Archived: Dimensions 3-5 Station Road

We considered all the evidence against the outcomes we inspected to help answer our five key questions; is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well led?

This is a summary of what we found -

Is the service safe?

During the inspection we observed staff giving care and support to people. They were respectful and treated people in a caring and supportive way. Care was planned and delivered in a way that was intended to ensure people's safety and welfare.

Staff spoken with were able to describe the different types of abuse and the action they would take if they saw or suspected any abuse. We saw the service had a process in place to respond to and record safeguarding concerns. We found the service had access to a copy of the local safeguarding protocols and followed them to safeguard people from harm.

We found robust arrangements in place to audit people's finance records to safeguard people using the service from financial abuse.

The service had policies and procedures in place in relation the Mental Capacity Act (2005) (MCA) and Deprivation of Liberty Safeguards (DoLS).

Is the service effective?

Support plans included details of people's life histories, personal preferences, and community connections. They also included details of people's relatives and their representatives and how they had been involved in their support planning. We found support plans were person centred, promoted people's independence and reflected their personal preferences.

We found evidence that people's support plans and risk assessments were reviewed regularly and responsively to meet people's needs. The manager had a comprehensive system in place to ensure staff read peoples new support plans and risk assessments.

Is the service caring?

Throughout our inspection the atmosphere within the service was calm, supportive and friendly. Two people had gone out to a day service. One person had chosen to watch one of their favourite movies and conducted along to the music. During the inspection a person showed us their knitting and told us they were baking a chocolate birthday cake later on in the day.

One staff member told us about their key worker role and, that support was based around individual needs and preferences so choice was promoted and respected. Another staff member told us how important it was to use the right tone of voice when speaking with people they supported.

Staff described how people used facial expression, verbal noises, body language and gestures to communicate their choice. One staff member said '[person] communicates by gestures and points at what they would like to wear and picks his clothes and the colours'.

Is the service responsive?

We found that support plans contained clear information about the type of decisions people were able to make and how best to support people to make these decisions. Staff knew people and their individual ways of communicating and were aware that some people needed more time and support to make decisions.

A pictorial complaints procedure was available for people to look at in their records.

Is the service well-led?

Quality monitoring systems were in place to make sure the manager and staff learned from audit checks. As a result the quality of the service was continuously improving.

Staff were provided with specialised training to meet the needs of people they supported. This meant that people were being supported by suitably trained staff.

Regular medication observation assessments of staff competency were undertaken to ensure staff were supporting people safely with their medicines.

The service held meetings with relatives to review the performance of the service. This helped to ensure that people received a good quality service at all times.

When we inspected the service in November 2012 we asked the service to complete an action plan regarding ensuring where people did not have the capacity to consent, the provider acted in accordance with legal requirements. On this inspection we found that the provider was now meeting this standard.

Our observations throughout the inspection showed that staff knew people really well and their individual ways of communicating and their support needs.

A pharmacist inspector from the Care Quality Commission visited the service on 10 September 2013 and found that people were protected against the risks associated with the unsafe use and management of medicines.

People were cared for by staff who were supported to deliver care and support safely and to an appropriate standard.

When we inspected the service in November 2012 we asked the service to complete an action plan regarding people's records. On this inspection we found that the provider was now meeting this standard.

One person said that the staff at Station Road were, 'lovely helpers.' We saw that the direct care provided at Station Road was safe, appropriate and took people's individual needs into account.

We found that people's nutritional needs were met and that advice and support from speech and language therapists, specialist dieticians and nurses was sought when needed.

We found that medication was administered safely and that staff reassured and remained with people until they had taken it.

We saw that people benefited from equipment that was used safely and met their needs.

We found that staff were supervised and received training. A number of training courses were not within the provider's specified timescales.

We found that a system was in place to gather, record and evaluate information about the quality and safety of care provided.

We identified a number of issues relating to care records at Station Road. The majority of the records reviewed during our inspection did not detail or reflect the care observed during our inspection. We were concerned that this could result in people not receiving appropriate care and treatment.