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Inspection Summary


Overall summary & rating

Good

Updated 12 October 2017

This inspection took place on 7 August 2017 and was unannounced. Dimensions 5-6 Duchess Close, is a care home which provides care and support for up to six people with learning disabilities and complex needs. At the time of this inspection there were five people using the service.

There was a registered manager in place. The registered manager was present throughout the inspection. 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.

Risk assessments stated what people’s personal risks were. There was insufficient guidance provided for staff on how to mitigate these known risks. However, staff that we spoke with demonstrated an understanding of people’s personal risks.

We have made a recommendation around the recording and guidance for staff of risks that people faced.

We observed kind and caring interactions between staff and people. People’s responses to staff showed that people felt safe and supported. Relatives were positive about people’s safety within the home.

Procedures relating to safeguarding people from harm were in place and staff understood what to do and who to report it to if people were at risk of harm.

Medicines were managed safely and administered on time. There were records of medicines audits and staff had completed training on medicine administration.

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

Staff had regular supervision and annual appraisals that helped identify training needs and improve the quality of care.

People were supported to eat healthily. There was a varied menu and snacks and drinks were available if people required.

There was a complaints procedure and relatives knew how to make a complaint.

Staff knew how to report accidents and incidents. These were followed up and learning from them was used to improve the quality of care for people.

Care plans were person centred and reflected individuals’ preferences. Relatives were involved in planning people’s care.

People had individual weekly activities timetables that reflected things that they enjoyed. People were supported in the community with appropriate staffing levels.

Audits were completed by both the home and the organisation to check the quality of care. This included health and safety, medicines and overall care provision.

Staff had regular team meetings where they were able to share ideas and raise any concerns.

Inspection areas

Safe

Requires improvement

Updated 12 October 2017

Aspects of the service were not safe. Personal risks people faced were identified, however there was insufficient guidance on risk assessments to enable staff to effectively mitigate the known risk. Staff we spoke with had a good understanding of how to work with people's know risks.

Staff were able to tell us how they could recognise abuse and knew how to report it appropriately. People were actively encouraged and supported to report concerns.

There were sufficient numbers of staff to ensure people’s needs were met.

People were supported to have their medicines safely.

Effective

Good

Updated 12 October 2017

The service was effective. Staff had on-going training to effectively carry out their role. Staff received regular supervision and appraisals. People were supported by staff who regularly reviewed their working practices.

Staff were aware of the Mental Capacity Act 2005 (MCA) and the Depravation of Liberty Safeguards (DoLS).

People’s healthcare needs were monitored and referrals made when necessary to ensure wellbeing.

People were supported to have enough to eat and drink so that their dietary needs were met. People were given choice through pictures and verbal prompts.

Caring

Good

Updated 12 October 2017

The service was caring. People were supported and staff understood individual’s needs and were patient and kind in their interactions.

People were treated with respect and staff maintained privacy and dignity.

Where people were unable to be involved in planning their care, relatives were encouraged to have input into their care.

Responsive

Good

Updated 12 October 2017

The service was responsive. People's care was person centred. Care plans included information on what was important to the person.

Staff were knowledgeable about people’s individual support needs, their interests and preferences.

People were encouraged to be as independent as possible, be part of the community and maintain relationships.

Relatives knew how to make a complaint. There was an appropriate complaints procedure in place.

Well-led

Good

Updated 12 October 2017

The service was well-led. There was good staff morale and guidance from management.

Relatives and staff were positive about the management of the home.

The home had a positive open culture that encouraged learning.

Systems were in place to ensure the quality of the service people received was assessed and monitored.