East Cornwall & Plymouth DCA provides care to people with learning disabilities, acquired brain injuries and dementia. On the days of our inspection the service was providing personal care to 21 people, some living in shared housing.

At our last inspection we rated the service good. At this inspection 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. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

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Why the service is rated good:

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 safety was promoted through safe staff recruitment, training, supervision and staffing arrangements.

Staff fully understood how to safeguard people from abuse and discrimination. The registered manager worked closely with the local authority safeguarding adults team.

An attitude of positive risk taking meant people were not overly restricted in their daily lives.

People received their medicines as prescribed, with staff assistance.

Staff understood hygienic practice and had the equipment to protect people from infection and cross contamination.

People received a varied menu which they were able to influence.

Each person had a comprehensive, well organised care plan, based on their needs and wishes. Where the person was unable to take part in decision making, their representatives, or independent advocacy, was arranged for them.

Staff knew people well. A health care professional said, “Staff certainly know people very well and have made good relationships.”

People were treated with dignity and respect. Staff understood the importance of equality and diversity and worked hard to remove barriers which might restrict people’s lives.

People were supported to follow meaningful activities, make and benefit from relationships and enjoy time in the community.

Staff spoke positively about the management and provider organisation. They felt their views were listened and responded to and had not been afraid to speak up if not happy with any aspect of the care. Concerns and complaints were robustly investigated and followed up.

There were effective systems in place to monitor the quality of the service, including listening to people’s views.

Further information is in the detailed findings below

The inspection took place on 27 April 2016, 3 & 17 May 2016 & 7 June 2016 and was announced.

East Cornwall & Plymouth DCA provides care and support to people with learning disabilities, acquired brain injuries and dementia. On the days of our inspection the service was providing personal care to 21 people.

There was a registered manager in post. 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 cared, and staff demonstrated through their conversations and interactions compassion and kindness for people. People’s privacy and dignity was promoted. People were actively involved in making decisions about how they wanted to live their life.

People received care which was responsive to their needs. People and their relatives were encouraged to be part of the care planning process and to attend care reviews. This helped to ensure the care being provided met people’s individual needs and preferences. Care plans were used to help people focus on their future ambitions as well as recognising their achievements.

People’s relatives told us their loved one was safe and felt comfortable with staff. People were protected from abuse because staff understood what action to take if they were concerned someone was being abused of mistreated.

People’s risks associated with their care were effectively managed to ensure their freedom was promoted. People were supported by adequate staffing to help meet their needs. The provider wanted to ensure the right staff were employed, so people and their relatives were invited to be involved in the recruitment process. People’s medicines were managed safely, staff received training and had their ongoing competence assessed in respect of medicines management.

People received care from staff who had undertaken training to be able to meet their needs. The provider used their pre-assessment process to assess whether staff required additional training, in order to meet people’s needs effectively, prior to them using the service. People’s human rights were protected because the registered manager and staff had an understanding of the Mental Capacity Act 2005 (MCA). People’s nutritional needs were met because staff followed people’s care plans to make sure people were eating and drinking enough. People were supported to access health care professionals to maintain their health and wellbeing.

The service was well led, by a registered manager who demonstrated the provider’s values. There were quality assurance systems in place to help assess the ongoing quality of the service people received, and to help identify promptly areas which required improvement. The provider and registered manager promoted the ethos of honesty, learned from mistakes and admitted when things had gone wrong.

Many of the people who use this service have complex needs that include communication difficulties. Therefore, some people we met with were not able to communicate freely with us and needed the support of the staff to give us information.

We were able to speak with two people who use the service and we observed five other people receiving support. The people we spoke with were able to tell us how they make choices regarding their care and support. We also observed staff encouraging people who use the service to make choices e.g. planning for the days activities. Both people we spoke with told us that they like to go out to cafes and shopping and that staff go with them to help them. One person also told us that they like to go out for walks and the staff were able to explain to us how the persons independence and confidence has grown over the past six months through the support from United Response.

One of the people we spoke with said that in their house [which they share with other people], they take it in turns to choose what the main meal of the day is going to be. They also told us that they always help cook the food and go shopping to buy it.

One person told us that they liked their home and had been vacuuming and cleaning windows with their support worker earlier that day. We observed staff involving other people who use the service in domestic tasks e.g. washing dishes and saw that independence to do these tasks is promoted and assistance and support given where necessary.

We were also told during our visit to one person who uses the service that they like United Response, where they lived and the things they did with the staff every day. They also said they were happy, but if they didn’t like something they would tell the staff.

We used a number of different methods to help us understand the experiences of people using the service from the agency. The people we met who used the service had complex needs which meant they were not able to tell us their experiences.

During our visit we were able to meet some of the people who used the service and observed staff as they provided care and support. This helped us gain a better understanding about people's support needs and experiences of the service.

We also looked at records and spoke to staff on duty. The staff confirmed that they supported people with all their daily living tasks, including personal care and meeting there nutritional needs.

The staff we spoke to had all attended safeguarding training and all understood what constitutes abuse. Staff knew who they needed to approach if they had any concerns.

Staff were able to speak confidently about the care practices they delivered. The staff we spoke with showed they understood how they contributed to people's health and wellbeing.

There were sufficient staffing in place and staff received a range of training opportunities to ensure they could meet people's needs.

We found auditing systems in place to establish the quality of the service being provided. Auditing systems ensure all areas would be monitored and any issues would be identified and addressed.