Background to this inspection
Updated
22 July 2021
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 Care Act 2014.
Inspection team
The inspection was carried out by an inspector, an assistant 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
This service provides care and support to people living in ‘supported living’ settings, so that they can 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; this inspection looked at people’s personal care and support.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
We gave a short period notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection and we wanted to speak with people and the provider needed to gain people’s consent.
Inspection activity started on 10 May 2021 and ended on 21 May 2021. We visited the office location on 10 May 2021.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all of this information to plan our inspection.
During the inspection
We spoke with six people who used the service and four relatives about their experience of the care provided. We spoke with eleven members of staff including the registered manager, locality managers and care workers.
We reviewed a range of records. This included four people’s care records and medication records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records.
Updated
22 July 2021
About the service
Dimensions Midlands Domiciliary Care Office is registered to provide personal care services to people in their own homes or in supported living settings. At the time of inspection 37 people were receiving the regulated activity. Most people lived in their own property with a small number sharing with other people or living with their families.
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.
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 using this service and what we found
Improvements were needed to the providers governance of infection prevention and control and monitoring of care records. Although managers confirmed checks were in place there were no records of what had been checked and any issues identified. This increased the risk of people receiving inconsistent care. People told us they felt safe and were able to approach managers with any concerns.
Checks on medication were in place, however we did find some gaps in recording of prescribed creams. Staff had received training in relation to infection control, but some staff were not aware of the correct order to don and doff PPE.
Staff received training in safeguarding and knew how to recognise and report signs of abuse. The service ensured accidents and incidents were recorded and reviewed to improve care and lessons learned were shared across the service.
We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.
This service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture. People told us how they were supported to make choices about their care and where they lived. Care was person centred and individualised to each person.
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 03 September 2019).
Why we inspected
The inspection was prompted in part by notification of a specific incident following which a person using the service died. This incident is subject to a criminal investigation. As a result, this inspection did not examine the circumstances of the incident.
The information CQC received about the incident indicated concerns about the management of fire risks. This inspection examined those risks. We undertook a focused inspection to review the key questions of safe and well-led only.
We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe and well led sections of this report.
We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.
The overall rating for the service has changed from Good to Requires Improvement. This is based on the findings at this inspection.
We have found evidence that the provider needs to make improvement. Please see the safe and well led sections of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Dimensions West Midlands Office on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.