United Response – Wiltshire DCA, a supported living service for people with learning disabilities and autistic people, was rated Good overall following inspections in May 2023, with both Safe and Well-Led key questions rated Good. The service demonstrated strong person-centred care, effective risk and medicines management, robust safeguarding systems, and well-embedded quality assurance, with no failure themes identified.
Strengths
· Risk assessments balanced independence with safety and were regularly reviewed with people and their representatives.
· Medicines administration records fully completed and support regularly reviewed to promote independence.
· Sufficient staffing maintained through consistent long-term agency staff to address shortages.
· Effective safeguarding systems with staff demonstrating good understanding of protection responsibilities.
· Strong infection prevention practices observed, with staff trained in IPC and PPE use.
Quality-Statement breakdown (10)
safe: Systems and processes to safeguard people from the risk of abuse
Good
safe: Assessing risk, safety monitoring and managementGood
safe: Staffing and recruitmentGood
safe: Using medicines safelyGood
safe: Preventing and controlling infectionGood
safe: Learning lessons when things go wrongGood
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirements; Continuous learning and improving careGood
well-led: Promoting a positive culture that is person-centred, open, inclusive and empowering; Duty of candourGood
well-led: Engaging and involving people using the service, the public and staff, fully considering their equality characteristicsGood
United Response - Wiltshire DCA was rated Good across all five key questions at its October 2017 inspection, demonstrating strong person-centred care, well-trained and caring staff, and effective leadership with a positive open culture. Minor shortfalls were identified in medication temperature monitoring and incomplete Mental Capacity Act documentation, both of which the registered manager committed to address immediately.
Concerns (3)
moderateMedication management: “temperature checks were not completed or recorded in medicine cabinets. One person received liquid medicines which could not be stored over a certain temperature.”
moderateConsent / capacity: “people's records did not always contain an assessment of their capacity. Where decisions had been made in people's best interests...these were not always being recorded fully.”
moderateRecord keeping: “There were no records to show the rational for these decisions, no mental capacity assessments to show that people did not have capacity to manage their medicines.”
Strengths
· Personalised, person-centred care plans with outcomes set by people and regular person-centred reviews involving families and health professionals
· Strong staff training programme including role-specific training (epilepsy, diabetes, dementia, breakaway techniques) and comprehensive induction following Care Certificate framework
· Regular supervisions and annual appraisals in place, with staff reporting these as useful and supportive
· Positive, caring relationships between staff and people supported, evidenced through observed interactions and stakeholder feedback
· Robust complaints system with accessible easy-read version and prompt follow-up by registered manager
United Response DCA Wiltshire received a Good rating across all five key questions at its announced inspection on 31 March and 1 April 2015. The service demonstrated strong person-centred practice, safe staffing and medicines management, and effective governance, with no failure themes identified.
Strengths
· Staff understood safeguarding responsibilities and knew how to raise concerns; safeguarding alerts managed appropriately
· Comprehensive, regularly reviewed risk assessments encouraged independence while keeping people safe
· Safe medicines management with appropriate responses to the four administration errors recorded in 12 months
· Staff received core and specialist training, regular supervision via team feedback and one-to-one sessions, and annual appraisals
· Person-centred planning tools and annual review meetings ensured care was individualised and people led decisions
effective: Nutrition and hydration
Good
effective: Access to healthcareGood
caring: Kindness, compassion and dignityGood
caring: Person-centred approaches and decision-making supportGood
caring: Privacy and dignityGood
responsive: Person-centred reviews and care planningGood
responsive: Responding to changing needsGood
responsive: Activities and community accessGood
responsive: Complaints handlingGood
well-led: Leadership and management cultureGood
well-led: Quality monitoring and auditingGood
well-led: Regulatory compliance and duty of candourGood