last comprehensive inspection by selecting the ‘all reports’ link for United Response – Durham and Darlington DCA on our website at www.cqc.org.uk.

Follow Up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to older and younger adults with physical and learning disabilities and mental health conditions. Not everyone using United Response – Durham and Darlington DCA receives regulated activity. CQC only inspects the service being received by people provided with ‘personal care’, which includes help with tasks related to personal hygiene and eating. Where they do, we also take into account any wider social care provided. At the time of our inspection 25 people were receiving personal care from the service.

There was a registered manager in place. 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.

People and their relatives told us staff helped to keep people safe. Risks to people were managed safely. Staff were supported to maintain high standards of infection control. Plans were in place to support people in emergency situations that disrupted the service. Policies and procedures were in place to safeguard people from abuse. People’s medicines were managed safely. Staffing levels were based on the assessed level of support people needed. The provider’s recruitment procedures minimised the risk of unsuitable staff being employed.

Staff were supported with a wide range of training, supervisions and appraisals. Newly recruited staff were required to complete the provider’s induction programme before they could support people without supervision. 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. People’s food and nutrition was managed effectively. People were supported to access external professionals to monitor and promote their health.

People spoke positively about the support they received from the service and described staff as caring. Relatives also spoke positively about the support people received, describing staff as kind and supportive. People were treated with dignity and respect. People’s independence was promoted and they were supported to maintain and enhance their independent living skills. People and their relatives told us staff were very effective at communicating with people and helping to ensure their voices were heard. Policies and procedures were in place to support people to access advocacy services.

People received personalised care based on their assessed needs and preferences. Support plans were regularly reviewed to ensure they reflected people’s current support needs and preferences. People and their relatives were involved in developing and reviewing people’s support plans. People were supported to access activities they enjoyed. Policies and procedures were in place to investigate and respond to complaints. At the time of our inspection nobody at the service was receiving end of life care but policies and procedures were in place to provide this if needed.

Staff spoke positively about the culture and values of the service. People and their relatives spoke positively about the management of the service. The registered manager had forged links with other agencies and care providers to help benefit the health and wellbeing of people using the service. The registered manager and provider carried out a number of quality assurance checks to monitor and improve standards at the service. Feedback was obtained from people, relatives, staff and external professionals. The registered manager had informed CQC of significant events in a timely way by submitting the required notifications. This meant we could check that appropriate action had been taken.