Background to this inspection
Updated
4 December 2018
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service,and to provide a rating for the service under the Care Act 2014.
This inspection was undertaken on 8, 9, 10 ,11 and 12 October 2018. We gave the provider three days' notice that we would be visiting their head office. We gave the provider notice as we wanted to make sure the registered manager would be available for the inspection.
The inspection visit was carried out by three inspectors, two assistant inspectors and two experts by experience. We visited head office and three supported living schemes. The schemes were where people who had a learning disability lived in shared houses or flats. The assistant inspectors made telephone calls to staff and the experts by experience made telephone calls to relatives of people who used the service. Experts by experience are people who have used or care for someone who has sued this type of service.
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Before the inspection, we asked the provider to complete a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We reviewed the completed PIR and previous inspection reports before the inspection. We also reviewed other information we had about the provider, including notifications of any significant events, safeguarding alerts and feedback from the public about the service.
On the first day of the inspection we met with the registered manager and looked at records in the office. We spoke with seven people who used the service and met another seven people who were not able to talk with us. We spent time with those people and observed their interactions with staff and their daily routines to check on their wellbeing.
We read the care records for 13 people. We read their support plans, risk assessments and all records relating to the care and support they received. We spoke with 11 relatives of people who received support from Dimensions.
We read four staff files to check on the provider’s recruitment process. We looked at staff training, supervisions and appraisals. We read other records in the schemes and some that the registered manager emailed to us after the inspection. These were quality monitoring records for two schemes, medicines records, audits, complaints, accidents and incidents, safeguarding investigations, activity records and health and safety records.
Updated
4 December 2018
This inspection took place between 8 and 12 October 2018 and was announced.
At our last inspection in February 2016 we rated the service Good. At this inspection we found evidence continued to support the rating of Good.
There was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.
This service provides care and support to people living in '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.
At the time of this inspection the service was providing personal care and support to 88 people living in their own homes. The majority of these people lived in a supported living scheme in a shared house or flat.
The registered manager was supported by locality managers who managed between three and four supported living schemes each.
The service also provided a specialist service providing Applied Behaviour Analysis and positive behaviour support for people with an autistic spectrum condition to develop their life skills and independence. These people had structured teaching and support programmes delivered by a suitably qualified team.
Staff understood how to safeguard people and risks were managed effectively to help people keep safe and protect their rights.
There were some minor concerns about medicines recording which the registered manager addressed when we brought these to their attention and put steps in place to prevent recurrences.
The service offered “active support” and worked with, rather than for, people they supported. People played an active role in planning their lives and in their day to day routines. People were supported to have maximum choice and control of their lives and the service supported them in the least restrictive way possible; the policies and systems in the service supported this practice.
People had choice around what they ate, whether they cooked their own meals or had their meals cooked by staff and how they spent their time.
The service provided support to people to maintain good health and with managing health conditions. People had good support to maintain their independence and their right to privacy was respected. The service helped people with maintaining relationships with their families and friends.
People were involved in planning their care. The service ensured care plans were person centred and updated as and when people's care needs changed.
Effective systems were in place to manage complaints. People using the service and their relatives told us they were happy with the service. The service was person-centred and inclusive.
The service maintained records of care and support provided, people's health needs and wellbeing.
The registered manager had strong leadership skills and introduced new initiatives and ideas to improve opportunities for people. Staff felt well supported by the managers.
The provider was continually improving the service and worked in partnership with health and social care professionals to ensure people's health and social care needs were met. The provider had a comprehensive quality monitoring process. We have made one recommendation about improving the follow up action to the existing quality monitoring processes to ensure improvements are made without delay when needed.