Background to this inspection
Updated
10 January 2020
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
This inspection was carried out by one inspector and an assistant inspector.
Service and service type
This service provides care and support to people living at 43 '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 four days’ notice. This was because we needed people’s permission to call them. It is also a large service, so we needed to make arrangements for accessing people’s records.
Inspection activity started on 12 November 2019 and ended on 25 November 2019. We visited the office location on 20 November 2019.
What we did before the inspection
We contacted the quality assurance teams of three different local authorities and spoke at length with them about their experiences and professional views of the service. We reviewed the information the registered manager and provider must send us by law about the service. 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.
During the inspection
Most people were unable to talk with us. We spoke with two people, 18 people’s relatives, eight members of staff, two locality managers and the registered manager. We looked at recruitment checks of three members of staff, staff training records, complaints, and people’s care records.
After the inspection
We continued to look at people’s records which we requested to be sent securely to us, this included records of medicines, assessments, reviews and care plans. In total we looked at 15 people’s records. Team meeting records. A sample of compliments. We requested feedback from six health and adult social care professionals, we received feedback from three professionals.
Updated
10 January 2020
About the service
Dimensions Luton supports people who live in supported living services located in Bedfordshire, Hertfordshire, Cambridge, and Buckinghamshire. The service was supporting 76 people with the regulated activity of personal care.
The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.
People’s experience of using this service and what we found
We found some shortfalls with how the service was being monitored and assessed by the registered manager and the provider.
People’s relatives felt confident that people were safe in the care of staff and the service. There were good processes and systems in place to protect people from the potential risk of abuse and respond to incidents. People had risk assessments and care plans which guided staff about how to meet people’s needs. There were sufficient staff to support people and respond to their needs. People received their medicines. People’s mood controlling medicines were being managed in a way to reduce the use of these. Staff knew how to promote good hygiene in people’s homes.
Professionals spoke highly of the staff in terms of their knowledge and motivation to keep people healthy. Relatives were confident that people’s health was monitored carefully, and GP’s and other health professionals were contacted when it was needed. There were good plans to enable staff to support people who had complex needs when eating and drinking. Staff were knowledgeable about what people liked to eat and drink.
Staff were satisfied about the training they received. They felt supported by their line managers and felt comfortable about seeking direction and raising issues with them. Specialist training was proved when this was needed. Staff knew how to promote choices for people.
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.
Relatives felt staff were caring and respectful with people. Staff had a good understanding about the importance of forming caring relationships with people and to involve them in their day to day care.
Care was arranged so people’s needs were met by a regular group of staff who knew them well. People saw regular staff to promote people’s wellbeing and their need for routine. Staff supported people to fulfil their interests.
The service was making plans with people in regard to some aspects of their end of life needs, but these did not always include people’s wishes and wants at this part of their lives. We made a recommendation about this.
People would be asked their views in their yearly reviews. However, these were often late, and the service had not considered other ways of gaining people’s views of their care. Reviews often lacked details about people’s experiences or future goals. We made a recommendation about this.
There was a good culture in the staff team who spoke about putting people first and supporting them to live happy lives.
The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.
The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.
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 20 May 2017).
Why we inspected
This was a planned inspection based on the previous rating.
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.