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Archived: Dimensions 1-2 Orchard Mews Good

Reports


Inspection carried out on 16 September 2015

During a routine inspection

The inspection took place on the 16 September 2015. The inspection was unannounced.

Dimensions are a specialist provider of a wide range of services for people with learning disabilities and people who experience autism. This service provides care and support for up to six people with a learning disability. The home consists of two adjoining bungalows with an office in the middle. Each bungalow has three bedrooms, a lounge, bathroom, laundry room and a large kitchen /diner. The home has a large garden to the rear and parking to the front.

The service had a registered manager. 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 and associated Regulations about how the service is run. The manager was also the registered manager for another Dimensions service nearby and was supported in these roles by an assistant locality manager.

Some areas required improvement. Where people were at risk of their health deteriorating quickly, escalation plans were in place, but these were not always being followed and had not been updated in light of revised guidance from healthcare professionals.

Staff had received training in the Mental Capacity Act (MCA) 2005 and the Deprivation of Liberty Safeguards. Staff acted in accordance with people’s wishes and choices. Systems were being implemented to support staff to assess and record mental capacity assessments and best interests decisions.

Staff were trained in how to recognise and respond to abuse and understood their responsibility to report any concerns to their management team.

Safe recruitment practices were followed and appropriate checks had been undertaken which made sure only suitable staff were employed to care for people in the home. There were sufficient numbers of experienced staff to meet people’s needs.

Staff received a comprehensive induction which involved learning about the values of the service, the needs of people using the service and key policies and procedures. Staff were supported to provide appropriate care to people because they were trained, supervised and appraised.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. Where people’s liberty or freedoms were at risk of being restricted, the proper authorisations were either in place or had been applied for.

People were supported to have enough to eat and drink and their care plans included information about their dietary needs and risks in relation to nutrition and hydration.

Staff had a good knowledge and understanding of the people they were supporting. Staff were able to give us detailed examples of people’s likes and dislikes which demonstrated they knew them well.

People were supported to follow their interests and make choices about how they spent their time.

There was an open and transparent culture within the service and the engagement and involvement of people and staff was encouraged and their feedback was used to drive improvements. There were a range of systems in place to assess and monitor the quality and safety of the service and to ensure people were receiving the best possible support.

We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. 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 13 December 2013

During an inspection to make sure that the improvements required had been made

This was a follow-up inspection, to check the provider’s progress against areas where we found non-compliance on our previous inspection visit 10 September 2013. We spoke with a senior member of staff and inspected the service’s procedures and systems for disposal of medicines. It was not necessary for us to speak with people using the service during this follow-up inspection.

We found the provider had addressed the issues we had identified previously and there were effective procedures and systems in place for disposal of medicines.

Inspection carried out on 10 September 2013

During a routine inspection

We spoke with three of the six people using the service, two members of staff, the manager, and a Person Centred Planning (PCP) Facilitator from the local authority. We observed support given to people using the service during our inspection. The three people spoken with told us they were happy and liked living at the home. One person told us, “it’s nice” and another person told us they were “happy here”. People appeared happy and contented, and care and support were observed to be respectful and responsive to individuals’ needs.

Staff ensured people were enabled to give their consent to care and support whenever possible. Where people did not have capacity to consent, effective systems ensured their rights and well-being were protected in line with legal requirements.

People living at the service and staff knew and got on well with each other. We reviewed care plans for two of the six people at the service and found they were detailed, up-to-date and person-centred.

Medicines were administered correctly, but the service’s systems for the return and disposal of unused medicines were ineffective and created an identifiable and avoidable risk.

The provider’s recruitment and selection processes ensured staff employed were suitable and sufficiently skilled to provide effective care and support to vulnerable people. There were sufficient staff working to meet people’s fundamental care and welfare needs at all times.

The service was open to suggestions for improvements and responded positively to comments and complaints. Regular audits helped maintain high standards as part of an ongoing quality assurance programme.

Inspection carried out on 12 December 2012

During a routine inspection

We spoke with two people using the service who were able to communicate verbally and four members of staff, and observed support given to all people living at the service. People told us they were happy at the service, were supported to do what they wanted, and were involved in decisions made about their care and support.

We reviewed care plans for four people using the service and they were detailed, up-to-date and person-centred. Staff demonstrated the importance of developing positive relationships and gaining personal knowledge of the people in their care. Support was observed to be person-centred, respectful and responsive to individual needs.

Staff were positive about the support they received from managers. Inductions were structured and service-specific, and staff had sufficient training to carry out their roles

effectively.

The service had adequate systems for recording and responding to complaints, and an easy-read guide to the process was available to all people using the service.

The service had effective procedures in place for safeguarding vulnerable adults and staff followed the appropriate local safeguarding process.