Dimensions London North/East Domiciliary Care Office

At our last inspection in February 2016 we rated the service Good. At this inspection we found evidence continued to support the rating of Good.

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.

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

At the time of this inspection the service was providing personal care and support to 88 people living in their own homes. The majority of these people lived in a supported living scheme in a shared house or flat.

The registered manager was supported by locality managers who managed between three and four supported living schemes each.

The service also provided a specialist service providing Applied Behaviour Analysis and positive behaviour support for people with an autistic spectrum condition to develop their life skills and independence. These people had structured teaching and support programmes delivered by a suitably qualified team.

Staff understood how to safeguard people and risks were managed effectively to help people keep safe and protect their rights.

There were some minor concerns about medicines recording which the registered manager addressed when we brought these to their attention and put steps in place to prevent recurrences.

The service offered “active support” and worked with, rather than for, people they supported. People played an active role in planning their lives and in their day to day routines. People were supported to have maximum choice and control of their lives and the service supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People had choice around what they ate, whether they cooked their own meals or had their meals cooked by staff and how they spent their time.

The service provided support to people to maintain good health and with managing health conditions. People had good support to maintain their independence and their right to privacy was respected. The service helped people with maintaining relationships with their families and friends.

People were involved in planning their care. The service ensured care plans were person centred and updated as and when people's care needs changed.

Effective systems were in place to manage complaints. People using the service and their relatives told us they were happy with the service. The service was person-centred and inclusive.

The service maintained records of care and support provided, people's health needs and wellbeing.

The registered manager had strong leadership skills and introduced new initiatives and ideas to improve opportunities for people. Staff felt well supported by the managers.

The provider was continually improving the service and worked in partnership with health and social care professionals to ensure people's health and social care needs were met. The provider had a comprehensive quality monitoring process. We have made one recommendation about improving the follow up action to the existing quality monitoring processes to ensure improvements are made without delay when needed.

Dimensions London Domiciliary Care Office provides support and personal care to people living either in their own flat or in supported living projects where some amenities are shared. There were approximately 69 people using the service at the time of our inspection.

There was a registered manager in post at the time of our inspection. 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 and associated Regulations about how the service is run.

We identified some outstanding elements in the way the service was run and how people who used the service were involved in providing feedback on and assessing the quality and safety of service provision.

The service had taken a creative approach to the way it involved people in monitoring the quality of service provision. We saw how this approach had led to improved outcomes for people using the service and improvements to their care.

The registered manager ensured that people using the service and their representatives were at the centre of the quality assurance process and we saw that their views were encouraged and acted on.

The vision and values of the service were understood by management and staff and were imbedded into the day to day running of the service.

Staff were supported and their views about the quality of service were also encouraged and acted on within a framework for continuous improvement.

People told us they were well treated by the staff and felt safe and trusted them.

Staff could explain how they would recognise and report abuse and they understood their responsibilities in keeping people safe.

Where any risks to people’s safety had been identified, the management had thought about and discussed with the person ways to mitigate risks.

The service followed robust recruitment procedures to make sure that only suitable staff were employed.

People who used the service and their relatives were positive about the staff and told us they had confidence in their abilities. Staff told us that they were provided with training in the areas they needed in order to support people effectively.

Staff understood that it was not right to make choices for people when they could make choices for themselves and people’s ability around decision making, preferences and choices were recorded in their support plans and followed by staff.

People told us they were happy with the support they received with eating and drinking and staff were aware of people’s dietary requirements and preferences.

People confirmed that they were involved as much as they wanted to be in the planning of their care and support. Support plans included the views of people using the service and their relatives.

People and their relatives told us that the management and staff were quick to respond to any changes in their needs and support plans reflected how people were supported in accordance with their current needs and preferences.

People told us they had no complaints about the service but said they felt able to raise any concerns without worry.