DCA Essex

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

People received safe care and treatment from staff who understood their healthcare needs and followed healthcare guidance from professionals. At the previous assessment the provider was in breach of regulation because they had not safely managed people’s medicines. At this assessment the provider had made enough improvement and was no longer in breach of regulation for safe care and treatment.

This service scored 72 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

There was an open culture where the management team spoke about their learning as an organisation since their last assessment. There were robust systems to record incidents, complaints, and compliments and clear processes in place to investigate, analyse and learn from incidents. Lessons learnt were discussed during staff meetings, enabling staff to reflect and share ideas of how to improve things further. The manager analysed incidents, accidents and complaints to identify any common themes, patterns and lessons learnt. Action was taken to address lessons learnt, for example, around individual people’s care and medicines.

People’s care needs were well-coordinated. People and their relatives told us staff supported them to access different health and social care services when needed. The manager explained how they communicated with other services, assessed, and reviewed people’s needs and ensured smooth transitions between healthcare services.

People were safeguarded from abuse. The manager and staff had a good understanding of safeguarding and their responsibility to report notifiable incidents. A staff member said, “We have been trained how to meet people’s needs and keep them safe from avoidable harm.” Another staff member said, “I feel people are safe but if I felt they wasn’t I would report this to the local authority.” Another staff member told us they need to be aware of the signs of abuse including nonverbal communication, for example, changes in mood, behaviour or attitude towards particular people or situations. Staff spoke confidently about reporting concerns both to management and externally.

Some people were aware of measures in place to keep them safe. For example, people’s money and medicines were locked away and managed for them by the provider. People’s care plans were detailed and incorporated risk assessments. People had a wide range of risk assessments that included, medicines management, finance, community access and eating and drinking. Staff told us they risk assessed environments for hazards as part of their normal practice.

People’s environments were safe, and health and safety checks and audits were completed. People’s homes were clean and personalised, decorated how individuals wanted them. People’s gardens were well cared for.

The manager told us the service had consistent staffing and agency staff were not required. A staff member said, “We have access to some face to face training, for example, manual handling and first aid. Other training is accessed online and we are sent alerts when training is due.” Staff had a good understanding of their role and responsibilities, and many understood their responsibility to report concerns externally to the local authority and CQC if they felt they wouldn’t be listened to internally. A staff member said, “I love working for DCA Essex and I feel we have enough training. I feel every time I work, I support someone to have an amazing day full of happiness.”

Staff training was reviewed to ensure staff had the knowledge and skills to meet people's needs. Staff were up to date with training. Staff were recruited following a robust recruitment process and a Disclosure and Barring Service (DBS) check. DBS provide information including details about convictions and cautions held on the Police National Computer. The information helps employers make safer recruitment decisions.

We did not look at Infection prevention and control during this assessment. The score for this quality statement is based on the previous rating for Safe.

The provider safely managed people’s medicines. At the previous assessment the provider was in breach of regulation because they failed to safely manage medicines; they had failed to ensure appropriately trained staff were available to administer emergency buccal medicines for people with epilepsy. At this assessment the manager explained the provider had learnt a lot since the last assessment and had made changes that included an improved training programme. There was a better understanding and emphasis on having staff with the correct skills to administer emergency buccal medicine. The manager explained there was now a minimum number of trained staff in each house and where a person was prescribed buccal there was always a trained staff member on duty.

The manager had put systems in place to ensure people were safely supported with their medicines. As part of a lessons learnt review, staff supporting a person prescribed buccal must carry the medicine on them at all times. This means there should be no delay in administering the emergency medicine. We checked medicine administration records and confirmed stock records were correct; we spoke to staff who told us the provider has made a lot of changes, and they felt confident they had the support they needed to manage people’s medicines. Staff felt they could speak openly about the previous concerns and had told us they felt reassured they would not be in the same situation again. When we visited the home of people who were prescribed buccal, we noted there were enough trained staff on duty to support in the event of a seizure and staff were carrying the emergency medicine on their person. 'When required' (PRN) medicines protocols were in place for prescribed PRN medicines and an alert system was in place to help ensure staff knew when changes had been made to people’s prescriptions.