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Dimensions Somerset Frome Domiciliary Care Office Requires improvement

The provider of this service changed - see old profile

Inspection Summary


Overall summary & rating

Requires improvement

Updated 18 December 2020

About the service

Dimensions Somerset Frome Domiciliary Care Office is a domiciliary care agency. It provides personal care for older and younger people with learning disabilities and/or autism in their homes or flats in the community. At the time of the inspection 94 people were receiving support.

Some of the people lived in one of the 12 supported living services whilst other lived in shared accommodation or individual homes and flats. Many of the households had multiple occupancy of over three people with shared living spaces. Many of the people required 24-hour support and this changed for some during the COVID-19 pandemic.

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.

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

The service was not well led. Quality assurance systems did not effectively monitor each household and drive improvement. When concerns were identified they had not always been rectified. Some concerns found during the inspection had not been identified by the provider’s quality assurance systems.

People were not always kept safe from risks which could lead to potential harm. Care plans were mixed and missing key information or details known by staff. When people’s needs changed, care plans had not always been updated to reflect this.

There was a high turnover of senior staff and staff at each household leading to inconsistencies of support and systems. Agency staff were used and during the COVID-19 pandemic staff had been relocated from temporarily closed day services.

People told us they were safe or displayed they were comfortable around staff. Relatives had mixed views about the care and support their family members received. Staff had good understanding of how to recognise potential abuse. However, they lacked knowledge of external places they could report concerns.

The service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture. When households under the registration were not fully meeting the principles we heard of plans to find more suitable living arrangements and staff training. The provider had a model of support and care placing people at the centre of all the choices and support they received. Relatives confirmed they were involved in most decisions when people were less able to express choices themselves. Staff told us of the provider’s ethos where people’s privacy, dignity, human rights and choice were central to their daily lives. However, the COVID-19 pandemic had placed some limitations on practices because they were trying to follow government guidance to keep people safe.

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 11 August 2018).

Why we inspected

We received concerns in relation to the management of the service and peoples’ safety. As a result, we undertook a focused inspection to review the key questions of Safe and Well-Led only. We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has changed from Good to Requires Improvement. This is based on the findings at this inspection.

We looked at infection prevention and control measures under the Safe key question. This is to provide assurance that the households visited, and the provider can respond to coronavirus and other infection outbreaks effectively.

We have found evidence that the provider needs to make improvements. Please see the Safe and Well Led sections of t

Inspection areas

Safe

Requires improvement

Updated 18 December 2020

The service was not always safe.

Details are in our safe findings below.

Effective

Good

Updated 18 December 2020

Caring

Good

Updated 18 December 2020

Responsive

Good

Updated 18 December 2020

Well-led

Inadequate

Updated 18 December 2020

The service was not well-led.

Details are in our well-Led findings below.