Background to this inspection
Updated
1 March 2019
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
This inspection took place on 15 January 2019 and was unannounced.
It was carried out by one adult social care inspector and one assistant inspector.
The provider had not completed a Provider Information Return (PIR) because we had not requested one. The PIR is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We looked at other information we held about the service and provider before the inspection visit.
We spoke informally with two people who used the service because they had limited verbal communication. Instead we spent time with others carrying out observations. We spoke with the registered manager and three members of staff. Following the inspection, we spoke with three relatives on the telephone.
We looked at three people’s care records in various depths. We observed care and support in communal areas. We looked at two staff files, information received from the provider, staff rotas, quality assurance audits, staff training records, the complaints and compliments system, medication files and environmental files.
During the inspection we asked for further information including quality assurance documents and follow ups to some things we found. We received all this information in the time scales given and the information has been included in the report.
Updated
1 March 2019
This inspection took place on 15 January 2019 and was unannounced. This is the first inspection for the location under this new provider.
Dimensions Somerset Amberleigh is a ‘care home’ which provides short stay opportunities and emergency placements for people with learning disabilities and autism. 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 Amberleigh accommodates up to six people at one time. At the time of inspection there were 17 people using the service for either regular short stays or emergency placements. Most of the people we met had limited verbal communication due to complex and profound needs. Their opinions were captured through observations, interactions they had with staff and their reactions when we spoke with them. People were accommodated across two floors with multiple communal spaces on the ground floor. Each person had a bedroom which was personalised with their belongings whilst staying at the home. People were free to move around the home if they could. During the inspection we were informed the provider had announced the service was closing.
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.
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.
Improvements were required around how medicines were managed. Temperatures for medicine storage was monitored to ensure medicines were not damaged. Staff had received medicine management training. However, liquid medicines were not always measured accurately and some records were not completed in a way to prevent mistakes. When people’s needs had changed between stays the needs and potential new risks had not always been considered.
People appeared comfortable in the presence of staff and were smiling during interactions. Relatives thought their family members were safe whilst staying at the service. Most risks had been identified and ways to minimum them had been considered. Health and safety checks were being completed by staff and external agents. When concerns had been identified action was being taken.
The management had been working on developing 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 service.
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. This included specialist training to meet people’s specific needs. Links had been developed with health professionals if people required access to them.
People were supported to have choice and control over their lives. 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. Those requiring specialist diets had their needs met in line with current best practice.
Care and support was personalised to each person which ensured they could make choices about their day to day lives. Care plans contained information about people’s needs and wishes and staff were aware of them. These were in the process of being updated in line with people’s changing needs. Staff knew how to recognise when people were getting upset and relatives knew how to complain. There was a system in place to manage complaints.
We observed people were supported by kind and patient staff. People’s privacy and dignity was respected by staff. 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.