Archived: Dimensions 59 Lion Road

The home provides residential care for up to eight people with learning disabilities. It is located in the Twickenham area.

At the time of our inspection the home had a registered manager. 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 and associated Regulations about how the service is run.

At the last inspection in April 2015 the home met all the key questions and were rated good in each with an overall good rating.

People using the service and a relative said that the home provided a nice place to live and they were very happy there, especially with the way that staff treated and supported them. People chose the activities they wanted to do and when they wished to do them. There was a good choice of home and community based activities available. People felt safe living at Lion Road and using the facilities that were available in the local community. The home had a warm and welcoming atmosphere that was friendly and inclusive. People’s body language and their interaction with staff and each other was positive throughout our visits.

The records kept by the home were accessible, up to date and covered all aspects of the care and support people received and were regularly reviewed. This included peoples’ care plans that contained information about their choices, activities and safety. This information helped staff to perform their duties efficiently and professionally, although they already had a lot of knowledge about each person. People using the service and their relatives were encouraged to discuss health needs with staff and had access to GP’s and other community based health professionals. People were supported by staff to choose healthy meal options and maintain balanced diets whilst meeting their likes, dislikes and preferences. This helped protect them from nutrition and hydration associated risks. People told us they liked the choice and quality of their meals.

People were very familiar with the staff who supported them, they were well supported and enjoyed the way staff delivered care to them. The staff were skilled and provided care and support in a professional, friendly way that focussed on people as individuals. Staff said they enjoyed working at the home and had received good training and support from the registered manager.

A relative said the management team was approachable, responsive and listened to them. People said they liked the registered manager. The quality of the service provided was consistently monitored and assessed.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

Staff treated people with dignity and respect throughout our visit and people said this was how they were always treated. They also said they felt safe living at the home. We saw that there were robust safeguarding procedures in place, that staff were trained in, knew how to operate and they understood how to safeguard people. Details of areas or circumstances specific to individual people were also recorded in the sample of 4 care plans we looked at.

Systems were in place to make sure that the manager and staff learned from events such as accidents and incidents, listening to people's concerns, complaints, whistleblowing and investigations. This reduced the risks to people and helped the service to improve.

The home had policies and procedures that adhered to the Mental Capacity Act and Deprivation of Liberty Safeguards (DoLS). Training was provided for relevant staff to understand when an application should be made and how to submit one. People living at the home were being re-assessed under (DoLS). This meant that people and their rights were safeguarded.

We toured the building, garden and saw that the home was safe, clean and hygienic with well maintained equipment that was regularly serviced. This meant people were not put at unnecessary risk.

People's care needs were taken into account by the manager and the rota when making decisions regarding the required staff numbers, qualifications, skills and experience. This ensured that people's needs were met.

No staff were currently subject to disciplinary action and policies and procedures were in place to make sure that unsafe practice was identified and people were protected.

Is the service effective?

There was an advocacy service available should people require it. This meant that people could access addition support if they required it.

The home assessed people's health and care needs with them and those that wanted to were involved in contributing to their care plans. Any specialist care and support such as dietary, mobility or equipment needs had been identified in people's person centred support plans. A sample of the support plans we saw had been signed identifying that people had been involved in producing them. People told us "I'm a bit tearful today as my keyworker is leaving and this is their last day", "I go to head office for a chat" and "I work in a pizza restaurant and bring some home".

The layout of the service enabled people to move around freely, safely and there was suitable equipment to support them to achieve this.

The visiting policy and visitors' book demonstrated that people were able to see their visitors in private and that visiting times were flexible.

Is the service caring?

We saw that people were supported by kind and attentive staff. The staff were patient and gave encouragement when supporting people. People commented,"I get good support and was asked who I wanted as a keyworker'.

People and their relatives completed an annual satisfaction survey. Where shortfalls or concerns were raised these were addressed.

We saw in 4 support plans that people's preferences, interests, aspirations and diverse needs had been recorded and that care and support had been provided in accordance with this information.

Is the service responsive?

People regularly completed a range of activities in and outside the home. During our visit people were engaged in a leaving party for a long standing member of staff that included cakes, cards, presents, music and drinks. One person returned from work during our visit. People attended and carried out a number of activities individually and as a group that they had chosen. The home had access to transport, that enabled people to be involved in activities within their local community and further afield.

People knew how to make a complaint if they were unhappy. We looked at how complaints were investigated and saw that they were investigated properly and action was taken if necessary.

Is the service well-led?

We saw that the manager and staff listened to people's needs, opinions and acted upon them. The service worked well with other agencies and services to make sure people received support in a joined up way. This was demonstrated by the relationship the home had with community based health services.

Appropriate notifications to the Care Quality Commission were made.

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

They enjoyed living at Lion Road, liked the staff, the way they were treated and felt safe.

They said Lion Road was a very nice place to live. "I like it here, this is my home".

They did not tell us about the number of staff who work at Lion Road or the complaints process. They did tell us they were asked what they thought about the service and that there were weekly community meetings where they could talk about things that were important to them. They staff treated them well and were there if they needed anything. "The staff are nice and help me when I need it".

One person told us they had a keyworker and that they met monthly to update their support plan.

We saw that people were treated with dignity and respect during our visit.

They were supported to make decisions and their opinions and views were asked in a relaxed, unhurried and comfortable way.

The records we saw were up to date, accessible and easy to understand.

The home was clean, tidy and well maintained.

There was a complaints policy and procedure that people could understand and access easily.

There were enough staff on duty and on the rota who were competent, experienced and knew people using the service well to provide a good service.