United Response Cornwall DCA provides care and support to people in their own homes. People who used the service, at the time of the inspection, had a learning disability. The service provides support to people in mid and west Cornwall.

At the time of our inspection 38 people were receiving a personal care service. These services were funded through Cornwall Council or the NHS.

There were three registered managers in post who was responsible for the day-to-day running of the service. 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 and associated Regulations about how the service is run.

We carried out this announced inspection on 19, 20 and 21June 2017. The service was last inspected in March 2015 and was found to be meeting the regulations and was rated as ‘Good’.

Most of the people we met, had limited verbal communication skills. However we were able to speak with some people, who were positive about the support they received from the service. They said the service was, “Good”, and “Fine”. Relatives we spoke with said, the service had “Transformed (my relative’s) life…previously (they) were not supported just looked after,” “I cannot speak highly enough” (about the service), “Excellent, I could not want for a better organisation,” and “(My relative) is looked after superbly.”

People were safe. Staff had received training in how to recognise and report abuse. All were clear about how to report any concerns and were confident that any allegations made would be fully investigated to help ensure people were protected.

There were enough suitably qualified staff available to meet people’s needs. The service was flexible and responded to people’s changing needs. People told us they had a team of regular staff and their visits were at the agreed times.

People received care from staff who knew them well, and had the knowledge and skills to meet their needs. People and their relatives spoke very highly of staff and typical comments included; “I have nothing but praise for them”, and “They listen.”

Staff were knowledgeable about the people they cared for and knew how to recognise if people’s needs changed.

Staff were aware of people’s preferences and interests, as well as their health and support needs, which enabled them to provide a personalised service. Staff were kind and compassionate and treated people with dignity and respect.

The management had a clear understanding of the Mental Capacity Act 2005 and how to make sure people who did not have the mental capacity to make decisions for themselves had their legal rights protected.

Staff told us there was good communication with the management of the service. Staff said management were, “Really good,” and “Very supportive.”

There were effective quality assurance systems in place. The service had an effective management team, and Care Quality Commission registration, and notification requirements had been complied with.

We carried out this inspection on 16 and 19 March 2015. This was the first inspection of Cornwall DCA at their new registered offices and the inspection was announced.

There were two registered managers in post as they cover the whole of the county of Cornwall. 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.

Cornwall DCA is a domiciliary care service that provides care and support to people in their own homes. This includes people with general health needs, mental health needs, and learning disabilities. The care ranges from a few hours of support a week up to 24 hour care for people in supported living. A supported living service is one where people live in their own home and receive care and support in order to promote their independence. People have tenancy agreements with a landlord and receive their care and support from the domiciliary care agency. As the housing and care arrangements are separate, people can choose to change their care provider without losing their home.

We visited by agreement, people living in their homes where supported living support was being provided by this service. Some people lived in their own homes and others lived in a shared house where people had their own bedrooms and shared the other parts of the house with staff supporting them throughout the 24 hour period.

People told us they “trusted” the care staff who supported them and felt they were safe. Staff were confident about the action to take if they had any safeguarding concerns and were confident the registered manager would follow up any worries they might have. Risk assessments clearly identified any risk and gave staff guidance on how to minimise the risk. They were designed to keep people and staff safe while allowing people to develop and maintain their independence.

People were supported by stable and consistent staff teams who knew people well and had received training specific to their needs. People were involved in recruiting and choosing the staff who supported them. Efforts were made to match staff with people by identifying any shared interests and hobbies.

Staff told us they enjoyed their work and were well supported through supervision, appraisals and training. The registered managers spoke highly of the staff team describing them as committed and enthusiastic in their approach to their work.

Staff had high expectations for people and were positive in their attitude to support. Staff were respectful of the fact they were working in people’s homes. The service offered flexible support to people and were able to adapt in order to meet people’s needs and support them as they wanted.

Care plans were personalised and clearly guided staff in how to support people well at various times of the day and in different situations. This allowed a consistent approach from staff when supporting people in their own homes.

The management team had a clear set of values which was also apparent in our discussions with staff. People and staff told us they felt involved in the development of the service and that management listened to any ideas and suggestions they had and took them on board.