Two adult social care inspectors carried out this inspection. At the time of this inspection Dimensions (Wakefield) was providing care and support to approximately 60 people. As part of our inspection we contacted 43 people who used the service or their relatives. We spoke with eight people who used the service and with five relatives to obtain their views of the support provided.
We also visited the agency office and spoke with five care workers and the operations director. In addition we looked at a selection of records.
We considered all the evidence against the outcomes we inspected to help answer our five key questions; is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well led?
Below is a summary of what we found. If you want to see the evidence supporting our summary please read the full report.
Is the service safe?
People who used the service and relatives told us they felt safe when the care workers were in their home and that their belongings and furniture were looked after well. Two people said, 'there is nothing I'm not happy with.'
We found risk assessments had been undertaken to identify any potential risk and the actions required to manage the risk. This meant that people were not put at unnecessary risk but also had access to choice and remained in control of decisions about their lives.
We found there was an effective recruitment procedure in place to ensure people employed were of good character and had the skills and experience necessary for the work they performed
The service had completed enhanced Disclosure and Barring Service (DBS) checks, formerly known as Criminal Records Bureau (CRB) checks for all staff working at the agency. This helped to protect people who were receiving a service.
Is the service effective?
Most people and relatives spoken with said they preferred to have regular care workers that they could get to know and who would know what care they needed. Most people said they did not always have regular care workers and this could be a problem when the care to be delivered had to be explained to different care workers.
There were mixed views from relatives we spoke with. Positives views from relatives were that the regular care workers were really good, supported their loved ones and had a good relationship with them. One relative said, 'it's more than a job [to the staff] it's like they're looking after their own daughter.'
Three relatives we spoke with were unhappy about the number of agency staff used. One relative told us, 'it makes it difficult for [family member] as agency staff have no experience of working with them. Agency staff do not have the time nor the inclination to do tasks.' Another relative told us, 'we have discussed with Dimensions the inability to maintain core staff. They always promise to get a core team in place but it always seems to fall apart.'
People who used the service and relatives said that staff, 'always turned up and were never late.'
People's health and care needs were assessed on a regular basis. We saw people who used the service and their relatives had been involved in writing plans of care and these were reviewed and updated regularly.
People who used the service and relatives told us they thought their regular care workers were experienced and well trained. Relatives did not feel that some of the agency staff were so well trained. One relative said, 'a lot of agency workers are used and things go wrong. Our [family member] needs a very restricted diet and also needs exercise and if agency staff are working they wouldn't be able to take them out as they are frightened of their disability and they can't cope.'
Is the service caring?
People who used the service told us most care workers were kind, patient, cheerful, polite and caring, especially their regular carers. Positive comments included, 'I do like living here, yes they do look after me. They [staff] help me to get dressed and prepare food,' 'it is a nice place to live' and 'nothing I'm not happy with.'
Relatives told us, 'it's been excellent and very poor. It varies a great deal due to staff moving in and out. There are some good staff and some terrible staff, so it's not a consistent service' and 'we're really happy. She's [daughter] got a lovely social life, better than she had with us. Staff help with everything from personal hygiene to preparing food. It's 24 hour care. Staff work in shifts and there's always somebody with her.'
Is the service responsive?
Relatives said they would contact the office if they had a concern or a complaint. They all knew how to contact the office. In the main relatives said they had a good relationship with office staff and managers'. One relative said, 'office staff keep us informed of meetings etc. and have told us we can contact them at any time if we have any worries or concerns.'
One relative told us they had raised a concern with a manager twice and had not been given any feedback regarding their concern. The relative said they were disappointed that no one had done anything. We fed this back to the operations director who was unaware of this concern and said he would deal with it.
Is the service well-led?
Satisfaction surveys and review meetings had been used to enable people to share their views on the service provided. This helped the provider to assess if people were receiving the care and support they needed. We found evidence to confirm people had been listened to and changes made to improve their care and support package.
When asked if there was anything about their care service they would change, the most common response was: care to be provided from regular, experienced carers and less from unknown carers (agency staff).