Background to this inspection
Updated
14 December 2019
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
Inspection team
The inspection team consisted on one inspector, two assistant inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type.
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats, as well as care and support to people living in 32 ‘supported living’ settings, so that they can live 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 had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
We gave the service 24 hours’ notice of the inspection. This was because we needed to be sure that the provider or registered manager would be in the office to support the inspection.
What we did before the inspection
We used the information the provider sent us in the provider information return (PIR) This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections.
During the inspection
We visited five supported living services and spoke with seven people about their experience of the care provided. We spoke with eight members of staff including the registered manager, four assistant locality managers, one service lead and two support workers.
We reviewed a range of records. This included seven people’s care records and multiple medication records. We looked at four staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection
On 7 and 10 October 2019 the Expert by Experience spoke with one person who used the service and eight relatives by telephone about their experience of the care provided. We continued to seek clarification from the registered manager, returning to the office on 31 October 2019 to validate evidence found. We looked at training data, mental capacity and deprivation of liberty assessments and quality assurance records.
Updated
14 December 2019
About the service
Dimensions Colchester Domiciliary Care Office is a domiciliary care service providing personal care to people in their own homes. 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. At the time of the inspection the service was supporting a total of 100 people. Ninety-four people received support with personal care.
The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.
People’s experience of using this service and what we found
People using the service were supported to stay safe. Staff had good understanding of safeguarding procedures and how to report concerns. Risks to people, including the spread of infection were assessed and managed well. 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; the policies and systems in the service supported this practice.
The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence. The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. The introduction of ‘Active Support’ a model of care developed in conjunction with the University of Kent and The Behaviour Foundation provided support to people which focused on them having as many opportunities as possible to gain new skills and become more independent.
Sufficient numbers of staff were employed and adjusted when needed to meet people’s complex needs. The recruitment, induction and training processes in place ensured staff had the right skills and experience and were suitable to work with people who used the service.
Systems were in place to ensure people’s medicines were managed safely, including working towards reducing people’s psychotropic medicines. These are medicines that affect the mind, emotions, and behaviour. The organisation had implemented campaigns designed to improve outcomes for people using the service. ‘I’m with Sam’ promoted awareness of dealing with and tackling hate crimes against people with a learning disability and autism, and ‘My GP and me campaign’ was designed to improve outcomes for people with learning disabilities or autism when visiting their GP.
People using the service were cared for by staff that knew them well. People had access to food and drink of their choice and were supported to live a healthy lifestyle. Staff worked well with other professionals to ensure continuity of care and support to people when moving between services. People’s privacy, dignity and independence was promoted and respected. People’s communication needs had been assessed and were meeting the requirements of the Accessible Information Standards. This set of standards sets out the specific, approach for providers of health and social care to meet the communication needs of people with a disability, impairment or sensory loss.
Work was in progress to develop end of life care plans to ensure people’s wishes will be considered at such time, and ensure they experience a pain free and comfortable death.
Staff were aware of the vison and values of the company, and intuitively applied these in their day to day roles ensuring person received person centred care. People, their relatives and staff were involved in the service, and feedback was used to improve the service provided.
Systems were in place to assess the quality of the service and ensure risks and regulatory requirements were being understood and managed. Where things had gone wrong, the registered manager took quick and appropriate action to put things right. Systems were in place to learn from incidents and improvements made. The provider had a range of ways to engage with people and their families to ensure they were involved in how the service was ran. This included annual regional events and involving people who used the service as ‘quality checkers’ to have oversight of the services provided, and involving them in the recruitment of staff.
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 Good (published 10 January 2017).
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
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.