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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

Reports


Inspection carried out on 28 July 2014

During a routine inspection

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 carried out on 14, 15 May 2013

During a routine inspection

The inspection team was led by a CQC inspector joined by an Expert by Experience, who had personal experience of using or caring for someone who uses this type of service. We used telephone interviews and home visits to people who used the service and to their main carers (relatives or friends) to gain their views about the quality of the service the received.

We visited and observed four people who received their care from the service. We spoke with 15 other people on the phone. Eight relatives also commented about the quality of service their family member received. All responses stated that people found their care to be good or excellent.

We checked medication in the service we visited and found that the policy and procedure had been followed and ensured that people received their medication as prescribed and in a safe way.

We observed staff implementing appropriate moving and handling procedures, making people as comfortable as possible.

Most people felt that staff were well trained and used their knowledge to deliver safe care for people. Staff spoken with confirmed that the training records we saw were accurate and that they had attended all their training.

People explained to us that the provider regularly checked their satisfaction with the quality of service.

We checked records both electronic and in hard copies and all were up to date and appropriate.

Inspection carried out on 16, 19 November 2012

During a routine inspection

We spoke with people who received a service and observed the care and support provided to people at three different houses. We also spoke with two relatives. Feedback from people who received a service and relatives was very positive. People said that the staff were kind and respectful and that they received the care that they needed. Our observations showed that staff supported people in a patient and sensitive way. During our discussions with staff we found that they were knowledgeable about the needs of people they were providing support to and that they were enthusiastic about providing a good quality service to people.

Staff said that they received good support and training which enabled them to carry out their roles effectively. However, we identified that for some staff there were areas of training that had not been provided in a timely way.

The standard of records was variable and not all the necessary records were able to be located at the registered office. The majority of care records provided good, clear guidance to staff about how to meet people’s needs but we also identified some that were in need of updating.

The organisation had a quality assurance system in place but we found that this was not always carried out according to the organisation’s own procedures. There was not always evidence of action having been taken to address any identified issues.