About the service Dimensions Somerset Newholme is a residential care home registered to provide personal care to up to eight people. At the time of the inspection there were seven people living at the home. The home specialises in the care of people who have a learning disability and/or autism. People living at the home also have complex physical healthcare needs.
We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.
People’s experience of using this service and what we found
Right Support:
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests. However, records relating to capacity assessments were not regularly reviewed.
Most staff told us there were enough staff to meet people's needs, although this included a high use of agency staff. Staffing levels were based on the needs of the people living at the service. We observed safe staffing levels throughout the inspection and staff appeared unhurried and responsive to people. Safe recruitment processes were in place.
The service gave people care and support in a safe, clean, well equipped, well-furnished and well-maintained environment that has recently been decorated to take into account people’s sensory needs. The premises were homely, and people's bedrooms were personalised.
People were supported to maintain their health and wellbeing. Staff enabled people to access specialist health and social care support in the community.
Right Care:
Care records were under review at the time of the inspection and we identified areas where improvements were required to ensure safe consistent care was provided.
Staff were not always trained appropriately to support people.
People received their medicines in line with their preferences by staff who knew people well. Staff mostly followed systems and processes to safely administer medicines, however improvements were needed to ensure medicines were stored safely.
People received kind and compassionate care. Staff protected and respected people’s privacy and dignity. They understood and responded to their individual needs. People could communicate with staff because staff supported them consistently and understood their individual communication 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:
The ethos, values, attitudes and behaviours of the management and staff provided support in the way each person preferred and enabled them to make meaningful choices. People had care plans in place. However, these had not always been reviewed or updated. The registered manager was prioritising updating records.
Staff and the management team at the service spoke positively about people within the service and wanted people to live their best lives. Staff demonstrated their knowledge of people and how to support them to manage their individual risks. Staff placed people’s wishes, needs and rights at the heart of everything they did.
Staff evaluated the quality of support provided to people, involving the person, their families and other professionals as appropriate.
People’s quality of life was enhanced by the service’s culture of improvement and inclusivity.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was requires improvement (published 24 June 2021)
Why we inspected
This inspection was prompted by a review of the information we held about this service.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
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 identified a breach in relation to the management of the service, and have made recommendations in relation to consent and the management of medication.
Please see the action we have told the provider to take at the end of this report.
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 work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.