Archived: Dimensions Foxdown Littlefield Green

Accurate and appropriate plans of care for people who use the service were not maintained. Risks were not always identified or assessed. We did not see evidence of regular or recent care reviews. This meant people were not sufficiently protected from the risk of inappropriate care.

At our inspection on 10 January 2014 we found the provider had completed all employment checks required under the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. Gaps identified in employee's work histories had been investigated and explanations were recorded. All other recruitment checks required were documented. This meant the provider had taken steps to establish staff were of good character.

People's care plans had been reviewed since our last inspection and some information had been updated. However, we found no evidence that identification and assessment of risks had been reviewed or updated. This meant that people who use the service were at risk of inappropriate care due to a lack of proper information about them.

We did not speak with people who use the service at this inspection, but we did speak with the person managing the service on the day of our inspection. The location did not have a registered manager at the time of our inspection. This is a condition of registration with the Care Quality Commission (CQC). We discussed this matter with the person acting as manager and brought it to the attention of the provider. The manager told us they would be submitting an application for the role of registered manager.

Care and support were offered as directed by people's needs and wishes. Staff communicated well to ensure people's current needs were met. One relative said 'It's a happy family unit.' However, the service did not maintain regular reviews to ensure support and care records were updated when necessary.

The home was spacious and well maintained. It was decorated to meet the needs and preferences of people who use the service. Regular and responsive maintenance and servicing was completed.

Recruitment checks were undertaken. We found some of the information required in accordance with the requirements of schedule 3 of the Health and Social Care Act 2008 was not available. Although we found documented evidence of confirmation of identification and Disclosure and Barring Service checks, we did not see gaps in employment history appropriately investigated.

The provider carried out quality assessments to ensure the service met the Health and Social Care Act 2008 regulations. They sought feedback from people who use the service at weekly meetings, and conducted surveys to gather feedback from relatives and advocates of people who use the service.

We spoke with the person managing the service, who had been in post for two weeks at the time of our inspection. Throughout this report, we have referred to this person as the acting manager. The location did not have a registered manager at the time of our inspection.

We spoke with relatives of people who live in the home. One relative said, 'Because he is unable to communicate verbally, staff come and show me what he has done and ask for approval on what he has chosen'. Another relative said, 'They involve us in parties at Christmas time and social events, I have always been very pleased with the way they have looked after him, they have brought him out of his shell'.

Staff were knowledgeable of people's specific health and personal care needs and how they wanted those needs to be met. We looked at people's care plans and supporting documents. We found peoples care plans detailed their needs, and how to meet those needs whilst minimising identified risks.

The provider had ensured staff received appropriate support and professional development to deliver care and support to the people who live in the home.

We found people and their relatives had opportunities to contribute their views about the quality of the service and knew who to contact should they have a concern or complaint about the services provided.