During an assessment under our new approach
Date of Assessment: 14 February 2025 to 17 March 2025. DCA Alderwood North is a care at home service providing personal care and support to people with a range of different needs including learning disabilities, autistic spectrum disorder and physical disabilities. The service supported 9 people but not all people received regulated care and support. This was the first assessment of the service and we assessed all of the quality statements in all of the 5 key questions.
We assessed the service against ‘Right support, right care, right culture’ guidance to make judgements about whether the provider guaranteed people with a learning disability and autistic people respect, equality, dignity, choices, independence and good access to local communities that most people take for granted.
Lessons were not always learnt to continually identify and embed good practice. There was limited review and analysis of incidents to identify learning and improvement. The provider did not always work well with people and healthcare partners to understand what being safe meant to them and how to achieve that. Risk assessments and care plans were completed but there was inconsistency in the quality of care plans. The provider made sure there were enough qualified, skilled and experienced staff who worked together well to provide safe care which met people’s individual needs but they did not always make sure staff received effective support, supervision and development.
Local health and care professionals had identified improvements needed to be made to care plans to ensure care was delivered effectively. Staff teams recorded information about their care and support but there was no evidence of how this information was reviewed and analysed to identify common themes so plans for additional tailored support could be put in place. Staff did not always support people to live healthier lives, or where possible, reduce their future needs for care and support. The provider did not always escalate concerns and identify actions to support improvement in health outcomes for people.
We observed care which was person-centred and members of staff knew people’s routines, habits and preferences. People had access to local health and care services. Information was provided to people appropriately in ways they could understand. People lived independently and they were supported to visit people to develop and maintain friendships and relationships.
Members of staff knew the people they supported and they delivered care with kindness and compassion. People lived in their own homes independently and they were treated as individuals. People were supported to maintain their independence. We saw evidence they made choices and had control of their lives. Feedback from members of the staff team indicated workforce well-being was not supported by the local management team.
There was an inconsistency in the leadership and culture of the service. There was a disconnect between the management team and the staff team. Leaders did not have the skills, knowledge, experience and credibility to lead effectively. We saw limited evidence the management team were compassionate and inclusive leaders. Governance systems and processes were not effective in identifying key areas for service improvement and development. Audits and reviews had not identified deficiencies in people’s care plans and risk assessments. The provider did not always encourage creative ways of delivering equality of experience, outcome and quality of life for people.
The provider was in breach of the legal regulations relating to safe care and treatment and good governance and we have asked the provider for an action plan in response to the concerns found at this assessment.