Background to this inspection
Updated
21 December 2023
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. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.
Inspection team
The inspection team consisted of 1 inspector and an Expert by Experience.
An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.
The service also provides care and support to people living in ‘supported living’ settings, so that they can live as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.
Registered Manager
This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the CQC to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.
At the time of our inspection there was a registered manager in post.
Notice of inspection
The inspection was announced. We gave the service 24 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.
Inspection activity started on 30 November 2023 and ended on 5 December 2023. We visited the location’s office on 30 November 2023.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used all this information to plan our inspection. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make.
During the inspection
We visited the registered office location and reviewed records relating to 3 people who used the service, 3 staff files and audits used to monitor the service. We spent some time observing and listening to staff interactions with people. We spoke with the registered manager, a team leader and a senior carer.
We visited 2 supported living services and observed staff interactions. We conducted a visual inspection of the buildings and looked at records relating to medicines and health and safety checks. We spoke with a further 4 staff, which included a service manager, 2 team leaders and a support worker.
Following the inspection site visit we spoke with 4 people who used the service and 5 relatives via telephone.
Updated
21 December 2023
About the service
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.