22 September 2022
During a routine inspection
About the service
Dimensions Berkshire & Hampshire Domiciliary Care Office is a domiciliary care agency providing personal care to people in their own homes. This service provides care and support to people living in a number of 'supported living' settings, so that they can live as independently as possible. The service provides support to older people, younger adults and people with a learning disability and associated needs. 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. At the time of inspection, one person was receiving support with personal care.
People’s experience of using this service and what we found
Right Support:
¿ The registered manager did not use safe recruitment procedures to employ staff. There was a risk the person could be supported by unsuitable staff putting them at higher risk of harm.
¿ Staff supported the person with their medicines in a way that promoted their independence. However, other aspects of medicine management such as record keeping and checks needed improvement.
¿ The person had a choice about their living environment and were able to personalise their rooms. The person invited us to view their room and showed us how they sorted their rooms.
¿ The service and staff supported the person to have the maximum possible choice, control and independence, over their own lives.
¿ Staff focused on person’s strengths and promoted what they could do, so the person had a fulfilling and meaningful everyday life.
¿ The person were supported by staff to take part in activities and pursue their interests in their local area and achieve their aspirations and goals.
¿ The service worked with the person to plan for when they experienced periods of distress or anxiety and supported them to overcome it.
¿ The service made reasonable adjustments for the person so they could be fully involved in discussions about how they received support, including support to travel wherever they needed to go.
¿ Staff supported the person to make decisions following best practice in decision-making. Staff communicated with the person in ways that met their needs.
¿ Staff supported the person to play an active role in maintaining their own health and wellbeing and access specialist health and social care support in the community.
¿ We judged the person was 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. However, the policies and systems in the service had to be improved to continue supporting this practice.
Right Care:
¿ Person’s care, treatment and support plans did not always reflect their range of needs and support so staff could promote their wellbeing and enjoyment of life.
¿ The service did not always have enough appropriately skilled staff to meet person’s needs and keep them safe following best practice guidance.
¿ The registered manager assessed and reviewed risk assessments and actions of mitigation with staff’s support. They worked with the person to help them review and assess risks they might face.
¿ Person could communicate with staff and understand information given to them because staff supported them consistently and understood their individual communication needs. Staff spoke to the person politely giving them time to respond and express their wishes.
¿ Person received care that supported their needs, aspirations and was focused on their quality of life.
¿ Staff promoted equality and diversity in their support for the person. They understood person’s cultural needs and provided culturally appropriate care.
¿ Person received kind and compassionate care. Staff protected and respected person’s privacy and dignity. They understood and responded to their individual needs.
¿ Staff understood how to protect person’s from poor care and abuse. The service worked well with other agencies to do so. Staff had training on how to recognise and report abuse and they knew how to apply it.
¿ Person had opportunities to try new activities that enhanced and enriched their lives.
Right Culture:
¿ The registered manager did not always follow their quality assurance policy effectively so they could assess, monitor and mitigate any risks relating to the health, safety and welfare of the person using services, the service and others.
¿ The registered manager did not consistently maintain accurate and complete records relating to person’s care and service management.
¿ Person was able to lead inclusive and empowered lives because of the ethos, values, attitudes and behaviours of the management and staff.
¿ Staff knew and understood the person well and were responsive, supporting their aspirations to live a quality life of their choosing.
¿ Staff turnover was low, which supported the person to receive consistent care from staff who knew them well.
¿ Staff placed person’s wishes, needs and rights at the heart of everything they did.
¿ The person and those important to them were involved in planning and reviewing of their care.
¿ The person was supported by staff who understood their different range of needs or sensitivities. This meant the person received compassionate and empowering care that was tailored to their needs.
¿ The service enabled the person and those important to them to work with staff to develop the service. Staff valued and acted upon person’s views.
¿ Staff and the service ensured risks of a closed culture were minimised so that the person received support based on transparency, respect and inclusivity.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk.
Rating at last inspection
This service was registered with us on 1 December 2020 and this is the first inspection.
Why we inspected
This inspection was based on the information we held about this service. The service has not been inspected since their registration.
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, risk management, record keeping, management of medicine, staff training and competence 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.