Archived: Dimensions Woodmere Lower Wokingham Road

Updated 16 March 2022

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 Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This included checking the provider was meeting COVID-19 vaccination requirements. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by two inspectors.

Service and service type

Dimensions Woodmere Lower Wokingham Road is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

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

This inspection was unannounced.

What we did before the inspection

Prior to the inspection we looked at all the information we had collected since the last inspection about the service including previous inspection reports and notifications the registered manager had sent us. A notification is information about important events which the service is required to tell us about by law. We sought feedback from the local authority and some professionals who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke to the registered manager and the deputy manager. We observed interactions between staff and people living at the service and briefly spoke to three people who use the service. We gathered feedback from four staff members. We reviewed a range of records relating to the management of the service, for example, records of medicine management, risk assessments, accidents and incidents; quality assurance system; and maintenance records. We looked at five people's care and support plan and associated records. We looked at two staff files in relation to recruitment. 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 registered manager to validate evidence found. We looked at further records and evidence including quality assurance records, incidents and accidents, training data, and policies and procedures. We sought feedback from six more staff members. We contacted all relatives and spoke with three relatives about their experience of the care provided. We contacted seven professionals who work with the service and received three responses.

Updated 16 March 2022

About the service

Dimensions Woodmere Lower Wokingham Road is a care home (without nursing) which is registered to provide a service for up to six people with learning disabilities. There were five people living in the home on the day of the inspection. Dimensions Woodmere Lower Wokingham Road accommodates people in a large adapted building. Three people had their own flats and two people shared a flat.

People’s experience of using this service and what we found

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.

The service was able to demonstrate how they were meeting most parts of the underpinning principles of Right support, right care, right culture. However, some improvements are required. The model of care is satisfactory; it ensured that people could live their lives how they chose and as an individual member of society. The staff supported people to have choice and control in their life. The care was person-centred and promoted people's dignity, privacy and human rights. The staff and the registered manager worked in a positive way to ensure that people received good care.

Effective recruitment processes were not in place to ensure, as far as possible, that people were protected from staff being employed who were not suitable. The management of medicines and premises was not always safe. Not all staff were up to date with, or had received, their competency checks and mandatory training. Risks to people's personal safety had been assessed. However, action was not always taken to reduce the risks where possible and the plans were not always in place to minimise those risks.

Quality assurance systems in place were not effective in ensuring compliance with the fundamental standards and identifying when the fundamental standards were not met. When incidents or accidents happened, it was not always clear that it was investigated, and lessons were learnt. The registered person did not inform us about notifiable incidents in a timely manner. The registered person did not ensure that clear and consistent records were kept for people who use the service and the service management.

We have made a recommendation about seeking guidance from a reputable source to ensure the principles of the Accessible Information Standard were met.

Relatives felt their family members were kept safe in the service. Professionals also felt people who use the service were supported well. Relatives told us they felt they could approach the management and staff with any concerns and that communication was good. The staff members felt staffing levels were sufficient to do their job safely and effectively. The registered manager appreciated staff contributions to ensure people received the best care and support. Staff felt the registered manager was managing the service well, and they could approach the registered manager for any advice, help or support. The registered manager and staff understood their responsibilities to raise concerns. There was an emergency plan in place to respond to unexpected events and the premises and equipment were kept clean.

During the pandemic, the registered manager continued working with the staff team to ensure they provided caring and kind support consistently. Staff had ongoing support via regular supervision and appraisals. They felt supported and maintained great teamwork. The staff team recognised and responded to changes in people’s needs and ensured a timely response from different professionals. People received effective care and support from staff who knew them well. People enjoyed the food and could choose what they ate and where to eat. People had their healthcare needs identified and were able to access healthcare professionals such as their GP.

People, their families and other people that mattered were involved in the planning of their care. People were encouraged to live a fulfilling life with activities of their choosing as much as possible and were supported to keep in contact with their families.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

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 6 August 2018).

Why we inspected

This was a planned inspection based on the previous rating.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Enforcement and Recommendations

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to quality assurance; notification of incidents and management changes; record keeping; management of medicine; and staff training, supervision and recruitment. We have made a recommendation about meeting the Accessible Information Standard.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.