We carried out a review of the data available to us about United Response - Ipswich DCA on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about United Response - Ipswich DCA, you can give feedback on this service.
This announced inspection was started on 2 August 2018 and we visited people who used the service in their own homes. We gave the service 48 hours’ notice of the inspection site visit because some of the people using it could not consent to a home visit from an inspector, which meant that we had to enable the service time to arrange for a ‘best interests’ decision about us visiting or meeting people.
On the day of our inspection, there were 60 people being supported with personal care by the service.
During our last inspection in July 2015 the service was rated as good in all the key questions and good overall. At this comprehensive inspection, which we carried out on 2 August 2018 we found the evidence continued to support the rating of Good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. Because the rating remains Good, this inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.
The service had a long standing 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.
Some people shared a house with other people who use the service and others lived individually. The registered manager oversaw the running of the service, and each individual shared house had a service manager.
The service continued to be well led; the registered manager was organised and knowledgeable about the people being supported and was well supported by the providers of the service. People, their relatives and the staff told us that the registered manager was open, supportive and had good management skills. There were robust systems in place to monitor the quality of service the providers offered people.
We saw examples of positive and caring interaction between the staff and people supported by the service, people were treated with kindness and respect. People were able to express their views and staff listened to what they said, respected their views and took action to ensure their decisions were acted on. Staff protected people’s privacy and dignity.
People and their relatives told us that they still felt safe using this service. People were protected from bullying, harassment, avoidable harm and abuse by staff that were trained to recognise abusive situations and knew how to report any incidents they witnessed or suspected. Staff clearly understood their responsibilities to raise concerns and there were arrangements in place for reviewing and investigating incidents when things went wrong. Staff told us they would not hesitate to report any suspicions they had about people being abused.
Risks were assessed and steps had been put in place to safeguard people from harm without restricting their independence unnecessarily. Risks to individual people had been identified and action had been taken to protect them from harm.
Staffing levels were sufficient to keep people safe and staff continued to be safely recruited which helped protect people from harm. People continued to be supported to manage their medicines in a way that ensured that they received them safely and at the right time. There were also appropriate infection control practices in place.
People’s needs assessments were detailed and they received effective care in line with current legislation from staff who had the knowledge, qualifications, skills and experience they needed to carry out their roles.
The management and staff were a strong team and worked well together to ensure that people received consistent person-centred care when they used or were supported by different services. Staff still asked people for their consent before they supported them in line with legislation and guidance.
Caring and supportive staff offered advice to people to help them make healthy decisions around food and supported them to eat and drink enough to maintain a balanced diet. People were also supported to maintain good health and gain access to healthcare services when they were needed.
People received care that was personalised to them and responsive to their needs. Although people told us that they rarely needed to complain, we saw that the service listened to people’s experiences, concerns and complaints. They continued to take action to investigate their complaints, learn by their mistakes and make any changes needed to avoid them happening again.
We visited the offices of Ipswich DCA on 8 July 2015 and the visit was announced. We carried out visits to people who use the service on 9, 13 and 17 July 2015, we also telephoned people who used the service during this period.
The service provides care to people who may have a learning difficulty or are on the autistic spectrum. People may also have a physical disability. This support may be in individual accommodation or shared houses.
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 we visited were happy and relaxed. They were involved in the activities of daily living and attending outside appointments supported by staff. Staff were knowledgeable about the people they supported engaging with them in a friendly and relaxed but respectful manner.
There were suitable arrangements for the safe storage, management and disposal of medicines. Where people may lack capacity to make particular decisions the decision making process was recorded and the appropriate people consulted. The Mental Capacity Act 2005 and how it affected this service was understood and put into practice by staff.
There were sufficient suitably qualified staff to meet people’s needs. A mix of part-time and full-time staff gave the service flexibility to support people with their various interests throughout the day. People using the service were involved in the recruitment of staff. Appropriate checks were carried out to ensure staff were suitable to work in this type of service. Staff were supported through a system of induction and training.
People were encouraged to participate in decisions relating to the running of the service and how their care was provided. Regular meetings took place for people who lived in shared housing supported by the service. People living in the shared housing visited other shared housing where the service provided support to carry out quality assurance surveys. There was a robust system of quality assurance checks in place.
Support records were detailed and contained specific information to guide staff who were supporting people.
We considered our inspection findings to answer questions we always ask; is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well-led?
This is the summary of what we found:
Is the service safe?
There were always suitably qualified and experienced staff on duty, who had access to an out of hours on call system when required. We saw staffing vacancies were being recruited to and core hours were being covered adequately by permanent or temporary staff. The service had a robust recruitment process and ensured induction and training of their staff equipped them to carry out their roles safely. This meant people were protected from unsafe care practices.
There were systems in place to review people's needs and ensure they were being appropriately met. Frequent audits undertaken at people's homes demonstrated to us that the service was managed in the interest and safety of people using them. Good working relations between partner agencies including housing providers meant that people's needs were being met by a joint agency approach.
Staff had received training in safeguarding vulnerable adults from abuse and the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). Staff were provided with the information that they needed to recognise and report concerns so that they knew how to protect people from abuse as far as possible. We could not see how people always consented to their care or treatment or how decisions were made in their best interest.
Is the service effective?
People's care records showed that care was planned and delivered in a way that was intended to ensure people's safety and welfare. We saw that the records had been reviewed and updated monthly or as required. This meant that staff were provided with up to date information about how people's needs were to be met. However, we found gaps in record keeping which could lead to care not being delivered correctly.
We saw that staff were available to meet people's needs and reviews were held where there had been a change in people's needs to see if the support was still appropriate to meet their needs.
Is the service caring?
The interactions we observed by staff were kind and we found staff responded appropriately to people's requests and needs. We spoke with some relatives, and found they were regularly involved and included in their family members care.
Is the service responsive?
People had support determined around their assessed needs. However this support was flexible and took into account changes in people's needs.
People were supported to see other professionals such as general practitioner, community dentist, chiropodist, optician, and district nurse. This showed that people's general health care needs were considered and that the service was responsive to people's changing needs. However, we identified gaps in records particularly when there was more than one agency involved in meeting people's health care needs. This meant that the service might not always respond quickly enough to prevent a decline in a person's health.
Is the service well led?
The service was well managed with effective leadership and an open and transparent culture. There were systems to support staff and ensure their work performance met the high expectations of the organisation.
The service actively assessed the quality of its service provision to ensure it was delivering high quality care. It also learnt from its mistakes.
Due to the complex needs of the people, we visited which included sensory impairment and limited or no verbal communication we were unable to gain their views and experiences of the service directly. However, we were able to make general observations of the quality of the service they received. We found that people's views and experiences were taken into account in the way the service was provided and delivered in relation to their care. People were supported in promoting their independence and community involvement and that there was enough skilled and experienced staff to meet their needs.
One person showed us around their home and invited us to see a baking session which was taking place. People using the service were all engaged in creating cakes in preparation for their Halloween party. Staff had supported people in purchasing and making Halloween decorations and everyone using the service was enthusiastic and enjoying the opportunities available. One person told us, "I love living here. There is lots going on. I can go into town when I like. I can go to bed when I want. I have no worries."
We found that staff had a detailed knowledge of the people who they cared for. They were providing support which had been designed to meet the specific needs of each individual. Care plans were person centred and provided good evidence of support given. Risk assessments were in place to ensure people's safety and welfare and these were updated regularly. Staff told us about many methods they used to communicate effectively with people using the service and how they supported people to feel fulfilled and safe.
Everyone we spoke with told us they had regular, reliable and competent support workers that were attentive and understood their needs. One person told us 'they (support workers) leave me alone when I am tired or down and help me when I want'. They also told us the support workers will 'cheer me up when I am sad and know what I like to do'.
People we spoke with told us they were fully consulted about their support plans and had been asked for their views about the service they received. They all said their privacy and dignity was respected and they felt safe with their support workers.