Dimensions 7 Huntley Close

Dimensions 7 Huntley Close is a 'care home'. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

Dimensions 7 Huntley Close accommodates up to six people with learning disabilities in one adapted building. There were six people at the service at the time of inspection.

All the accommodation is on the ground floor which allows people, including those who use a wheelchair, to have full access.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

Rating at last inspection

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

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Rating at this inspection

At this inspection we found the service remained Good.

Why the service is rated Good

The registered manager also managed one of the provider’s other services and divided their time between the two homes. There was a clear management structure in place which meant that there was enough support in place for staff.

People received safe care because staff knew the risks each person faced and the actions to take to minimise these risks. Staff understood their responsibility to protect people from abuse and report any concerns. There were enough staff to provide each person with the support they needed in all aspects of their life. People received the medicines they needed safely. Safe arrangements were in place in the event of the home being unusable. The staff learnt from any accidents and incidents to improve the care people received.

Staff underwent comprehensive induction training and then attended regular training which developed their skills and knowledge. They used this training in practice to deliver safe and effective care. Staff were safely recruited and they understood how to prevent infections. People’s needs were regularly assessed and there were detailed care plans to guide the staff in the support they offered to people. People had access to all health care services and staff knew when people needed medical help or advice.

People 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 supported this good practice. People had enough food and drink of their choice to keep them well and healthy.

There was considerable wear and tear which, although did not affect people’s safety, required repair or replacement and the registered manager was working to ensure the housing association made those repairs.

People were supported by kind and caring staff. Staff assisted people to be involved as much as possible in their own care. People were treated with dignity and respect and staff provided all personal care in private. Families and friends were welcome to visit and staff supported people to visit their family homes.

Each person was treated as an individual. Their care was planned according to their individual needs, wishes and preferences. There were many opportunities for people to enjoy a range of activities inside and outside the home. There had not been any complaints but there was a system in place for complaints to be investigated and used as an opportunity to improve.

Relatives said that because they had regular contact with staff and managers they were satisfied to discuss issues as they arose, and these were responded to well. Where it had been discussed people’s end of life wishes were included in people’s care plans but there was scope to include more information.

The registered manager and staff had clearly defined roles and they all worked together for the benefit of the people they supported. The staff felt supported and valued and they shared information they needed to offer the right support to people. The registered manager and provider used a system to evaluate the quality of the service and this was used to make improvements. The staff and registered manager worked with others including health professionals to make sure people received good care.

Further information is in the detailed findings below

Dimensions 7 Huntley Close is a care home which provides accommodation and personal care for up to six people who have different forms of learning disabilities such as Autism whilst living with other complex needs such as epilepsy or cerebral palsy. At the time of our inspection there were five people living at the home. All of the accommodation is provided on the ground floor so that all facilities are accessible to everyone. There was a spacious and secure garden for people to use.

The home did not have a registered manager in place. ‘A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.’ The provider had arranged temporary management coverage at the home. We have been informed the provider has submitted application to the CQC to become the registered manager.

People and their relatives told us they felt safe at Dimensions 7 Huntley Close. Staff had a clear understanding about the signs of abuse and were aware of what to do if they suspected abuse was taking place. There were systems and processes in place to protect people from harm.

There were sufficient numbers of staff deployed who had the necessary skills and knowledge to meet people’s needs. Recruitment practices were safe and relevant checks had been completed before staff started work.

Medicines were managed, stored and disposed of safely. Medicines were administered by competent staff and any changes to people’s medicines were prescribed by the person’s GP.

People lived in a safe well maintained environment. Fire safety arrangements and risk assessments for the environment were in place. The service had a contingency plan that identified how the home would function in the event of an unforeseeable emergency such as fire, adverse weather conditions, flooding or power cuts.

Staff were up to date with current guidance to support people to make decisions. Staff had a clear understanding of the Mental Capacity Act (MCA) and Deprivation of Liberty Safeguards (DoLS) and as well as their responsibilities in respect of this.

The provider ensured staff had the skills and experience which were necessary to carry out their role. Staff had received appropriate support that promoted their development. The staff team were knowledgeable about people’s care needs.

People had enough to eat and drink and there were arrangements in place to identify and support people who were nutritionally at risk; such as monitoring people’s food and fluid intake and weight.

People had access to healthcare professionals who had specialist experience with people who had specific needs to support their well-being. The provider worked effectively with healthcare professionals and was pro-active in referring people for assessment or treatment.

Staff treated people with compassion, kindness, dignity and respect. People’s preferences, likes and dislikes had been taken into consideration and support was provided in accordance with people’s wishes. People’s privacy and dignity were respected and promoted when personal care was undertaken.

People’s needs were assessed when they entered the home and on a continuous basis to reflect changes in their needs. Staff understood the importance of promoting independence and choice. People were able to personalise their room with their own furniture and personal items so that they were surrounded by things that were familiar to them. People had the right to refuse care and support and this information was recorded in their care plans.

People were encouraged to voice their concerns or complaints about the service and there were different ways for their voice to be heard. Suggestions, concerns and complaints were used as an opportunity to learn and improve the service people received.

People had access to activities that were important and relevant to them. There were a range of activities available within and outside of the home.

People’s care and welfare was monitored regularly to ensure their needs were met. The provider had systems in place to regularly assess and monitor the quality of the care provided.

People told us the staff were friendly and management were always approachable. Staff were encouraged to contribute to the improvement of the home. Staff told us they would report any concerns to their manager and felt supported by the management.

During our inspection we looked at outcome 21 and found that Dimensions were compliant. We saw that all records were up to date. People that used the service were provided with opportunities to express their views and opinions concerning the service they received and this was documented. We saw records in place for the home that were up to date and included records concerning the home environment and peoples care needs.

You can see our judgement on the front page of this report.

We noted improvements on all three issues noted above. We saw improvements in cleanliness, and noted all the communal areas in the premises had been completely redecorated since our last visit. We saw that shortfalls on the inside and outside of the premises had been remedied, for example the rubbish and discarded electrical equipment had been removed from the garden. Previously the recruitment records had been kept at head office and therefore not available for inspection. During this follow up visit we were able to review these records and noted that the majority of information required by regulation was on each person's file.

During the inspection we identified some new concerns related to record keeping and this is discussed in more detail later in this report.

We noted people who lived at this service were included in decisions about their day to day activities and staff sought consent from them, either verbally or by observing body people's language. We noted residents approached staff when they needed assistance with their care and welfare and staff understood the needs of residents and communicated well with them. There was a pleasant and relaxed atmosphere within the home.

We noted some shortfalls during our visit. These related to the safety and suitability of the premises, and also to the recruitment records for staff. The records were not made available to us during the inspection.

We noted that people were treated respectfully by staff who demonstrated that they communicated well with residents and understood their needs.

People who lived at the service were observed to approach staff when they needed assistance in relation to their care or activities. There was a homely and relaxed atmosphere within the home.

People were kept safe, and staff had a good knowledge of safeguarding procedures.

Training records showed staff had received appropriate training for the work they were doing. Those staff we interviewed told us that the provider was good on training. One told us 'Dimensions are very good on the training. It has really helped me a lot.'

We noted that there were a variety of quality assurance processes in place, and that the provider was taking steps to ensure there was a plan for the continuous improvement of the home.