Archived: United Response - Matlock DCA

Updated 2 May 2019

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

Inspection team: One inspector conducted the inspection over one day.

Service and service type: United Response Matlock DCA is a domiciliary care agency that provides support to adults with a learning disability living in their own homes.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided. We were advised at the inspection that the registered manager was leaving the service and would be cancelling their registration with us. An interim service manager was in post at the time of the inspection.

Notice of inspection: We gave the service a weeks’ notice of the inspection visit 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.

What we did when preparing for and carrying out this inspection:

We reviewed information we had received about the service since the last inspection. This included details about incidents the provider must notify us about. We contacted the local authority who commission services from the provider. We assessed the 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. We used all this information to plan our inspection.

During the inspection, we spoke with four people who used the service. Following the inspection one person’s relative provided us with feedback about the support their relative received. We observed the support people received from staff within the communal areas of their home. We spoke with two staff members that were supporting people, on the day of the inspection and two staff by telephone. We spent time with the interim service manager during the inspection. We looked at the records held regarding three people’s care and support and we checked how medicines were managed. We also looked at two staff recruitment files and other documents to review how the provider monitored the support people received.

The interim service manager shared with us their action plan, so that we could see the actions they were taking to drive improvements. We reviewed this information as part of the inspection process.

Updated 2 May 2019

About the service: United Response Matlock 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 Matlock DCA. Some people received support from staff at various times of the day and others over a full 24-hour period. 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. At the time of the inspection 16 people were provided with the regulated activity of personal care.

People’s experience of using this service:

There were systems in place to monitor the quality of the service and drive improvement but these had not been used effectively to ensure support plans were kept up to date. Some people’s support files, at the time of the inspection were not up to date. This meant that staff did not have clear guidance to ensure people’s needs and preferences were met.

Staff understood the support people needed to make decisions when people could not independently make specific decisions regarding their care. Although mental capacity assessment forms were seen in people’s support files, these had not been completed. This meant we could not be confident that people’s rights were upheld or that they were supported to have maximum choice and control of their lives and were supported in the least restrictive way possible.

Support plans were in place to promote positive behaviours and safeguard people from injury when they became anxious. The interim service manager confirmed that they were working through everyone’s positive behaviour plans to ensure they were up to date and relevant. They were able to demonstrate through their action plan that they were auditing all support files on an ongoing basis and had introduced shift planners that provided details of people’s routines. This supported staff, particularly new and agency staff to ensure people’s preferred routines were followed. We saw staff feedback was also included on the planner to demonstrate people were supported to follow their preferred routines.

There were several staff vacancies at the time of the inspection and several shifts were being covered by agency staff, who were working alongside permanent staff whilst new staff were being recruited. We saw that despite the staff vacancies, sufficient staff were available through the use of regular agency staff, where needed.

The outcomes for people using the service reflected the principles and values of Registering the Right Support in the following ways; People were supported to take reasonable risks to enable them opportunities to lead a full life. People were supported to make decisions about what they ate and drank. People spent their day as they preferred were supported to take part in social activities of their choice to enhance their well-being.

Staff understood their responsibilities to safeguard people and were clear on reporting any concerns. People were supported to take their medicines in a safe way. Recruitment checks were undertaken, to determine the suitability of new staff and protect people that used the service. The risk of people acquiring an infection, was minimised as infection control procedures were in place and followed.

People were supported as needed, to ensure their preferences and dietary needs were met. Healthcare services were accessible to people with staff support as needed, and they received coordinated support, to ensure their preferences and needs were met.

Information was available in an accessible format to support people’s understanding. People maintained relationships with their family and friends and were encouraged to give their views about the service. This included raising any concerns they had. People and their representatives were involved in their care to enable them to receive support in their preferred way.

Rating at last inspection: Overall rating Good, with Requires Improvement in Well Led (report published 11/01/2016 ).

Why we inspected: This was a planned inspection based on the rating at the last inspection. At this inspection we found the required improvements from the last inspection had been made. However we identified that other areas of improvement were needed and we have rated the home overall as ‘Requires Improvement’.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.

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