Dimensions The Mulberries

Updated 24 October 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was conducted by 2 inspectors, 2 pharmacist inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Dimensions The Mulberries is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under 1 contractual agreement dependent on their registration with us. Dimensions The Mulberries is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection and we sought feedback from the local authority. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

During our visit we spoke with 2 visiting relatives of people who use the service, 3 support workers, 1 senior support worker and the registered manager. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us. We reviewed a range of records relating to the management of the service including 2 people’s care plans and records, medicines support records, health and safety records, and quality checks of the service. After our visit we also spoke with 3 relatives and 1 professional involved with a person who uses the service. We continued to seek clarification from the provider to validate evidence found. We looked at procedures, care records, staff training and staff recruitment records.

Updated 24 October 2023

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

About the service

Dimensions The Mulberries is a care home for up to 7 people with learning disabilities and/or autism. At the time of our inspection, 5 people were living at the service.

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

The service was able to demonstrate how they were meeting some of the underpinning principles of right support, right care, right culture. However, they needed to make improvements to fully meet these.

Right Care

People mostly received care that was kind and staff respected their privacy, but we saw people were not always treated with dignity and respect at all times.

Staff understood and responded to people’s individual needs. They communicated with people in ways that met their needs. The service gave people care and support to meet their sensory and physical needs, but some areas of the environment was not always kept sufficiently clean or safe at all times.

The service had enough staff to keep people safe. Staff had training on how to recognise and report abuse and they knew how to apply it.

Right Support

Staff supported people with their medicines, but the medicines management arrangements were not always effective.

Staff enabled people to access health and social care support. Staff helped people to enjoy a variety of activities at home and in the community.

The provider follow appropriate recruitment procedures to ensure only suitable staff were recruited to work at the service.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Right Culture

The provider's monitoring processes were not always effective in helping to ensure people consistently received good quality care and support.

There was a culture of supporting people to receive compassionate care that was tailored to their needs, but we received mixed feedback about the leadership at the home.

The service involved relatives and advocates in planning and reviewing people’s care.

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

Rating at last inspection

The last rating for this service was good (published 13 December 2018).

Why we inspected

We received concerns in relation to providing safe support to people. As a result, we undertook a focused inspection to review the key questions of safe, responsive and well-led only. We inspected and found concerns about people being treated with dignity and respect so we widened the scope of the inspection to include the key question of caring as well.

We looked at infection prevention and control measures under the safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

We have found evidence that the provider needs to make improvements. Please see the safe, caring and well-led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Dimensions The Mulberries on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified breaches in relation to dignity and respect, safe care and treatment and good governance at this inspection. Please see the action we have told the provider to take at the end of this report. We have also made a recommendation regarding mealtime support.

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.