Dimensions Hertfordshire Domiciliary Care Office

Updated 18 November 2022

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 Health and Social Care Act 2008.

Inspection team

The inspection was completed by one inspector and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there were two registered managers in post.

Notice of inspection

We gave the service 48 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. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with three people and eight relatives about their experience of the care provided. We spoke with 14 members of staff including the registered manager, operations manager and care workers. Not all people who used the service were able to talk with us and they used different ways of communicating including using Makaton, gestures and their body language. We adapted our communication styles by using sign language, as well as making observations of people's responses to communicate with them.

We reviewed a range of records. This included care records and medication records. We looked at four staff files in relation to recruitment, and a variety of records relating to the management of the service.

Updated 18 November 2022

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

About the service

Dimensions Hertfordshire Domiciliary Care Office is a domiciliary care agency providing personal care to 24 people at the time of the inspection.

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.

People’s experience of using this service and what we found

Right Support

Care plans focused on people's strengths and started to build on people’s goals and long term aspirations.

Staff supported people with their medicines in a way that promoted their independence and achieved the best possible health outcome, however there was further development needed to the, 'as and when required' medicine protocols.

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.

Staff supported people to play an active role in maintaining their own health and wellbeing and enabled people to access specialist health and social care support in the community.

Right Care

The provider did not ensure staff met the government guidance when adhering to safe infection prevention control practices.

The provider made sure that there was enough skilled staff to meet people's needs and keep them safe, as well as ensuring their met best practice guidance. Staff had training specifically for learning disability and autism and this was something that the provider planned to continue developing.

Staff understood how to protect people 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.

Right Culture

Professionals spoke highly about the responsiveness of staff, however they felt that the communication with the management needed to improve.

Staff felt supported and the management team were always available. The registered manager had a good understanding of their responsibilities towards people they supported and had passion in delivering person-centred care.

The provider had quality assurance systems in place, which ensured they were capturing the good practices as well as where improvements were needed.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

This service was registered with us on 01 September 2021 and this is the first inspection.

Why we inspected

This inspection was the first inspection since the location was registered.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.