Archived: Dimensions Real Focus

Updated 15 July 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked 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.

The inspection took place on 30 and 31 May 2017 and was announced. The provider was given a few days’ notice because the location provides a domiciliary care service and we needed to be sure someone would be available to assist with the inspection.

The inspection was carried out by two inspectors.One visited the office for a day and met with the management team and spoke with staff and professionals. The other inspector spoke with families of people using the service.

Before the inspection we reviewed all the information we held about the provider including a provider information return. This 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.

The seven people using the service were not able to speak with us so we contacted a relative and a professional who knew them well to speak on their behalf. We had feedback from three relatives and four professionals who worked with people using the service.

The manager was not available during the inspection. We met with the Senior Behaviour Analyst and the two Applied Behaviour Analyst (ABA) supervisors. We spoke on the phone with the Regional Managing Director. The service works with five people in London and two people in Margate. Dimensions Real Focus call their staff Behaviour Therapists. We spoke with five Behaviour Therapists, (three who work in London and two who work in Margate) and a service manager on the phone. We also had contact with a locality manager in Margate.

We carried out pathway tracking where we read the risk assessments, support plans and records of service provided for four people, and checked with relatives and professionals whether the plans were being followed in practice.

We looked at staff rosters, training and supervision records, concerns and complaints, and quality assurance records.

Updated 15 July 2017

This inspection took place on 30 and 31 May 2017 and was announced. This was the first inspection of this service since it was registered in January 2015.

The service provider, Dimensions (UK) Ltd, has 70 locations registered with the Care Quality Commission. Their statement of purpose states that “REAL Focus is our intensive programme of Positive Behaviour Support to help children and young people with autism and Asperger’s syndrome develop their life skills and independence.”

Dimensions Real Focus offers personal care and specialist support to people who have a learning disability and autistic spectrum condition. The specialist support is positive behaviour support and Applied Behaviour Analysis (ABA). At the time of this inspection there were seven people receiving this service. They were all over 18 and no children were receiving a service at that time. The service was provided to people in their own homes which included living with family or in supported living.

There was no registered manager at the time of this inspection. The manager had applied for registration and this application was in progress. 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.

Staff provided a safe service. Risks to people’s safety were assessed and managed. Each person had one or two staff to support them at all times to keep them safe and enable them to go out when they wanted to.

People received person centred support from well trained staff. Staff were suitably qualified and provided with the training needed for the role. Staff felt supported by the management team.

People had good support with their health, behaviour, wellbeing, leisure activities, eating and drinking. They were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service support this practice. Where physical intervention is used this was carried out in a planned way using least restrictive methods and reviewed regularly by suitably qualified ABA supervisors.

Staff supported people to go out and do the things they enjoy as well as helping them with learning new skills and with their personal care. Senior staff monitored people’s progress in terms of their behaviour and learning new skills.

People’s families were involved in planning their support. However, we have made a recommendation that the service reviews its response to concerns in a more centralised way so this can be monitored by the provider. This is because some professionals and relatives said the service was not always responsive in a timely way.

The provider monitored the quality of the service regularly and there was ongoing improvement. There was a plan in place for developing the service and this was reviewed regularly by senior staff.