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Dimensions 2 Dunstans Drive Good

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Inspection report

Date of Inspection: 3, 4 September 2014
Date of Publication: 23 September 2014
Inspection Report published 23 September 2014 PDF


Inspection carried out on 3, 4 September 2014

During a routine inspection

The inspection team consisted of one adult social care CQC inspector. On the day of our inspection four people used the service. People who use the service were not able to communicate verbally with us. However, we were able to find out about their experiences of people using the service through observation and speaking with their family or representatives. We spoke with four people, two people�s relatives, two care workers, and the registered manager. We observed staff interactions with people. Records relating to the management of the home were reviewed. These included two people�s support plans, daily support records, incident records and the employment files for six staff members.

We considered all the evidence we had gathered under the outcomes we inspected, which related to people�s care and welfare, Infection control and cleanliness, requirements relating to workers staffing, assessing and monitoring the quality of service provision and records. We used the information to answer five key questions; is the service safe, effective, caring, responsive and well-led.

This is a summary of what we found. The summary describes what people�s relatives and the staff told us, what we observed and the records we looked at.

Is the service safe?

Relatives of people who use the service were complimentary of how the provider maintained people�s safety. One relative told us ��X feels safe there. X is definitely much happier there.� Personal evacuation plans were in place to ensure people�s safety in the event of a fire at the service.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards which applies to this type of service. The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to this type of service. The service was safe because requirements in relation to the DoLs had been met. The registered manager had received training in relation to DoLs and was aware of the recent case law. They told us the people they provided care for did not have the capacity to determine where they wanted to live and all received a high level of support and supervision within the service. The registered manager informed us that they had started the process of submitting DoLs applications for these people following consultation with the local authority. This was confirmed by our observations during the inspection.

The service was safe because the provider had taken action to ensure people were protected from the risk of infection. People were cared for in an environment that was safe, clean and hygienic. People were protected from the risk of infection because protocols based on current Department of Health guidelines were followed.

We found the provider had put measures in place to improve the recruitment and selection process. This meant people who use the service were not placed at risk of being cared for by staff who were not suitable to provide their care and treatment.

Is the service effective?

The service demonstrated effective practices through the assessment of people�s health and care needs. People's views about the type of care they wanted had been sought. People confirmed their involvement in the development of their support plan. We found staff had a good understanding of people�s care and specific support needs.

The relatives we spoke with were complimentary about the care received. One relative told us �staff manage the (specific care) needs of X very well. I have confidence in them.�

The provider had an effective system in place to identify, assess and manage risks to the health, safety and welfare of people who use the service and others in relation to incidents. There was a system for monitoring and learning from incidents. The provider could identify possible trends that may require additional actions, such as risk assessments and the implementation of appropriate actions, to minimise the risk of occurrences to people and others.

The provider had taken action to ensure people's records and other records relevant to the management of the service were always accurate and fit for purpose. People�s records and confidential staff information were stored securely.

Is the service caring?

People were supported by kind and supportive staff. One relative told us �The staff are very caring . Overall it is a very friendly place.� All interactions we observed between the staff and people were respectful and courteous. We saw that care workers gave encouragement when supporting people. People were able to do things at their own pace and were not rushed.

We saw feedback from relatives was positive. People were complimentary about staff support and care. One relative said �They (staff) know X very well. They are good at meeting X�s needs.�

Is the service responsive?

The service was responsive. Relatives we spoke with confirmed they had been listened to and provided examples of improvements made to the service following their feedback. One relative told us �I feel listened to; they take my ideas on board.� Another relative told us that they could give their feedback on the service at the annual person centred reviews and when staff contacted them. A relative said �I find the person centred review helpful. There is an opportunity to put my suggestions for improvement forward. They (the provider) have acted on suggestions I have made.�

We saw people�s and relative�s feedback was sought through meetings and surveys. The provider was responsive to comments from people, such as improvements to the supper menu and the implementation of a planned refurbishment of the service to meet people�s wishes and suggestions.

Records confirmed people�s preferences and diverse needs had been identified. Staff provided examples of care and support being provided in accordance with people�s wishes, for example, in relation to activities and personal hygiene.

Audits and checks ensured people�s safety and wellbeing was promoted. Where issues were identified, an action plan was formulated. Progress and completion of this was monitored. We saw issues were identified and actions completed appropriately.

Is the service well-led?

The service was well led. We spoke with relatives who told us that they felt the service was well led.

The staff were very satisfied with the leadership and the management of the service. Staff told us that they were able to call the registered manager if they had any concerns.

The provider had systems in place to regularly assess and monitor the quality of service that people received. In relation to staff training, systems were in place to ensure staff always received appropriate training to be able to deliver care to people safely and to an appropriate standard.