Archived: Dimensions 82-84 Booth Road

Dimensions 82-84 Booth Road is a care home for up to eight adults. There was one vacancy when we inspected. The service specialises in providing support to people who have a learning disability or who are on the autistic spectrum. Autism is a lifelong condition that affects how a person communicates with and relates to other people, and how they experience the world around them.

There was a registered manager in post at the service. A registered manager is a person who has registered with the 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 and their representatives provided good overall feedback about the service. We found that the service was working hard to improve people’s quality of life. For example, people received good support to go out lots. There were ongoing efforts to find activities that people liked. Some people had been on holiday, in line with agreed personal goals and the provider’s current business plan.

Staff worked well together and came across as motivated to provide people with good support. People were treated in a respectful and friendly manner. They were encouraged to maintain and develop skills and independence, and were supported with relationships that were important to them.

People were provided with support to maintain good health and nutrition. The advice of appropriate healthcare professionals was sought and followed where needed. People’s individual needs and preferences were kept under review. Action was taken to address individual risks to people using the service, and safeguarding procedures were properly used to help keep people safe.

There was a positive and empowering culture at the service. 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, including in response to our feedback. This all helped to assure that high quality care was being provided.

However, the service was not consistently safe. Whilst enough staff were working at all times, there were avoidable safety risks to people using the service arising from some staff working long hours across consecutive days. Systems had not ensured that appropriate written references were always obtained for new staff. Whilst people received their medicines as prescribed, a number of people’s as-needed medicines lacked specific guidance around offering it to them.

We made one recommendation in this report based on an area for development identified at this inspection. This was around developing staff skills in respect of recognising and responding to people’s individual communications.

During our inspection, we saw four people who resided at the home. They appeared content. Staff communicated with people in a patient and caring manner.

We spoke with the registered manager, deputy manager and two care workers. They were able to tell us about how to safeguard people and knew the potential signs of abuse such as physical, sexual and financial abuse; and could describe what to do if they had a safeguarding concern.

We spoke with two care workers. They told us that they felt supported in their role and that they had received recent training. They told us they felt the home was well led.

The provider had an effective system to regularly assess and monitor the quality of service that people received. Quarterly audits were undertaken by the provider's internal compliance team. We looked at the August 2013 audit and saw that the home scored highly for 'housing, health & safety' and for 'planning and delivery of support to people.'

People received safe care in that the planning was person centred and reflected their needs, risks and how these would be managed. Regular reviews of care ensured all care provision reflected each individual's changing care needs.

Staff demonstrated that they understood aspects of safeguarding process relevant to them. They told us they were well supported by the management and were aware of their limitations but confident to approach managers when they needed to.

The provider had systems to monitor the quality of the service, some of which we saw had been utilised to produce existing service improvement plans.