Archived: Dimensions Somerset Yeovil Domiciliary Care Office

Updated 19 April 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 was planned to check 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 took place on 18, 19 and 22 January 2018 and was announced.

We gave the service 48 hours’ notice of the inspection visit because it is across multiple locations and the manager is often out of the office supporting staff or providing care. We needed to be sure that they would be in.

Inspection site visit activity started on 18 January 2018 and ended on 22 January 2018. It included spending time in the office, visiting three supported living houses, speaking with staff and telephone calls to relatives. We visited the office location on 18 and 22 January 2018 to see the manager and office staff; and to review care records and policies and procedures.

It was carried out by one adult social care inspector and an expert by experience who made telephone calls. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service for people.

The provider had not completed a Provider Information Return (PIR) because there had been an internal error. The PIR 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. During the inspection we looked at things which would have been on the PIR. We spoke with other health and social care professionals and looked at other information we held about the service before the inspection visit.

We spoke with nine people who lived in the three supported living homes. We also had informal conversations with people in the supported living houses as we walked around and completed the inspection. We spoke with the registered manager, operations director, performance manager and 10 members of staff including team managers, assistant team managers and support workers. During the inspection, on the telephone we spoke with 12 relatives.

We looked at six people’s care records. We observed care and support in communal areas. We looked at three staff files, information received from the provider, staff rotas, quality assurance audits, staff training records, the complaints and complements system, medication files, environmental files, statement of purpose and a selection of the provider’s policies.

Following the inspection we asked for further information including provider policies, other documents relating to the service and staff recruitment records. We received all of this information in the time scales given.

Updated 19 April 2018

This inspection took place on 18, 19 and 22 January 2018 and was announced. This is the first inspection for the provider.

Dimensions Somerset Yeovil Domiciliary Care Office is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community and specialist housing. It provides a service to, older and younger disabled adults including people on the autistic spectrum.

This service provides care and support to 94 people living in 13 ‘supported living’ settings, so that they can live in their own home as independently as possible. Many of the people using the service required up to 24-hour support from staff due to their disabilities. 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 houses were located in a range of areas from the countryside to in a town. Each house had multiple occupation. Houses in multiple occupation are properties where at least three people in more than one household share toilet, bathroom or kitchen facilities. Some houses had individual areas created for people who struggled to share with others. There were offices in each home and some had sleep-in rooms for staff.

Not everyone using Dimensions Somerset Yeovil Domiciliary Care Office receives a regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.” Registering the Right Support CQC policy

The service had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. Each supported living home had a team manager who reported directly to the registered manager. There was a performance manager working alongside the registered manager and providing additional support to the team managers.

People and their relatives using the service thought they were kept safe. Most medicines were managed safely. Improvements could be made with some administration records and practices. Risk assessments were carried out to enable people to retain their independence and receive care with minimum risk to themselves or others.

The management had developed positive relationships with people. People and their relatives were happy with the support they received. There were some mixed feelings about whether there were enough staff to meet their needs from the relatives. Inconsistencies were found with how people’s recruitment had been managed throughout the service.

People were protected from potential abuse because staff understood how to recognise signs of abuse and knew who to report it to. When there had been accidents or incidents systems were in place to demonstrate lessons learnt and how improvements were made. Staff had been trained in areas to have skills and knowledge required to effectively support people. People told us their healthcare needs were met and staff supported them to see other health professionals

People were supported to have choice and control over their lives and staff supported them in the least restrictive way possible. When people lacked capacity decisions had been made on their behalf following current legislation. People were supported, when required, to eat a healthy, balanced diet.

Care and support was personalised to each person which ensured they were able to make choices about their day to day lives. Care plans reflected people’s needs and wishes and they had been involved where possible. People and their relatives knew how to complain and there was a system in place to manage them.

People and their relatives told us, and we observed, that staff were kind and patient. People’s privacy and dignity was respected by staff. Their cultural or religious needs were valued. People, or their representatives, were involved in decisions about the care and support they received. The provider was developing systems to ensure people had a dignified death.

The service was well led and shortfalls identified during the inspection had mainly been identified by the management. There was a proactive approach from management and additional scrutiny was being sourced from external agencies. The provider had completed most statutory notifications in line with legislation to inform external agencies of significant events.