Archived: Dimensions Dorset West Domiciliary Care Office

Dimensions Dorset West Domiciliary Care Office provides care and support to people with learning disabilities and autistic people who live in their own homes. It is registered to provide personal care. At the time of the inspection the service was delivering personal care to 21 people. Most people lived in their own home; some people house shared with up to two other people. Where staff slept in to ensure people were safe overnight, they had a private space to do so in people’s spare rooms. Staff did not have allocated space that people could not access in their homes. Staff worked in teams focussed on the support of individual people. People lived in their own home, or shared a home with up two other people who they got on well with.

In 'supported living' settings 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.

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.

People’s experience of using this 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 assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

Right Support:

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. Restrictions were reviewed and creative solutions sought to reduce their use.

Staff sought opportunities for people to increase their opportunities for choice and control through environmental and equipment changes, improved communication tools and strategies and skill development. This meant people were in control of most aspects of their day to day life.

Staff maintained exceptional focus on people’s strengths and promoted what they could do, this meant people had a fulfilling and meaningful everyday life and opportunities for new experiences.

People were supported to achieve their aspirations and pursue their interests. Staff worked collaboratively with people and their circles of support to review progress and find solutions to obstacles. This had led to people achieving goals they were rightly very proud of.

Staff worked creatively with people to plan for when they experienced periods of distress so that their freedoms were restricted only if there was no alternative.

All restraint and restrictions were recorded and reviewed. Staff learned from these incidents and actions were taken to reduce the chances of people becoming distressed.

The staff worked collaboratively with people, their families and professionals to ensure they had housing that met all their needs including sensory and physical needs. For people with very complex needs who caused damage to property when they were distressed this reduced the likelihood that they might lose their home and support. Where people had not yet secured appropriate housing staff advocated strongly on their behalf.

Staff enabled people to access appropriate health care. Staff supported people to play an active role in maintaining their own health and wellbeing. Staff worked collaboratively with professionals and families and sought creative solutions to reduce the impact of health inequalities.

Staff sought every opportunity to support people to make decisions. Staff used people’s preferred communication methods and style to optimise their choices, control and connections.

Staff supported people with their medicines in a way that promoted their independence and achieved the best possible health outcome.

Right care

Staff were all respectful. They understood people’s cultural needs and provided culturally appropriate care and support respecting family traditions, and ways of living and communicating.

People received extremely kind and compassionate care. Staff valued and respected the person/people they worked with and this meant they always protected and respected people’s privacy and dignity.

Staff understood how to protect people from poor care and abuse. The service worked well with other agencies to do so. Staff had training on how to recognise and report abuse and they knew how to apply it.

The service had enough appropriately skilled staff to meet people’s needs and keep them safe.

People could communicate with staff and understand information given to them because staff supported them consistently and understood their individual communication needs.

People who had individual ways of communicating, using body language, sounds, Makaton (a form of sign language), pictures and symbols could interact comfortably with staff because staff had the necessary skills to understand them.

People’s support plans were exceptionally detailed and personalised and reflected their range of needs and this promoted their wellbeing and enjoyment of life. Staff knew people very well and spoke confidently about these needs without reference to the documentation.

People could take part in activities and pursue interests that were tailored to them. The service gave people opportunities to try new activities that enhanced and enriched their lives.

People, families, professionals and staff collaborated to seek solutions that reduced risks people might face. Where appropriate, staff encouraged and enabled people to take positive risks.

Right culture

People led inclusive and empowered lives because of the ethos, values, attitudes and behaviours of the management and staff. The management structure had been created to support the organisation’s ethos, values, attitudes and behaviours.

People were absolutely at the centre of collaborative and respectful circles of support. Staff valued the knowledge and experience of people’s relatives and held them in high regard.

People were supported by staff who understood how best to support them as individuals. This meant people received compassionate and empowering support that was tailored to their needs. This support was rooted in a culture of transparency, respect and inclusivity.

Staff were extremely well supported and this reduced staff turnover. This supported people to receive consistent care from staff who knew them well.

Staff placed people’s wishes, needs and rights at the heart of everything they did. They valued the involvement of families and professionals. The management team enabled people, and families, to worked with staff to develop the service. Staff valued and acted upon people’s views.

Staff evaluated the quality of support provided to people. They involved people, their families and other professionals in a variety of ways in this process. People’s quality of life was enhanced by the service’s culture of ongoing improvement and inclusivity.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

This service was registered with us on 1 September 2021 and this is the first inspection.

Why we inspected

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

Follow up

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