DCA Essex

DCA Essex is a supported living service providing personal care to people with a learning disability, autistic people and people with a physical disability. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do receive personal care we also consider any wider social care provided. At the time of our inspection there were 32 people using the service, of which 23 received personal care.

Support was provided in shared houses and flats across Essex. The main office was in Braintree.

People’s experience of using this service and what we found

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. We considered this guidance as there were people using the service who have a learning disability and or who are autistic.

People had varied experiences of using the service, depending largely on the area in which they lived. Some people, and their representatives told us they were unhappy with the quality of support. They did not always receive safe, person-centred care. Other people received good quality care and achieved positive outcomes.

We made a recommendation about promoting people’s quality of life and involvement in reviews of their care.

Right Support:

Staff did not always support people safely with their medicines. The provider was addressing concerns we had in this area.

The provider needed to improve how they assessed risk across the service to enable staff to consistently provide safe support.

People were not always supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible and in their best interests; the policies and system in the service did not always support the provider to have oversight of this practice.

Some people did not consistently have the necessary support to take part in activities and pursue their interests in their local area. Other people had the support they needed and lived full and busy lives.

Staff enabled people to access specialist health and social care support in the community. Improvements were needed to ensure all staff had access to specialist guidance about people’s needs.

Right Care:

The service did not always have enough staff with the appropriate skills to meet people’s needs and keep them safe. Agency and new staff did not always have the skills and information to meet people’s needs.

Improvements were needed to ensure staff training was tailored to the needs of the people they supported.

People could communicate with staff and understand information given to them because staff understood their individual communication needs.

Right Culture:

The provider had not ensured there were effective tools to check and evaluate the quality of support provided to people. Improvements were needed to involve the person and their representatives, as appropriate, in the review process.

The provider needed to improve how they communicated with people when things went wrong, in line with their duty of candour.

Managers and staff were committed to improving the care and culture for people and had started to sort things out.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk.

Rating at last inspection

This service was registered with us on 23 June 2022 and this is the first inspection.

Although this service is being inspected as a new service it was created as part of a restructure by the provider and many of the care arrangements had been in place previously as part of other registered services.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

Enforcement

We have identified breaches in relation to support with medicines, risk management, governance and quality assurance at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.