17 May 2018
During a routine inspection
Dimensions Somerset Selwyn House is a ‘care home’ which provided short stay opportunities and emergency assessment placements. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
Dimensions Somerset Selwyn House accommodates up to eight people at one time. At the time of inspection there were 18 people using the service for either regular short stays or emergency assessments. Some of the people we met were able to verbally communicate with us and others were not. Their opinions were captured through observations, interactions they had with staff and their reactions. People were accommodated across two areas. One area for people with more complex needs and the other for more able people. Each person had a bedroom which was personalised with their belongings whilst staying at the home. There were communal spaces including a kitchen, dining room and lounges. There was a garden area and people were free to move around the home if they were able to.
“The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen”. Registering the Right Support CQC policy
At the time of the inspection there was a registered manager in place. 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.
People told us they were happy and others appeared comfortable in the presence of staff. Those able to tell us and one relative told us they were kept safe. Most medicine was managed safely. Temperatures for medicine storage needed to be monitored to ensure medicines were not damaged. Risk assessments were carried out to enable people to retain their independence and receive care with minimum risk to themselves or others. Health and safety checks were being completed by staff and external agents.
The management had developed positive relationships with people, their families and other professionals. There were enough staff to keep people safe including using regular agency staff. People’s needs led the allocation of staff numbers. Recruitment systems were in place to reduce the risk of inappropriate staff working at the home.
People were protected from potential abuse because staff understood how to recognise signs of abuse and knew who to report it to. When there had been accidents or incidents systems were in place to demonstrate lessons learnt and how improvements were made. Staff had been trained in areas to have skills and knowledge required to effectively support people. People had their healthcare needs met and staff supported them to see other health and social care professionals. When changes were identified to manage health needs staff liaised with health professionals.
People were supported to have choice and control over their lives and staff supported them in the least restrictive way possible. When people lacked capacity decisions had been made on their behalf following current legislation. People were supported to eat a healthy, balanced diet and had choices about what they ate. Small improvements were made during the inspection to ensure people on specialist diets had their needs met in line with current best practice.
Care and support was personalised to each person which ensured they were able to make choices about their day to day lives. Care plans contained a wealth of information about people’s needs and wishes and staff were aware of them. These were updated in line with people’s changing needs. People were listened to when they were upset and knew how to complain. There was a system in place to manage complaints.
People and one relative told us, and we observed, that staff were kind and patient. People’s privacy and dignity was respected by staff. Their cultural or religious needs were valued. People, or their representatives, were involved in decisions about the care and support they received.
The service was well led and shortfalls identified during the inspection had mainly been identified by the management. There was a proactive approach from the management and provider and additional scrutiny was being sourced from external agencies. The provider had completed statutory notifications in line with legislation to inform external agencies of significant events.