Background to this inspection
Updated
29 December 2022
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.
Inspection team
This inspection was carried out by two 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
This service provides care and support to people living in ‘supported living’ settings, so that they can live 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.
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 six registered managers were in post.
Notice of inspection
We gave the service 24 hours’ notice of the inspection. This was because we needed to be sure that the provider or registered manager would be in the office to support the inspection.
Inspection activity started on 20 October 2022 and ended on 15 November 2022. We visited the location’s office on 20 October 2022.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made judgements in this report. We used all of this information to plan our inspection.
During the inspection
We spoke to four people and eight relatives about their experience of care. We spoke to 13 staff members including care staff, registered managers and the regional manager. We received feedback from eight professionals who work with the service. We reviewed care pans, multiple medicine administration records and other records related to the management of the service. We visited five supported living services and observed the staff working with people and the environment.
Updated
29 December 2022
About the service
Dimensions Oxfordshire and Warwickshire is a Domiciliary care agency providing personal care to people living in ‘supported living’ settings. The service provides support to people with a learning disability and autism. At the time of our inspection there were 96 people using the service. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided. At the time of our inspection, 76 people were supported with personal care by this service.
People’s experience of using this service and what we found
People were supported by staff who were recruited safely and received training relevant to their role. The national health and social care recruitment challenges had impacted this staffing levels at this service, however there were systems in place to mitigate the impact as much as possible. Medicines were managed, stored and administered in line with guidance. Staff followed infection control guidance and the service had appropriate policies and procedures for the management of infectious diseases. Accidents and Incidents were reviewed by the registered manager and area managers. However we saw some incidents were not always notified to CQC appropriately.
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. We observed this service was meeting the principles of this guidance.
Right Support: 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 Care: People told us they were happy with the way they were supported, and we observed staff treated people respectfully and with kindness. People were supported to express views and make decisions about their care.
People's care was bespoke to them as individuals and their preferences as well as cultural and spiritual needs were supported by staff. People were supported to maintain relationships that were important to them and be an active part of their community.
Right Culture: The service had a culture which was person-centred and promoted good outcomes for people. The management team regularly sought feedback from people, professionals and their relatives and used this to plan service improvement. The management team maintained good relationships with external professionals and worked effectively with them.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
This service was registered with us on 13 May 2021 and this is the first inspection.
Why we inspected
This inspection was prompted by a review of the information we held about this service.
Enforcement and Recommendations
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection.
We will continue to monitor the service and will take further action if needed.
We have identified breaches in relation to statutory notifications. Please see the action we have told the provider to take at the end of this report.
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.