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Archived: Dimensions Real Focus Good

Inspection Summary

Overall summary & rating


Updated 15 July 2017

This inspection took place on 30 and 31 May 2017 and was announced. This was the first inspection of this service since it was registered in January 2015.

The service provider, Dimensions (UK) Ltd, has 70 locations registered with the Care Quality Commission. Their statement of purpose states that “REAL Focus is our intensive programme of Positive Behaviour Support to help children and young people with autism and Asperger’s syndrome develop their life skills and independence.”

Dimensions Real Focus offers personal care and specialist support to people who have a learning disability and autistic spectrum condition. The specialist support is positive behaviour support and Applied Behaviour Analysis (ABA). At the time of this inspection there were seven people receiving this service. They were all over 18 and no children were receiving a service at that time. The service was provided to people in their own homes which included living with family or in supported living.

There was no registered manager at the time of this inspection. The manager had applied for registration and this application was in progress. 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 2008 and associated Regulations about how the service is run.

Staff provided a safe service. Risks to people’s safety were assessed and managed. Each person had one or two staff to support them at all times to keep them safe and enable them to go out when they wanted to.

People received person centred support from well trained staff. Staff were suitably qualified and provided with the training needed for the role. Staff felt supported by the management team.

People had good support with their health, behaviour, wellbeing, leisure activities, eating and drinking. They were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service support this practice. Where physical intervention is used this was carried out in a planned way using least restrictive methods and reviewed regularly by suitably qualified ABA supervisors.

Staff supported people to go out and do the things they enjoy as well as helping them with learning new skills and with their personal care. Senior staff monitored people’s progress in terms of their behaviour and learning new skills.

People’s families were involved in planning their support. However, we have made a recommendation that the service reviews its response to concerns in a more centralised way so this can be monitored by the provider. This is because some professionals and relatives said the service was not always responsive in a timely way.

The provider monitored the quality of the service regularly and there was ongoing improvement. There was a plan in place for developing the service and this was reviewed regularly by senior staff.

Inspection areas



Updated 15 July 2017

The service was safe. Staff understood how to safeguard people. Risks to people�s safety are assessed and carefully managed. Staff knew the company�s whistleblowing policy. Staffing levels were one or two staff for each person. People received safe support with their medicines. Staff followed good infection control practices.



Updated 15 July 2017

The service was effective. Staff were trained for the job and provided with specialist training and ongoing support. Staff supervision was regular. People received effective support with eating, drinking and their health. The service had a good understanding of the Mental Capacity Act and Deprivation of Liberty Safeguards.



Updated 15 July 2017

The service was caring. People were supported by staff who formed good caring relationships with them. The service worked hard to ensure staff were compatible with the person they supported.


Requires improvement

Updated 15 July 2017

The service was not consistently responsive. Concerns were not treated in the same way as complaints as they were not recorded in a central record to enable the provider to have an overview. Some relatives and professionals thought the service was not always responsive quickly enough when they contacted them.

Staff planned person centred support and people were supported to take part in the activities they chose. The senior team worked hard to ensure staff who knew the person provided a responsive and consistent service to them.



Updated 15 July 2017

The service was well-led. The provider had good oversight of the quality of the service and was supportive to the management team. Regular audits of quality were carried out and there was ongoing improvement. The management team had a good knowledge of what was going well and what they could improve and kept detailed records of progress.