Archived: Dimensions Loddon Court 289 Wokingham Road Also known as Loddon Court

Dimensions Loddon Court 289 Wokingham Road is a care home which provides respite accommodation and personal care. People who use the service have learning disabilities or autism, and the length of their stay varies, from 24 hour periods to several months. The service also supports people who are transitioning from other care homes to independent living in the community. The care home can support eight people. At the time of our inspection, three people received respite care.

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.

People’s experience of using this service and what we found

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 service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

People received safe care. Any risks to them were assessed, documented and mitigated to protect people from avoidable harm. A relative stated, “[The person] presents with challenging behaviour and can become anxious and aggressive and I am always informed if he has any anxious moments in his stay. It is written in his communication book for me and I am told upon collection. The environment is safe for [the person’s needs…”

The service’s bathrooms required maintenance to ensure people’s needs were met. One bathroom was out of use entirely. The other bathroom’s temperature was exceeded safe levels and meant for people whose preference was a bath, they were restricted from taking a bath. Instead, they were offered washes in their room to ensure cleanliness. The registered manager and provider had attempted to have these issues rectified with the landlord, but without success. After our site visit, the ventilation system was repaired which ensured people were safe and the bathroom could be used again.

Staff were knowledgeable and skilled. They were competently able to provide the support people required. A community nurse said, “[This is] a valid service for the individuals we support to access. As a member of the local community team, I am happy with the excellent communication between us and they never hesitate to contact us for advice and support. I also know and support a number of individuals who have accessed this service and they are also very happy with the support they receive.”

We observed people’s support was very caring. Relatives, commissioners and professionals described the service as caring and staff as kind. We received comments from a social worker who wrote, “I have heard very positive feedback from service users and parents regarding their care. The other service users, all with complex needs are very satisfied with the service and enjoy going for respite.”

People’s care was specifically tailored to their individual needs. A dietitian told us, “I have found the care staff offering dignified and individualised care. Staff respond to health needs quickly and work with health care staff in [my team]. I have no concerns regarding the safety or care of clients in their care.”

The service was well-managed. There was a positive workplace culture. The registered manager ensured audits and checks were completed regularly to ensure the safety and quality of people’s care. The local authority commented, “The [registered] manager…communicates regularly with us and always follows up promptly and thoroughly on any concerns.”

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

Rating at last inspection

The last rating for this service was good (published 24 May 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Dimensions Loddon Court 289 Wokingham Road is registered to provide care for up to eight people, at any one time. The home provides a respite service for 40 people (currently) with learning and associated behavioural and physical disabilities. People generally stay in the service for an average of two nights, although this is flexible depending on the circumstances and their individual, assessed needs.

There were five people (called house guests) staying in the service, on the day of the visit. An outreach service is run from the same building. However, this report only relates to the provider's provision of residential respite care. The outreach services do not provide personal care and consequently fall outside the regulatory remit of the Care Quality Commission (CQC) and were not assessed as part of this inspection.

At the last inspection, on 29 April 2015, the service was rated Good. At this inspection we found the service remained Good.

Why the service is rated Good:

There is a registered manager running the service. 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.

The service remained safe. Staff who had been trained in safeguarding vulnerable adults and health and safety policies and procedures kept people as safe as possible. Staff understood how to protect people and followed the relevant procedures. General risks and risks to individuals were identified and action was taken to reduce them.

People’s needs were met and they were supported safely by large numbers of staff who provided excellent staffing ratios. The service made sure, that as far as possible, staff were recruited safely and were suitable to work with the people who live in the home. People were given their medicines safely, at the right times and in the right amounts by trained and competent staff.

The service continued to be effective. People’s health and well-being needs were met by staff who were well trained and responded to people’s current and changing needs. The service sought advice from and worked with health and other professionals to ensure they met people’s health and well-being needs.

People were supported to have maximum choice and control of their lives. Staff offered them care in the least restrictive way possible, the policies and systems in the service supported this practice.

The service continued to provide care with kindness and respect. Care staff remained attentive, responsive and knowledgeable about the needs of individuals. Individualised care planning ensured people’s equality and diversity was respected. People were provided with activities, as appropriate, according to their needs, abilities and preferences.

People, staff, other professionals and families continued to describe the registered manager as good. Staff said she was approachable and supportive. The service sustained the procedures with regard to continually assessing, reviewing and improving the quality of the care provided.

We looked at the safety and suitability of the home, and found that both the building and grounds were kept in good order. Most people we spoke with thought the home was adequate in its design but some had concerns of the size of the communal living areas. One person told us "the bedrooms are a good size but the lounges are too small if there are several wheelchair users in there."

Care workers were supported by the home to enable them to deliver care at an appropriate standard. Care workers had regular supervision and appraisals and had access to regular training.

The home had effective systems in place to monitor the performance of the service. People staying at the home, their relatives or carers were given opportunities to feed back to the manager about the service being provided and concerns raised were acted upon.

At the time of the visit there were two people living in the home on respite care who had limited verbal communication skills. We spent time observing interactions between people living in the home and care workers.

People who were living in the home were happy and relaxed. We observed people being treated with dignity and respect. We saw people making choices and being encouraged to be as independent as they were able. Likes, dislikes, abilities and goals were considered in relation to the support that people received and this was evidenced in their care plans.

The provider had ensured that appropriate staff were recruited and care workers were confident to recognise and report abuse. Care workers spoken with had a good understanding of safeguarding and had training in the safeguarding of vulnerable adults.

People living at the home and their families were supported when making complaints or concerns and the manager ensured that correct procedures were followed and outcomes used to enhance the service.