This inspection took place on 22, 23 and 25 May 2018 and was announced. We gave the service 48 hours’ notice of the inspection visit because it is small and the registered manager is often out of the office supporting staff. We needed to be sure that they would be in. This was the first inspection of this service since it was registered at this location in December 2016.

This service 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 regulated activity. 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 25 people were receiving personal care from the service.

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 and their relatives told us staff helped to keep people safe. Risks to people were managed safely. Staff were supported to maintain high standards of infection control. Plans were in place to support people in emergency situations that disrupted the service. Policies and procedures were in place to safeguard people from abuse. People’s medicines were managed safely. Staffing levels were based on the assessed level of support people needed. The provider’s recruitment procedures minimised the risk of unsuitable staff being employed.

Staff were supported with a wide range of training, supervisions and appraisals. Newly recruited staff were required to complete the provider’s induction programme before they could support people without supervision. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice. People’s food and nutrition was managed effectively. People were supported to access external professionals to monitor and promote their health.

People spoke positively about the support they received from the service and described staff as caring. Relatives also spoke positively about the support people received, describing staff as kind and supportive. People were treated with dignity and respect. People’s independence was promoted and they were supported to maintain and enhance their independent living skills. People and their relatives told us staff were very effective at communicating with people and helping to ensure their voices were heard. Policies and procedures were in place to support people to access advocacy services.

People received personalised care based on their assessed needs and preferences. Support plans were regularly reviewed to ensure they reflected people’s current support needs and preferences. People and their relatives were involved in developing and reviewing people’s support plans. People were supported to access activities they enjoyed. Policies and procedures were in place to investigate and respond to complaints. At the time of our inspection nobody at the service was receiving end of life care but policies and procedures were in place to provide this if needed.

Staff spoke positively about the culture and values of the service. People and their relatives spoke positively about the management of the service. The registered manager had forged links with other agencies and care providers to help benefit the health and wellbeing of people using the servi