Dimensions Somerset Taunton Domiciliary Care Office

Updated 14 February 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.

Inspection team

The inspection was carried out by one inspector 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, their own homes and flats, so that they can live as independently as possible. In ‘supported living’ settings, 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 were three registered managers in post. A fourth manager was also in the process of registering with us. We have therefore used the term ‘managers’ to describe both registered and unregistered managers in this report.

Notice of inspection

We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered managers would be in the office to support the inspection.

Inspection activity started on 18 November 2022 and ended on 13 December 2022. We visited the location’s office on 2 December 2022.

What we did before the inspection

Before the inspection we reviewed all of the information we held about the service, including statutory notifications. Statutory notifications include information about important events which the provider is required to send us. 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.

During the inspection

We met with three managers (two registered managers and one awaiting registration), one assistant manager (deputising for another registered manager) and with the area operational director at the office base. We visited three homes (where a total of 15 people lived) and had telephone calls with the relatives of nine people. We looked at records related to the care and support of five people. We spoke with seven members of staff, two registered managers, one assistant manager and the provider’s performance coach (who was supporting one recently appointed manager).

After the inspection

We continued to seek clarification from the provider to validate evidence found. The operations director sent us records relating to the management of the service including quality audits, service improvement plans, health and safety meeting minutes, staff meeting minutes, staff training records, staff survey results and examples of correspondence and information about services sent to family members.

Updated 14 February 2023

About the service

Dimensions Somerset Taunton Domiciliary Care Office provides care and support to people with learning disabilities and autistic people who live in their own homes. It is registered to provide personal care. At the time of the inspection the service was providing personal care to 28 people. Some people lived in their own home; other people housed shared. Where staff slept in to ensure people were safe overnight, they had a private space to do so in a spare bedroom.

In 'supported living' settings 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.

CQC only inspects the service being received by people provided with 'personal care'; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

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

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.

Right Support

People were supported to have maximum choice and control over 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.

Staff focused on people's strengths and promoted what they could do, so people had fulfilling and meaningful lives. People were supported by staff to pursue their interests and hobbies.

Staff enabled people to access specialist health and social care support in the community.

Staff supported people with their medicines in a way that promoted their independence and achieved the best possible health outcome.

Right Care

Staff spoke respectfully about people and treated them with compassion. Staff respected people's privacy and dignity. They understood and responded to people's individual needs.

Staff understood how to protect people from poor care and abuse. The service worked well with other agencies to do so. Staff had training on how to recognise and report abuse and they knew how to apply it.

People's care and support plans reflected their range of needs and this promoted their wellbeing.

People led busy lives and pursued interests which were tailored to them. The service gave people opportunities to try new things; this enhanced and enriched their lives.

Staff and people cooperated to assess risks people might face. Where appropriate, staff encouraged and enabled people to take risks.

Right culture

There was a clear ethos for the service. Staff knew and understood people and were responsive, supporting their aspirations to live a quality life of their choosing.

People received good quality care and support because trained staff and other specialists could meet their needs and wishes.

People were supported by staff who understood best practice in relation to the wide range of strengths, impairments or sensitivities people with a learning disability and/or autistic people may have. This meant people received compassionate care that was tailored to their needs.

The provider evaluated the quality of support provided to people, involving the person, their relatives and other professionals as appropriate.

There was an emphasis on improving people's services wherever possible. The service enabled people and those important to them to work with staff to develop the service. Staff valued and acted upon people's views.

Staff ensured risks of a closed culture were minimised so that people received support based on transparency, respect and inclusivity.

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 24 September 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.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.