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Dimensions 53 Cambridge Road Requires improvement

The provider of this service changed - see old profile

Inspection Summary


Overall summary & rating

Requires improvement

Updated 8 December 2018

We undertook an inspection of the service on 26 and 27 September 2018. The inspection was unannounced. At our last inspection we rated the service good.

Dimensions 53 Cambridge Road is a care home for up to six people with a learning disability. The building was purpose built, has six bedrooms across two floors, a shared living room and a kitchen dining area. There were five people living in the home at the time of the inspection.

The care service has been developed and designed to meet the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion to help ensure people with learning disabilities and autism using the service can live as ordinary a life as any citizen.

Since our last inspection, there had been a change of management at the service. The previous manager had left and a new manager had been appointed. The new manager had submitted an application to CQC to register as manager for the service. At the time of inspection, this application was still in progress. 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.’

At this inspection we rated the service ‘requires improvement’. We found that the service was in breach of four regulations. You can see what action we told the provider to take at the back of the full version of the report.

People’s risks were not fully assessed and managed in the least restrictive way. One person was put at risk of serious harm from the inappropriate use of bed rails. Medicines were not stored securely and people did not always have guidance for the use of their medication.

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible. People’s capacity to make decisions was not always assessed when decisions were made on people’s behalf. The provider had not always applied the principles of the Mental Capacity Act, resulting in people being deprived of their liberty.

Records were not kept accurately and were not always up to date. We found that the provider did not have sufficient quality assurance processes in place to identify quality and safety issues and take action to rectify these.

People were protected from the risk of abuse or neglect by staff who knew what signs to look for and how to report issues. Staff openly reported incidents and the service took action to prevent re-occurrence.

There were sufficient staff during the day to meet people’s needs and enable people to take part in social activities as they wished. However, staff reported there was not sufficient staffing levels at night to safely support people.

Staff had access to training, and had the appropriate skills, knowledge and experience to support people. The service referred people to other professionals as required and enabled people to access health services, such as their GP and dentist.

The premises were adapted to meet people’s needs and preferences. People had a choice of food to meet their dietary needs and preferences.

Staff used different methods of communication to meet people’s needs and ensure they were able to express their views and be involved in conversation.

Staff respected people’s dignity and privacy. Staff valued people’s individuality and enjoyed working in the home.

Staff ensured people had access to social activities which they enjoyed. People were encouraged to maintain relationships with people who were important to them.

Further information is in the detailed findings below.

Inspection areas

Safe

Requires improvement

Updated 8 December 2018

The service was not always safe.

People’s risks were not fully assessed and managed in the least restrictive way.

Medicines were not stored safely and securely.

People were protected from neglect and abuse. Staff reported incidents and the service took action to reduce the risk of re-occurrence.

Effective

Requires improvement

Updated 8 December 2018

The service was not always effective.

People’s capacity to make significant decisions was not always assessed. People were not always supported in the least restrictive way.

Staff had the appropriate skills, knowledge and experience to meet people’s needs.

People were supported to have access to food and drink to meet their individual needs and preferences.

The premises were adapted to meet people’s needs and people chose how their rooms were decorated.

Caring

Good

Updated 8 December 2018

The service was caring.

Staff treated people with dignity and respect. People’s privacy was respected. Staff spoke passionately about their work with people.

Staff knew people well and adapted their communication methods to engage people.

Responsive

Good

Updated 8 December 2018

The service was responsive.

People were supported to take part in social activities that interested them.

Staff encouraged people to maintain relationships with people who were important to them. The service was proud of the relationships they had with families.

Well-led

Requires improvement

Updated 8 December 2018

The service was not always well-led.

The service had undergone a recent change in manager.

Not all required incidents had been reported to the CQC. People’s records were not up to date or accurate.

The provider did not have robust quality assurance processes in place.

Staff and people’s relatives had confidence in the manager to make the improvements required.