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Archived: Dimensions Cambridge Domiciliary Care Office Good

The provider of this service changed - see old profile

This service is now registered at a different address - see new profile

Inspection Summary


Overall summary & rating

Good

Updated 13 January 2015

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008 and to pilot a new inspection process being introduced by CQC which looks at the overall quality of the service.

The inspection was announced. This meant that the provider was aware when we were inspecting and that staff were available to support our inspection.

The service currently provides care and support to 123 adults with a learning disability. The organisation manages services provided to people across four counties from the registered office location. The services provided vary from care and support provided for a few hours per day, or week, to individual people living in their own home to the provision of care and support on a 24 hours basis to people, or groups of people living together. The agency has a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.

All of the people that we talked with told us that they felt safe and that they would know what to do, and who to contact, if they thought they had been mistreated in any way. There were systems and processes in place to reduce the risk of people suffering any abuse. However people’s safety was being compromised in a number of areas this included how well medicines were administered, the staff understanding of how they should assess if people have the capacity to make certain decisions and ensuring there was always enough staff on duty with the right skills and knowledge to meet people’s needs.

The Mental Capacity Act 2005 sets out what must be done to make sure that the human rights of people who may lack capacity to make decisions are protected. Although the manager was aware of the requirements of the Mental Capacity Act 2005 and all staff had received training not all the staff that we talked with were able to tell us how it needed to be put into practice. The staff who are working directly with people must know what their responsibilities are regarding the MCA so that decisions are made in people’s best interests and people’s human rights are upheld. The manager was aware of the responsibilities and had taken appropriate action when he thought any restrictions had been placed on people.

Staff had been given training about how people should be treated as individuals and supported to make decisions and how to promote people’s dignity, respect and privacy. People who used the agency told us that staff were kind and treated them with dignity and respect and when they had raised any concerns they had been dealt with effectively.

People had been involved in the planning of their support and care. Important information about people’s history, preferences and goals for the future, which helped the staff get to know people and how they would like to be cared for and supported, was recorded in their support files.

The permanent staff had the support, skills and competencies they required to meet people’s needs. Care staff told us that they had attended all of the training they needed to do their job effectively and could request extra training if needed. We found that at times due to there being a shortage of permanent staff

There were effective systems in place to monitor and improve the quality of the service provided, which took into consideration the views of the people who used the agency. Staff felt that they could discuss any concerns with someone in the management team and that there was an open culture within the agency.

We found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see what action we told the provider to take at the back of the full version of this report.

Inspection areas

Safe

Requires improvement

Updated 13 January 2015

This service is not consistently safe.

The majority of the people who used the agency (that responded to us) told us that they felt safe and that they would know who to talk to if they were unhappy. Action had been taken to reduce the risk of abuse to people.

Action was needed to ensure that people always receive their medicines as prescribed, that there are always enough staff on duty with the right experience, skills and knowledge and that staff are aware of how to support people to make decisions when they have the capacity to do so or to how to make best interest decisions on their behalf.

Effective

Good

Updated 13 January 2015

The five questions we ask about services and what we found people’s history, preferences and goals for the future, which helped the staff get to know people and how they would like to be cared for and supported, was recorded in their support files.

The permanent staff had the support, skills and competencies they required to meet people’s needs. Care staff told us that they had attended all of the training they needed to do their job effectively and could request extra training if needed. We found that at times due to there being a shortage of permanent staff

There were effective systems in place to monitor and improve the quality of the service provided, which took into consideration the views of the people who used the agency. Staff felt that they could discuss any concerns with someone in the management team and that there was an open culture within the agency.

We found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see what action we told the provider to take at the back of the full version of this report.

Caring

Good

Updated 13 January 2015

This service is caring.

Observation of staff working with people and discussions with the manager and other staff showed that they aimed to put the people that used the agency at the centre of everything they did.

People told us they felt that they were treated with kindness and that the staff understood how they liked things to be done.

Responsive

Good

Updated 13 January 2015

The service is responsive.

People were encouraged and supported to express what was important to them and to be involved, as much as they are able to, in the assessment of their needs.

Concerns and complaints were explored and responded to in good time.

Well-led

Good

Updated 13 January 2015

The service is well-led.

The manager had effective quality assurance processes and audits in place so that they could make continuous improvements to the service people received.

Procedures were in place and being followed to ensure that accidents, incidents and complaints had been dealt with promptly and any action necessary had been taken to avoid any reoccurrence.

Care staff told us that they found the management team approachable and that if they had any concerns that they could discuss them.