United Response provides care and support to people living in a supported living setting, so that they can live in their own home as independently as possible. People’s care and housing is provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.

This announced inspection was started on 2 August 2018 and we visited people who used the service in their own homes. We gave the service 48 hours’ notice of the inspection site visit because some of the people using it could not consent to a home visit from an inspector, which meant that we had to enable the service time to arrange for a ‘best interests’ decision about us visiting or meeting people.

On the day of our inspection, there were 60 people being supported with personal care by the service.

During our last inspection in July 2015 the service was rated as good in all the key questions and good overall. At this comprehensive inspection, which we carried out on 2 August 2018 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. Because the rating remains Good, this inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

The service had a long standing registered manager. 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.

Some people shared a house with other people who use the service and others lived individually. The registered manager oversaw the running of the service, and each individual shared house had a service manager.

The service continued to be well led; the registered manager was organised and knowledgeable about the people being supported and was well supported by the providers of the service. People, their relatives and the staff told us that the registered manager was open, supportive and had good management skills. There were robust systems in place to monitor the quality of service the providers offered people.

We saw examples of positive and caring interaction between the staff and people supported by the service, people were treated with kindness and respect. People were able to express their views and staff listened to what they said, respected their views and took action to ensure their decisions were acted on. Staff protected people’s privacy and dignity.

People and their relatives told us that they still felt safe using this service. People were protected from bullying, harassment, avoidable harm and abuse by staff that were trained to recognise abusive situations and knew how to report any incidents they witnessed or suspected. Staff clearly understood their responsibilities to raise concerns and there were arrangements in place for reviewing and investigating incidents when things went wrong. Staff told us they would not hesitate to report any suspicions they had about people being abused.

Risks were assessed and steps had been put in place to safeguard people from harm without restricting their independence unnecessarily. Risks to individual people had been identified and action had been taken to protect them from harm.

Staffing levels were sufficient to keep people safe and staff continued to be safely recruited which helped protect people from harm. People continued to be supported to manage their medicines in a way that ensured that they received them safely and at the right time. There were also appropriate infection control practices in place.

People’s needs assessments were detailed and they received effective care in line with cu

We visited people living in their own homes who were receiving a service from United Response in Ipswich. We met with eleven people, spoke to one relative, reviewed three care plans in detail and spoke with five members of staff.

Due to the complex needs of the people, we visited which included sensory impairment and limited or no verbal communication we were unable to gain their views and experiences of the service directly. However, we were able to make general observations of the quality of the service they received. We found that people’s views and experiences were taken into account in the way the service was provided and delivered in relation to their care. People were supported in promoting their independence and community involvement and that there was enough skilled and experienced staff to meet their needs.

We visited nine people who received care from Ipswich DCA in their own homes. We used a number of different methods to help us understand the experiences of people using the service. People using the service had complex needs which meant that some were not able to tell us their experiences. Where this was the case, we observed care being given and we also spoke with the relatives of three people.

One person showed us around their home and invited us to see a baking session which was taking place. People using the service were all engaged in creating cakes in preparation for their Halloween party. Staff had supported people in purchasing and making Halloween decorations and everyone using the service was enthusiastic and enjoying the opportunities available. One person told us, "I love living here. There is lots going on. I can go into town when I like. I can go to bed when I want. I have no worries."

We found that staff had a detailed knowledge of the people who they cared for. They were providing support which had been designed to meet the specific needs of each individual. Care plans were person centred and provided good evidence of support given. Risk assessments were in place to ensure people's safety and welfare and these were updated regularly. Staff told us about many methods they used to communicate effectively with people using the service and how they supported people to feel fulfilled and safe.

We spoke with four people who used the service. They were very positive about their support workers and the service from Ipswich DCA. One person told us “the support workers are brilliant. I can talk to them or the manager about anything”. Another person told us “they (support workers) do a good job and work with me”.

Everyone we spoke with told us they had regular, reliable and competent support workers that were attentive and understood their needs. One person told us “they (support workers) leave me alone when I am tired or down and help me when I want”. They also told us the support workers will “cheer me up when I am sad and know what I like to do”.

People we spoke with told us they were fully consulted about their support plans and had been asked for their views about the service they received. They all said their privacy and dignity was respected and they felt safe with their support workers.

We visited the offices of Ipswich DCA on 8 July 2015 and the visit was announced. We carried out visits to people who use the service on 9, 13 and 17 July 2015, we also telephoned people who used the service during this period.

The service provides care to people who may have a learning difficulty or are on the autistic spectrum. People may also have a physical disability. This support may be in individual accommodation or shared houses.

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 we visited were happy and relaxed. They were involved in the activities of daily living and attending outside appointments supported by staff. Staff were knowledgeable about the people they supported engaging with them in a friendly and relaxed but respectful manner.

There were suitable arrangements for the safe storage, management and disposal of medicines. Where people may lack capacity to make particular decisions the decision making process was recorded and the appropriate people consulted. The Mental Capacity Act 2005 and how it affected this service was understood and put into practice by staff.

There were sufficient suitably qualified staff to meet people’s needs. A mix of part-time and full-time staff gave the service flexibility to support people with their various interests throughout the day. People using the service were involved in the recruitment of staff. Appropriate checks were carried out to ensure staff were suitable to work in this type of service. Staff were supported through a system of induction and training.

People were encouraged to participate in decisions relating to the running of the service and how their care was provided. Regular meetings took place for people who lived in shared housing supported by the service. People living in the shared housing visited other shared housing where the service provided support to carry out quality assurance surveys. There was a robust system of quality assurance checks in place.

Support records were detailed and contained specific information to guide staff who were supporting people.