Archived: United Response - Durham and Darlington DCA

Durham and Darlington Domiciliary Care Agency is a domiciliary care service that provides personal care and support to people with learning disabilities and autism who live in their own home or supported living. The service covers the Darlington, Gateshead and County Durham area and at the time of our inspection the service supported 27 people.

The service had a registered manager. 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 the time of our inspection the registered manager was about to retire and was job sharing with the replacement manager as part of a handover. The new manager had applied to CQC for registration and was awaiting their interview. The registered manager was not available at the time of our inspection due to a family bereavement. Therefore the inspection was carried out with the replacement manager.

We spoke with members of the staff team including service managers and care staff who told us that the registered manager was always available and approachable. We spoke with people who used the service on the day of the inspection and their relatives.

We saw that peoples prescribed medicines and topical medicines were recorded when administered. We looked at how records were kept and spoke with the replacement manager about how staff were trained to administer medicines and we found that the medicines administering, recording and auditing process was safe.

From looking at people’s support plans we saw they were person centred. ‘Person-centred’ is about ensuring the person is at the centre of everything and their individual wishes and needs and choices are taken into account. The support plans made good use of personal history and described individuals care, treatment, wellbeing and support needs. These were regularly reviewed and updated by the support workers and the registered manager.

People who used the service received person centred support and their individual needs were respected and valued.

Individual support plans contained risk assessments. These identified risks and described the measures and interventions to be taken to ensure people were protected from the risk of harm. The care records we viewed also showed us that people’s health was monitored and referrals were made to other health care professionals where necessary for example: their GP and care manager.

Our conversations with people who used the service and their relatives during the inspection showed us that people who used the service were supported in their own homes by sufficient numbers of staff to meet their individual needs and wishes.

We looked at the recruitment process and found that relevant checks on staff took place and this process was safe. People who used the service chose their own staff and together with their families were a major part of the recruitment process.

People were encouraged to plan and participate in activities that were personalised and meaningful to them. People were supported regularly to play an active role in their local community, which supported and empowered their independence including; accessing local facilities and the wider community.

We saw a compliments and complaints procedure was in place and this provided information on the action to take if someone wished to make a complaint and what they should expect to happen next. People also had access to advocacy services and safeguarding contact details if they needed it.

We found the service had been regularly reviewed through a range of internal and external audits. We saw action had been taken to improve the service or put right any issues found. We found people who used the service, their representatives and healthcare professionals were regularly asked for their views about the service via surveys.

The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The Act requires that as far as possible people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible.

People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the MCA. Any applications must be made to the Court of Protection. At the time of this inspection one application had been made to the Court of Protection and several others had gone through the process.

We found breaches 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.

We looked at records of training, manager's meetings and financial audits and checks. We found the service now reported safeguarding concerns in a timely way so that any concerns could be quickly dealt with.

We saw that financial audits had been used to make sure that each person was supported with their money in a safe way. We found the manager carried out additional checks to make sure staff managed finances in the right way.

We saw the agency had detailed care records about each person's abilities and needs. This meant staff knew exactly how to support each person. People said they helped to decide how they were supported.

People told us they 'liked' the staff. One person told us that since using the service they could now travel independently so they could go out on their own. One person told us, 'Staff help me to keep in contact with friends and help me find places I don't know.'

We looked at how the agency made sure people were protected from unsafe practices (called safeguarding adults). We saw the agency had not always followed its own systems to make sure people's finances or wellbeing were protected.

We saw the agency checked every member of staff to make sure they were suitable to work with people. Some people told us how they were involved in choosing new staff.

The provider carried out regular checks to make sure the service was good. People and their relatives and care professionals were asked for their views about the service.

We saw the agency had care records for each person which set out their individual, specific needs and abilities. This meant staff knew exactly how to support each person. People said they helped to decide what they needed support with and they were involved in choosing new staff.

Staff said they felt well trained and well supported by the agency. Staff comments included, 'we get lots of training' and 'it's a really good team to work with and it's well managed'.

The provider carried out regular checks to make sure the service was good. People and their relatives and care professionals were asked for their views about the service.