Dimensions South Hampshire Domiciliary Care Office

About the service

Dimensions South Hampshire Domiciliary Care Office is a domiciliary care provider. At the time of this inspection people received personal care support from the service in a variety of supported living services spread across Hampshire. The service supported people with a variety of care needs, including people living with autism and learning disabilities. Some people had very limited verbal communication skills.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

People’s experience of using this service and what we found

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people and providers must have regard to it.

The service was not able to demonstrate how they were meeting some of the underpinning principles of Right support, right care, right culture.

Right Support

More needed to be done to ensure that people were consistently supported to be kept safe. Improvements were needed to ensure medicines and risks were managed in a way that ensured the best possible outcomes. Staff needed to ensure people were supported safely to make decisions and record outcomes of best interest decisions staff supported people to have the maximum possible choice, control and independence and they had control over their own lives. Staff supported people to take part in activities and pursue their interests in their local area. Staff enabled people to access specialist health and social care support in the community.

Right Care

Managers had not always ensured that risks faced by people had been assessed and planned for. Staff were committed to providing an individualised response to people’s needs, but this was at times difficult as there were not always enough permanent staff resulting in a high use of agency staff. People received kind and compassionate care. Staff protected and respected people’s privacy and dignity. They understood and responded to their individual needs. Staff understood how to protect people from poor care and abuse. The service worked well with other agencies to do so. Staff had training on how to recognise and report abuse and they knew how to apply it.

Right culture

People received good quality care, support and treatment because trained staff could meet their needs and wishes. People’s support plans did not always reflect their needs or demonstrate that the person’s care had been reviewed. Checks to ensure that records were effective and up to date were not always completed appropriately. Whilst the provider demonstrated a commitment to create a culture of improvement that provided good quality care to people, the success of this approach had been affected by changes in leadership at the service and the high use of agency staff. Staff placed people’s wishes, needs and rights at the heart of everything they did. Staff ensured risks of a closed culture were minimised so that people received support based on transparency, respect and inclusivity.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Enforcement and Recommendations

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to medicines, Mental Capacity Act 2005 and good governance at this inspection.

Please see the action we have told the provider to take at the end of this report.

Rating at last inspection and update

This service was registered with us on 10 October 2020 and this is the first inspection.

Why we inspected

We undertook this inspection to assess that the service is applying the principles of right support, right care and right culture.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.