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Reports


Inspection carried out on 23 November 2017

During a routine inspection

Dimensions 43, Clayhill Road is a residential care home for up to six people with a learning disability. Some people may also have needs within the autistic spectrum. The service has two floors and people’s bedrooms were on both the ground and first floors.

At the last inspection, the service was rated Good, with Requires improvement (no breach) in Safe.

At this inspection we found the service remained Good and improvements had been made so that the service was also rated Good in Safe.

The service met all of the fundamental standards. People felt safe, well cared for and that they were treated with respect and dignity. We could see from people’s body language and facial expressions that interactions with staff were relaxed, friendly and respectful. Long term positive relationships with staff had also contributed to a reduction in instances of challenging behaviour. Staff were caring and treated people with patience and kindness, involving them in their care as much as possible, enabling and encouraging choice.

People were safe because staff understood how to keep them safe and acted appropriately. Identified risks to people and from the environment or equipment were minimised through effective risk assessments and actions were taken to address them.

People received their medicines as prescribed because the service had an effective system to manage these on people’s behalf.

A robust staff recruitment process helped ensure staff were suitably skilled and had the right caring approach to work with vulnerable adults. Staff received a detailed induction and thorough ongoing training They received ongoing support through one to one supervision, annual appraisals and periodic team meetings.

Staff communicated effectively about people’s needs and it was hoped the new recording system being introduced would further enhance this and effective record keeping.

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 practice. Their legal rights and freedom were protected and their consent was sought before support was provided. People were involved in choosing their meals, shopping and preparation as much as they wished and received a varied and nutritious diet. Their healthcare needs were met effectively.

The provider had already carried out some adaptation to the premises to meet people’s changing needs and was continually reviewing this to meet future needs. Equality and diversity needs were addressed appropriately and people were able to express their individuality. The service complied with the Accessible Information Standard and relevant documents were available in formats to support people’s understanding of them.

People’s care needs were kept under regular review and changes were made when necessary. Appropriate assistive technology was used to support people’s needs. The service liaised effectively with external health professionals to ensure people’s healthcare needs were met.

People led fulfilling lives because they had access to a wide range of appropriate activities, community resources and events.

The service was well managed. Management had effective systems of governance to ensure its proper operation. Stakeholder’s views about the service had been sought and acted upon.

Further information is in the detailed findings below.

Inspection carried out on 28 July 2015

During a routine inspection

The inspection took place on 28 July 2015 and was unannounced.

Dimensions 43 Clayhill Road, is a residential home providing care and support to up to six people with a learning disability. People may also have needs within the autistic spectrum.

The service was managed by 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 2008 and associated Regulations about how the service is run.

Overall we found the service was well run and met people’s needs effectively and safely.

However, the system of charging some people for staff meals when being supported in the community, was not sufficiently transparent to safeguard people from potential abuse. It could also discriminate against those with limited funds or who required two to one support in the community.

People were supported by a stable staff team who knew their needs well and were well supported and trained. The advice of external professionals had been sought promptly when required.

People’s nutritional and health needs were met and they were supported safely with their medicines. Their rights, dignity and privacy were respected and they were involved in planning their care and making day-to-day decisions about their lives.

They could take part in activities of their choice and access events and facilities in the community with staff support or independently, if able. People’s views were listened to and changes had been made in response to suggestions.

Inspection carried out on 14 October 2013

During a routine inspection

We found that people in the home were supported to make choices and decisions about their care and their consent was sought. The people we spoke with were happy living in the home and with the care provided.

Care records identified people’s needs and how they should be met. They showed that people were encouraged to do as much for themselves as they could and their privacy and dignity were respected. Staff confirmed how they did this.

Medication was managed appropriately on behalf of the people living at 43 Clayhill Road and proper records were kept of this.

The provider had appropriate records to demonstrate that a rigorous recruitment and selection process was in place for staff. The staff team was stable and no new staff had been recruited in the previous year.

The provider had systems in place to monitor the performance of the home. Systems were in place to seek the views of people supported, relatives and staff. However, most of these did not provide local information relating to this home, being either regionally or nationally collated. Not all of the survey systems had been carried out recently.

Inspection carried out on 7 November 2012

During a routine inspection

People told us they were involved in making decisions and choices about their care and their day-to-day lives and the records we saw reflected this.

Care plans and supporting documents were detailed and provided the information staff required to meet people’s needs. They were supported, where necessary, by detailed risk assessments. The support of external healthcare specialists had been sought where necessary.

People were supported to live a fulfilling life through activities and access to events and facilities in the community. They had opportunities to go away on holidays. The feedback from people about their care and support was very positive. People felt safe and well cared for.

The staff received a detailed induction and were provided with a rolling programme of training to enable them to support people appropriately. Staff were supported through regular supervision and annual performance appraisals. The provider had systems in place to monitor the operation of the service. However, the views of the people supported and their representatives, about the operation of the service, had not been sought recently.