Background to this inspection
Updated
5 January 2024
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.
As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.
Inspection team
The inspection was conducted by an inspector 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
Dimensions 4 Matlock Close is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under 1 contractual agreement dependent on their registration with us. Dimensions 4 Matlock Close is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
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 there was a registered manager in post.
Notice of inspection
This inspection was unannounced.
What we did before the inspection
We reviewed information we had received about the service since the last inspection and we sought feedback from the local authority. 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 used all this information to plan our inspection.
During the inspection
During our inspection we met 6 people who lived at the home and spoke with 4 relatives by telephone. We met 1 visitor, 4 support workers, 2 deputy managers and the registered manager. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us. We reviewed a range of records relating to the management of the service including 2 people’s care plans and records, medicines support records, health and safety records, and quality checks of the service. After our visit we also spoke with another relative and 1 professional involved with a person who uses the service. We looked at procedures, care records, staff training and staff recruitment records. We continued to seek clarification from the provider to validate evidence found.
Updated
5 January 2024
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 assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.
About the service
Dimensions 4 Matlock Close is a care home for up to 8 people with learning disabilities and/or autism. At the time of our inspection, 7 people were living at the service.
People’s experience of using this service and what we found
The service was able to demonstrate how they were meeting some of the underpinning principles of right support, right care, right culture. However, they needed to make improvements to fully meet these.
Right Care
People received care that was kind and staff respected their privacy.
Staff understood and responded to their individual needs. They communicated with people in ways that met their needs. The service gave people care and support to meet their sensory and physical needs, but some areas of the environment was not always kept sufficiently clean or safe at all times.
The service had enough staff to keep people safe. Staff had training on how to recognise and report abuse and they knew how to apply it.
Right Support
Staff supported people with their medicines, but the medicines management arrangements were not always effective.
Staff enabled people to access health and social care support. Staff helped people to participate in activities at home and in the community.
The provider follow appropriate recruitment procedures to ensure only suitable staff were recruited to work at the service.
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 Culture
The provider's monitoring processes were not always effective in helping to ensure people consistently received good quality care and support.
There was a culture of supporting people to receive compassionate care that was tailored to their needs. Staff were supervised and felt supported by registered manager and deputy managers they could approach for advice and help. The service involved people and relatives in planning and reviewing people’s care.
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 1 November 2018).
Why we inspected
This inspection was prompted by a review of the information we held about this service.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
The overall rating for the service has changed from good to requires improvement based on the findings of this inspection. We have found evidence that the provider needs to make improvements. Please see the Safe and Well-led sections of this full report.
You can see what action we have asked the provider to take at the end of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Dimensions 4 Matlock Close on our website at www.cqc.org.uk.
Enforcement
We have identified breaches in relation to safe care, medicines management and governance at this inspection. Please see the action we have told the provider to take at the end of this report
Follow up
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.