Archived: Dimensions 50 Fordbridge Road

Dimensions 50 Fordbridge Road is a care home which provides accommodation and personal care for up to eight people, who are living with a learning disability and have complex needs such as epilepsy and cerebral palsy. At the time of our inspection there were five people living there. People living at the home had various degrees of communication skills; they were unable to take part in a full discussion with us but we were able to engage with them and discuss their view points about the home. The home is a detached house with communal lounge, dining room, kitchen and bathroom facilities which people used. The accommodation is provided over two floors that were accessible by stairs and a lift. There was also a spacious and secure garden for people to use.

We had been informed by the provider that the home was closing down. Arrangements were beginning to be put in place for people for the smooth transition of moving out of the home. People and their relatives were involved in these decisions and their preferences and choices were respected. We conducted the inspection to review people’s care and support needs during this transitional period.

The home did not have a registered manager in place. ‘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.’ The provider had arranged temporary management coverage at the home. We have been informed the provider has submitted an application to be registered as manager with Care Quality Commission (CQC).

People and relative told us they were safe at the home. Staff had a good understanding about the signs of abuse and were aware of what to do if they suspected abuse was taking place. There were systems and processes in place to protect people from harm.

There were sufficient numbers of staff deployed who had the necessary skills and knowledge to meet people’s needs. Recruitment practices were safe and relevant checks had been completed before staff started work.

Medicines were managed, stored and disposed of safely. Any changes to people’s medicines were prescribed by the person’s GP and administered appropriately.

Fire safety arrangements and risk assessments for the environment were in place to help keep people safe. The service had a contingency plan that identified how the home would function in the event of an unforeseeable emergency such as fire, adverse weather conditions, flooding or power cuts.

Staff were up to date with current guidance to support people to make decisions. Staff had a clear understanding of Deprivation of Liberty Safeguards (DoLS) and the Mental Capacity Act (MCA) as well as their responsibilities in respect of this.

The provider ensured staff had the skills and experience which were necessary to carry out their role. Staff had received appropriate support that promoted their development. The staff team were knowledgeable about people’s care needs. People told us they felt supported by staff.

People had enough to eat and drink and there were arrangements in place to identify and support people who were nutritionally at risk. People were supported to have access to healthcare services and healthcare professionals were involved in the regular monitoring of their well-being. The provider worked effectively with healthcare professionals and was pro-active in referring people for assessment or treatment.

Staff treated people with compassion, kindness, dignity and respect. People’s preferences, likes and dislikes had been taken into consideration and support was provided in accordance with people’s wishes. People’s privacy and dignity were respected and promoted when personal care was undertaken.

People’s needs were assessed when they entered the home and on a continuous basis to reflect changes in their needs. Staff understood the importance of promoting independence and choice. People were able to personalise their room with their own furniture and personal items so that they were surrounded by things that were familiar to them. People had the right to refuse care and support and this information was recorded in their care plans.

People were encouraged to voice their concerns or complaints about the service and there were different ways for their voice to be heard. Suggestions, concerns and complaints were used as an opportunity to learn and improve the service people received.

People had access to activities that were important and relevant to them. There were a range of activities available within the home and outside.

People’s care and welfare was monitored regularly to ensure their needs were met. The provider had systems in place to regularly assess and monitor the quality of the care provided.

People told us the staff were friendly and management were always approachable. Staff were encouraged to contribute to the improvement of the home. Staff told us they would report any concerns to their manager and felt supported by the management.

During the visit we spoke briefly with those residents at home on the day of the inspection, and we spoke with one person in more detail. The overall impression was that people appreciated having the extra member of staff who now worked in the evenings.

A new manager is in post since our previous inspection and is currently registering with CQC. The previous manager's name appears on the front of this report as they are about to de-register with the Commission.

During our return visit in June 2103 we met all the current residents. We spoke with one person in some detail and with three other people more briefly. We observed residents as they received support and interacted with staff and the manager. We noted there was a friendly and homely atmosphere. People who lived at this service were encouraged to be independent and one person made us a cup of tea on arrival, and then sat with us whilst staff were busy with other residents.

People who lived at this service were encouraged to make choices, for example related to their meals, clothing, and activities, and we noted that staff respected those choices. We saw that people were asked for their consent before care and support was given, and their care and welfare needs were addressed by staff. We were told that the deputy manager 'Goes through my care plan with me and does the reviews.'

Residents were comfortable with the support they received, and the person who was interviewed told us they felt safe living there. They told us they knew how to make a complaint if they needed to, and overall said the home should get '12 out of 10' for the quality of the service.

The provider needed to do more work on ensuring there were sufficient staff to meet people's needs.

People were supported by staff to be as independent as possible but where it was needed, assistance was given in a timely way. We noted that staff were knowledgeable about the needs of residents in relation to their care and wellbeing.

We interviewed three staff and the acting manager about the needs of the current residents, and looked at three residents' care records. We noted that care records were well kept in an accessible format, to ensure residents were included in their care planning.

People were kept safe and staff had a good knowledge of safeguarding procedures. Training records showed that staff were up to date with the relevant training, though due to management changes, no staff had received an annual appraisal.

Quality assurance processes were well developed at this service, and whilst the company had identified areas for improvement, there were arrangements in place to ensure shortfalls had been remedied in a timely way.