Dimensions 7 School Drive

Services for people with learning disabilities and or autism are supported

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

The service was small domestic style property. It was registered for the support of up to five people. There were deliberately no identifying signs, intercom, cameras, industrial bins or anything else outside to indicate it was a care home. Staff were also discouraged from wearing anything that suggested they were care staff when coming and going with people.

People’s experience of using this service:

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

People liked and were comfortable around staff who understood how to keep them safe. Staff knew the risks to people’s health which were also documented in people’s care plans. The registered provider had a centralised system for recruitment and checking the background of potential staff. Staff and relatives we spoke with told us staffing was sufficient. Staff had received training and undertook checks to ensure people received their medicines safely. Changes made to people’s care were shared with staff so staff understood how to support people.

People's care was based on best practice standards and staff had the correct training to meet people's needs. Guidance on people's care was also shared through supervision and staff meetings. People were offered choices at mealtimes and supported with a specialist diet where appropriate. People were supported to attend healthcare appointments and advice from healthcare professionals was incorporated into people's care.

People liked and responded warmly to staff who understood their individual needs and care requirements. Care staff communicated with people in ways that was appropriate for each person. Care staff treated people with dignity and kindness and respected their personal items and space.

People were encouraged to develop interests and take part in activities that they enjoyed. People’s care plans were reviewed and updated in line with changing needs and preferences. People and their families were encouraged to speak with the staff and management of the home to ensure people received the care they needed. A system was in place to investigating and responding to complaints.

The registered provider had not always checked that notifications for the approvals of a Deprivation of Liberty had been submitted to the CQC as required. When this was identified during the inspection, this was immediately addressed and no harm had come to people.

An action plan was in place and progress was being monitored by the registered provider to ensure people received the care they needed. The registered provider was also supporting a new manager that had taken up the post. Work with other partners was also ongoing and the manager was keen to develop further the links with the local community.

Rating at last inspection: Good (21 September 2017)

Why we inspected: The inspection was prompted in part due to concerns received about how risks to people were managed. A decision was made for us to bring forward a planned inspection and include those risks.

The information CQC received about the incident indicated concerns about the management of falls from moving and handling equipment. This inspection examined those risks.

We found no evidence during this inspection that people were at risk of harm from this concern. Please see the Safe and Well led sections of this full report.

Follow up: We will continue to monitor notifications sent into us.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Dimensions 7 School Drive is a care home for up to five adults. The service specialises in providing support to people who have learning and physical disabilities.

There was a registered manager in post. 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.

People were kept safe from potential abuse and harm by staff who understood how to identify the various types of abuse and knew who to report any concerns to. Staff were trained and supported to meet the needs of people who lived at the home. Employment checks had been completed on staff to make sure they were suitable to work at the home. They were supported in their roles and attended training which was relevant to the needs of the people they cared for.

Staff were aware of any risks to people and were available when people needed assistance, so that risks to people’s safety were reduced. People’s medicines were managed safely. We saw medicines were stored correctly in locked cabinets and there was a clear process for recording and daily checks were in place so that all medicines could be accounted for.

People were asked for their consent for care and were provided with care that protected their freedom and promoted their rights. Staff asked people for their permission before care was provided and gave people choices about their support. Where people had not got mental capacity the provider had engaged relatives and best interest meetings to represent people’s wishes.

People were provided with support to maintain good health and nutrition. We saw people had food and drink they enjoyed. The advice of appropriate health care professionals was sought and followed where needed. People's individual needs and preferences were kept under review.

Staff had caring relationships with people and knew each person’s individual preferences and needs well. Relatives felt staff treated their family member with kindness and they felt involved in their care. On many occasions staff respected people’s privacy and personal space. However we heard some staff did not always respect people’s dignity, over lunch time some staff discussed people’s care in front of other people living at the home. The registered manager took action and addressed this lack of respect with the staff members concerned. Staff worked flexibly to provide people with good support. They encouraged people to maintain relationships that were important to them.

Relatives and people living at the home were assisted in how to make a complaint or raise a concern and felt happy to discuss it with the registered manager.

The registered manager and the provider demonstrated good management and leadership. The quality of the service was audited and action was taken where improvements were needed. There was open communication between the registered manager, relatives and staff. Relatives and staff were comfortable to make suggestions for improving people's individual care and were listened to. Staff understood what was expected of them and were supported through training and discussions with their managers. Regular checks were undertaken on the quality of the care by the provider and registered manager and actions were taken to develop the home further.

We inspected School Drive but we were unable to speak with people who lived at the home. This was because their communication difficulties meant they were unable to communicate with us. We spoke with two of the staff on duty and the deputy manager. We spent some time in communal areas and observed the interaction between staff and people who used the service.

We looked at the care records for two people and other supporting documents for the service. Consent had been obtained from people before care and treatment had been provided. Alternative arrangements had been made to support people who were unable to consent to their treatment or support. Staff told us they: 'Always ask people if they are happy with me giving care before I give it'. 'We have got to know people very well here so we know if they are not happy with anything'.

People's needs had been assessed and care and treatment was planned and delivered in line with their individual care plan. Staff told us they were aware of each person's needs and how to give care and support to meet those needs.

We saw that staff were kind and caring in their approach to people who lived in the home. Staff received support through staff meetings, staff supervision and training. This made sure that all staff had suitable skills so they provided consistent care to people who lived at the home.

Pictorial complaints procedures had been made available to help people should they wish to make a complaint

People's needs were assessed and care and treatment was planned and delivered in line with their individual care plan.

We found that people who used the service were protected from the risk of abuse. We saw that staff had a kind and caring approach towards people they supported.

People were cared for, or supported by, suitably qualified, skilled and experienced staff.

We found that the provider had systems in place to regularly assess and monitor the quality of service that people received.