Background to this inspection
Updated
17 October 2019
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
The inspection was carried out by one inspector.
Service and service type
Dimensions Kent Limited is a domiciliary care agency. It provides personal care to people living in their own flat. The service was also a supported living service. It provides care and support to people living in seven 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
This inspection was announced.
We gave the service 72 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and 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 with two people who used the service and five relatives about their experience of the care provided. We also saw how staff interacted with people in three people’s homes, as these people were not able to speak to us about their experiences. We spoke with eight members of staff including two locality managers, two assistant locality managers, three support staff and the regional assistant.
We reviewed a range of records. This included three people’s care records and two people’s medication records. We looked at one staff recruitment record and the staff training matrix. We also viewed a variety of records relating to the management of the service, which included audits, records of meetings, incidents and surveys.
After the inspection
We spoke with the registered manager as they were not available on the inspection visit. We discussed their role and improvements to the service since the last inspection.
Updated
17 October 2019
About the service:
Dimensions is a domiciliary care and supported living service providing personal care to 14 people in their own homes. People receiving care included people with a learning disability, autism, physical disability and people who may present in a different way due to their anxieties. The person using the domiciliary care service received care and support at agreed times when they needed it. Everyone in the supported living service required 24-hour support due to their complex needs.
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.
People’s experience of using this service:
There was a strong, visible person-centred culture. Developing positive and trusting relationships with people were at the heart of the service. A relative told us, “It is a homely environment. The place has a positive feeling and staff a positive attitude which my relative enjoys and it keeps their spirits up”. Staff went the ‘extra mile’ in providing kind and compassionate care. Good news stories were valued and shared and helped to ensure that people lived fulfilling lives.
Packages of care were tailored to meet people’s complex needs which meant people had choice, flexibility and continuity of care. People were supported to aspire to long- and short-term goals which improved their quality of life. Relatives described the service as ‘proactive’ and offering ‘stimulation’ to people.
People felt safe as they knew which staff were coming to support them and risks to their well-being had been reduced. Staff had a good understanding of people and used strategies to help promote their strengths and reduce anti-social behaviours.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.
People benefitted from being supported by staff who had the right skills and training to meet their needs. Staff understood how to follow guidance about people’s complex health and medical needs.
The service continued to be well-led and meet its values of ambition, courage, integrity, partnership and respect. People, relatives and staff had a voice in the running of the service. Strong working partnerships had been formed with a variety of health care professionals and local and national organisations. Everyone said they would recommend the service to others.
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 Outstanding (published 28 December 2016).
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
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.