Background to this inspection
Updated
8 April 2020
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. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
Inspection team:
The inspection team consisted of one inspector.
Service and service type:
Dimensions Baily Thomas House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
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 the service is small, occupancy varies each day, and we wanted to be sure there would be people and staff at the home to speak with us.
What we did:
The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
As part of the inspection we spent time with four of the people who were using the service. We spoke with the registered manager, and four members of staff. We looked at three people’s care records and two staff files including training and recruitment. We reviewed the service’s accidents and incidents, audits and complaints policies, and looked at other systems, including for medicines management.
As some of the people staying at Dimensions Bailey Thomas House had difficulties communicating verbally, we spent time during the inspection visit conducting a short observational framework for inspection (SOFI). SOFI is a way of observing care to help us understand the experiences of people who could not tell us verbally about their experiences at the service.
Following the inspection, we spoke with two relatives by telephone about their experiences of using the service.
Updated
8 April 2020
About the service:
Dimensions Baily Thomas House is a 'care home' registered to provide accommodation and personal care support for up to six people living with a learning disability, or autistic spectrum disorder. People may also have physical disabilities or show distressed or anxious behaviours, and some people had limited verbal communication.
The service primarily operates as a respite service but at the time of the inspection some people were living there longer term whilst awaiting accommodation and support to be organised for them elsewhere. On the day of the inspection five people in total were using the service.
Dimensions Baily Thomas House also provides day services for people living elsewhere within the community. As these day services do not provide personal care and accommodation for people this falls outside the regulation of The Care Quality Commission (CQC) and so did not form part of this inspection.
People’s experience of using this service:
Dimensions Baily Thomas House is used flexibly by 32 people in total throughout the year, who self-book accommodation for respite care. Some people used the service regularly each week, others for a short period of time on one occasion. People told us they valued the services provided. One relative said, “It feels a very happy place” and “they try their best to be flexible, to help meet our needs as well as (name of person).”
Since the last inspection a new manager had been registered. The registered manager had a clear understanding of the development needs of the service, and had been working on service development plans, training plans for staff and re-establishing the staff team.
Effective quality assurance systems were in place to assess, monitor and improve the quality and safety of the services provided. People and their relatives were regularly consulted on the operation of the service and asked to make comments or suggestions on how it could be improved, including through social events such as coffee mornings.
Risks to people were assessed and guidance available in people’s care plans on how to reduce risks and maintain continuity of care. The service understood one of the biggest risks to people’s well-being was the interface between services, home and ensuring clear communication about people’s needs. Relatives completed documentation before each stay to record any changes in people’s needs. Care plans were all being reviewed to ensure they were all up to date and comprehensive, reflecting every element of people’s needs and lifestyle. Plans also reflected professional guidance and involvement from community teams, including for example photographs of how to support the person to move and be positioned.
The service ensured changes in best practice guidance were implemented to help make improvements in people’s lives. For example, outcomes for people using the service for respite were in line with the principles and values of Registering the Right Support guidance. This meant people had opportunities to continue to be involved with their local community, and experience as many activities and choices as possible.
Risks to people’s health, safety and wellbeing were assessed and acted upon. Risk assessments gave staff clear direction on how to minimise risks for people. Risks from the environment were managed.
People living at the service were protected from abuse because staff had received training and were confident in raising concerns about people’s wellbeing. Safe medicines practice was understood and used. Families ensured information on any medicine changes were shared with the service.
People’s rights regarding capacity and consent were understood and information was available to help people understand their rights and how to keep safe. The service was acting on advice to make applications for Deprivation of Liberty Safeguards for each person to ensure their rights were protected while at the service.
Staff were provided with the training, supervision and support they needed. There was a thorough recruitment process which updated checks such as police record checks regularly, to ensure staff remained safe to work with people. Relatives told us there had been a higher turnover of staff which had led to the use of more agency staff, but this was settling with a new staffing team in place.
Staff were positive about the people they were supporting. We saw people engaging with staff with good humour and respect.
More information is in the full report
Rating at last inspection: This service was rated as good at their last inspection (report published on 26 June 2017).
Why we inspected: This inspection was scheduled based on the last inspection date and rating of the service.
Follow up: We will continue to monitor the intelligence we receive about the service. If any concerning information is received, we may inspect sooner.