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.