Dimensions Norfolk Domiciliary Care Office

Updated 17 November 2023

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 Health and Social Care Act 2008.

Inspection team

The inspection team consisted of 2 inspectors and 1 Expert by Experience who made telephone calls to relatives. 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 to people living in ‘supported living’ settings. ‘Supported living’ settings, enable people to 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 or care at home services; this inspection only looked at people’s personal care.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection 5 registered managers were responsible for overseeing the care provided at each supported living service and outreach services provided to people in their own homes. Each registered manager was accountable to the operations director.

Notice of inspection

The inspection was announced. We gave the service 3 days’ notice of the inspection. This was because we needed to be sure the provider or registered managers would be in the office to support the inspection.

Inspection activity started on 25 September 2023 and ended on 30 October 2023. We visited the location office 28 September 2023. We visited people living in 6 supported living settings on 04 and 06 October 2023. Final inspection feedback was given to the provider on 30 October 2023.

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 annually with key information about their service, what they do well, and improvements they plan to make. We liaised with the local authority quality assurance team, and reviewed information held about the service on our systems. We used all of this information to plan our inspection.

During the inspection

We met 15 people receiving support from the service, and spent time with them seeking their feedback, as well as observing care provided in communal areas of their homes. Not everyone using the service was able to speak with us, so staff supported people to give feedback using their preferred communication methods. We spoke over the telephone with 4 people’s relatives, to seek their feedback about the care and support provided by the service. We spoke with 16 members of staff including the 5 registered managers, the regional operations director and regional assistant. We also sourced feedback from 9 members of care staff and 5 external health and social care staff by email.

We reviewed 16 people’s care and support records, 11 people’s medicine administration records and 2 staff files. We also reviewed documents, policies and procedures relating to the safe running of this service. We continued to source information and clarification from the provider as an outcome of our visits to the care office and supported living services.

Updated 17 November 2023

About the service

Dimensions Norfolk Domiciliary Care Office provides the regulated activity of personal care. Staff provide care and support to people living in their own homes or flats, or in supported living services. The service provides support to a total of 55 people with a learning disability and or autistic people. At the time of our inspection there were 46 people in receipt of the regulated activity. 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.

People’s experience of the service and what we found:

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 assessment and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

Right Support: Value was consistently placed on the condition and cleanliness of people’s homes, with regular checks in place to ensure people lived comfortably. People’s care records demonstrated people and their relatives, as well as health and social care professionals were involved in the development of these documents. People’s privacy, dignity, choice and control, and their human rights were consistently upheld. 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.

Right Care: People were empowered to have choice and control over their daily lives. The care provided was person-centred and led by the wishes of the individual. Staff valued feedback from people and their relatives to tailor their care accordingly. Care outcomes were regularly reviewed, and staff worked collaboratively with health and social care professionals to achieve positive results. People led meaningful lives, making valuable contributions to their local community and households. Healthcare professional guidance was followed to protect people from risks such as pressure sores, choking, epilepsy and diabetes.

Right Culture: Registered managers provided clear leadership to their staff teams. People and their relatives were familiar with the registered managers and knew how to contact them if needing to discuss any concerns. Feedback was openly encouraged from people, their relatives and staff, and the registered managers valued all contributions as a way of driving service improvement. The provider had implemented a ‘closed cultures checklist’ which registered managers regularly reviewed to monitor the morale and health of their staff teams, this demonstrated a clear commitment by the provider to implementing Right Support, Right Care, Right Culture into their services.

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 Outstanding published 06 October 2017.

Why we inspected

This inspection was prompted by a review of information we held about the service.

Follow Up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.