Background to this inspection
Updated
16 June 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.
The inspection took place on 17, 19 and 23 April 2018 and was announced. We gave the service 48 hours notice of the inspection visit because the location provides a domiciliary care service to people who are often out during the day. We needed to be sure that they would be available to speak to us.
The inspection team included two inspectors and an expert by experience. An expert by experience is someone who has personal experience of using or caring for someone who uses this type of care service. The expert by experience's area of expertise was care of older people who use regulated services.
Before the inspection we spoke with two social workers from the local authority safeguarding team. We also reviewed key information before the inspection. We asked the provider to complete a provider information return (PIR). This is a document which gives information about the service such as what they do well and what improvements they plan to make. We also reviewed any notifications sent to us. By law, a provider must inform CQC of any significant events by sending a notification.
As some people were unable to communicate verbally, we observed four people receiving care in their own homes. We spoke with four people who received care and support and four relatives. We also spoke with the registered manager, five locality managers, two assistant locality managers and four members of staff. We reviewed records relating to people’s care and support including care plans, health records and medicines administration records. We also reviewed the provider’s policies and procedures on health and safety, lone working and the management of medicines as well as staff training records and recruitment files, and the provider’s service improvement plans. Following the inspection we reviewed further records sent to us by the provider, including staff meeting minutes and staff rotas.
Updated
16 June 2018
The inspection took place on the 17, 19 and 23 April and was announced. This was to ensure people, staff and relatives we needed to speak to would be available.
Dimensions Hampshire Domiciliary Care Office provides personal care and support for people living in their own homes across the county of Hampshire. This included supported living housing arrangements, with shared tenancies and sometimes 24 hour care support. At the time of our inspection, the service supported 124 people with personal care
At our last inspection we rated the service Good. At this inspection we found the evidence continued to support the rating of Good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.
The provider had shared concerns with the CQC regarding allegations of abuse of people by staff. These had been reported to the local authority by the provider and investigated by the provider and local authority. The staff responsible for the abuse had been immediately removed from the service. We visited people and inspected the service to ensure that these actions had been carried out. The provider had taken prompt action in response to safeguarding concerns and had implemented an action plan to ensure people’s safety and protect them from further abuse.
People were protected from harm or abuse from appropriately trained staff who used the providers’ robust reporting systems. Risks to people were assessed and managed safely by appropriately trained staff. People were supported to access their preferred activities, develop skills and have maximum control and choice in their lives so that their independence was promoted and their freedom respected. Sufficient numbers of staff were deployed to meet people’s needs and there were safe practices in place to ensure that people received medicines safely.
People 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.
People were supported according to their needs, choices and preferences by appropriately trained staff. Most care plans and risk assessments were regularly reviewed and updated. We found some examples of care plans which had not been reviewed on the specified dates. We raised this with the provider who then made arrangements to complete the reviews. Care plans accurately reflected people’s needs. Staff liaised effectively with healthcare professionals to support people’s health and wellbeing.
People received consistent support from caring staff who knew them well and treated them with respect. Staff encouraged and supported people to be involved in making decisions about their care.
People received personalised support which met their needs and preferences and developed their abilities. The provider had a complaints policy and people were supported to express their views. Arrangements were in place to provide care and support for people nearing the end of their lives. Assessments were recorded in people’s care plans.
The provider demonstrated an inclusive, person centred approach to delivering care which was understood and shared by staff. Effective systems were in place for monitoring the quality of care provided. Audits were used to identify improvements and drive service development. Feedback was regularly gathered from people and their relatives and used to drive service improvements.
Further information is in the detailed findings below.