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Dimensions Dorset Domiciliary Care Office Outstanding

Inspection Summary


Overall summary & rating

Outstanding

Updated 9 May 2018

The inspection took place on 5 March and was announced. The inspection continued on 6 March 2018 and was again announced.

Dimensions Dorset provides care and support to people with learning disabilities who live in their own homes. It is registered to provide personal care. At the time of the inspection the service was delivering personal care to 56 people.

This service provides care and support to people living in 62 ‘supported living’ settings, so that they can live in their own home as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.

The service also provides personal care to people living in their own houses and flats in the community. It provides a service to adults with learning disability and autism.

Not everyone using Dimensions Dorset receives a regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

There was a registered manager in post. 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.

People receiving support from Dimensions Dorset received highly individualised person centred care. Support plans contained detailed and personalised care plans and we saw that people had been supported to have a full and meaningful life enjoying interests, taking part in new experiences and being active members of the local community. There was an emphasis on the need for good communication with a range of documentation being provided in way to assist people in accessing information.

People, relatives, professionals and staff felt that the service was extremely well led. The provider, registered manager and staff actively promoted a positive, inclusive and open culture; this approach had a positive impact on the quality of the service people received. The structure of the service worked for people, so that locality managers were always available to support staff and people when needed. The service worked in conjunction with other organisations to improve care for people with a learning disability. There were robust quality assurance systems in place which monitored the service, identifying potential areas for improvement, and actions were taken to improve these.

Staff were highly motivated, worked well as a team and shared a common ethos of providing high quality, compassionate care with regard to people's individual wishes and support needs. Staff were valued, well supported and supervised by the management team.

Feedback from people, relatives and professionals described the service as excellent, one which exceeds expectations, outstanding and the best in the local Area.

There was a people council and the local representative worked in the local office. The Council was an elected body of people Dimensions supported that met four times a year on its own and twice with the Dimensions Board. Feedback from a local level had influenced changes at an organisational and national level which had led to positive impacts on people’s lives.

Family charters were in place. These outlined a commitment to involve people’s families in exactly what they wished to be involved in. The registered manager sat down with families and reviewed these on an annual basis to determine how much contact families wished to have with staff, the management, the organisation and what they may wish to be updated on.

People were supported by staff who received regular training specific to their needs. An inclusive and

Inspection areas

Safe

Good

Updated 9 May 2018

The service was safe.

There were sufficient staff available to meet people’s assessed care and support needs.

People were at a reduced risk of harm because medicines were managed safely, securely stored, correctly recorded and only administered by staff that were trained to give medicines.

People were protected by the prevention and management of infection control. Policies, equipment and schedules were in place.

Lessons were learnt and improvements made when things went wrong.

People were supported by staff who had completed safeguarding adults training and were able to tell us how they would recognise and report abuse.

People were protected from harm because risk assessments and emergency plans were in place and up to date.

Effective

Good

Updated 9 May 2018

The service was effective.

People’s needs and choices were assessed and reflected in support plans.

The service worked effectively across organisations during transition and admission to assess, meet and whenever possible exceed expectations.

Staff received training, supervision and appraisals to give them the skills and support needed to carry out their roles and meet people’s assessed needs.

Staff supported people to maintain and understand healthy balanced diets. Dietary needs were assessed where appropriate.

People’s choices were respected and staff understood the requirements of the Mental Capacity Act 2005. People’s capacity was assessed and best interest decisions recorded.

People were supported to access health care services and local learning disability teams.

Caring

Good

Updated 9 May 2018

The service was caring.

People were supported by staff that spent time with and treated them with kindness and compassion.

People were supported by staff that used person centred approaches to deliver the care and support they provide.

Staff had a good understanding of the people they cared for and supported them in decisions about how they liked to live their lives.

People were supported by staff that respected and promoted their independence, privacy and dignity.

Responsive

Outstanding

Updated 9 May 2018

The service was very responsive.

People were supported to create and achieve life changing goals and improve outcomes in their lives.

Staff considered how barriers due to disability and complex behaviour impacted on people's ability to take part and enjoy activities open to everyone.

Feedback from relatives described the service as excellent and one which exceeded expectations.

People's support plans were up to date, regularly reviewed and personalised to guide staff to provide extremely responsive, person centred and holistic support.

Support plans reflected people’s diverse needs, including those related to disability, gender and other protected characteristics.

Documentation, including support plans and key policies and procedures took account of people's needs and was produced in a format to assist people in understanding the content of documents.

A complaint policy and procedure was in place. Concerns were investigated by the registered manager and the outcome was shared and used to develop the service. This made people and relatives feel listened to, valued and important.

End of life care processes were being explored creatively and involved people and relatives to make sure that preferences, beliefs and choices were understood and respected.

Well-led

Outstanding

Updated 9 May 2018

The service was extremely well led.

People received high quality care and support as the provider's vision and values were understood and applied across all areas of the service. The organisational structure provided staff with strong leadership and support.

The registered manager and staff were committed to the development of the service and the sharing of good practice to promote the quality of life of those they supported.

The provider, registered manager and staff had across the organisation systems and processes to involve people who use the service, their family members, staff and external agencies. Their feedback was used to develop and monitor the service.

Relatives and professionals were extremely positive about the service, management and quality of care delivered, describing it as outstanding and the best in the Area.

There were family charters in place. These outlined a commitment to involve people’s families in exactly what they wished to be involved in.

A comprehensive and robust system to monitor and maintain the high levels of care and support provided to people was in place. These included quality checks completed by people who used Dimensions services.

The provider was committed to the development of the service and worked with external providers to improve services for people with a learning disability.