Dimensions South Yorkshire (South) Domiciliary Care Office received an overall rating of Good across all five key questions at its first CQC inspection in January 2023, supporting 53 people with learning disabilities in supported living settings. Minor shortfalls were identified in PRN medication protocols, copy-pasted risk assessments, staff understanding of mental capacity, and some outdated care plans, but these were promptly acknowledged by the provider.
Concerns (5)
moderateCare planning: “some risk assessments referred to other people rather than the person whose assessment it was, indicating it may have been "cut and pasted" from another person's risk assessment.”
moderateMedication management: “although some of these medicines had protocols, this was not the case for all of them. The provider told us they would address this when we raised it.”
moderateConsent / capacity: “we found some staff did not have a good understanding of what capacity meant. The registered managers confirmed they would address this and check staff's knowledge.”
minorRecord keeping: “some did not appear to have been reviewed for some time, meaning it was not clear whether people's preferences had changed.”
minorCommunication with families: “a small number of relatives told us they did not always feel engaged and felt there was a high turnover of staff and managers.”
Strengths
· Staff promoted equality and diversity and provided culturally appropriate care; relatives described their loved ones as well looked after and happy.
· Safe recruitment practices were followed and enough staff were deployed to meet people's needs, including one-to-one support where required.
· Staff had thorough inductions including two weeks shadowing, regular supervision, and a broad range of training refreshed to keep knowledge up to date.
· People were supported to access a wide range of community activities, employment, and social events, actively avoiding social isolation.
· Care plans contained detailed communication assessments including idiosyncratic gestures, signs and symbols, reflecting the Accessible Information Standard.
Quality-Statement breakdown (22)
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Assessing risk, safety monitoring and management; Learning lessons when things go wrongGood
safe: Staffing and recruitmentGood
safe: Using medicines safelyGood
safe: Preventing and controlling infectionGood
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawGood
effective: Staff support: induction, training, skills and experienceGood
effective: Supporting people to eat and drink enough to maintain a balanced dietGood
effective: Staff working with other agencies to provide consistent, effective, timely careGood
effective: Supporting people to live healthier lives, access healthcare services and supportGood
effective: Ensuring consent to care and treatment in line with law and guidanceGood
caring: Ensuring people are well treated and supported; respecting equality and diversityGood
caring: Supporting people to express their views and be involved in making decisions about their careGood
caring: Respecting and promoting people's privacy, dignity and independenceGood
responsive: Planning personalised care to ensure people have choice and control and to meet their needs and preferencesGood
responsive: Meeting people's communication needsGood
responsive: Supporting people to develop and maintain relationships to avoid social isolationGood
responsive: Improving care quality in response to complaints or concernsGood
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringGood
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirements; Continuous learning and improving careGood
well-led: Engaging and involving people using the service, the public and staffGood