19 October 2022
During a routine inspection
Dimensions Bracknell & Surrey Domiciliary Care Office is a domiciliary care agency. The service provides support to older people, young adults, autistic people and people living with learning disability. Staff provide personal care to people living in their own homes and supported living settings. 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. At the time of the inspection 49 people using the service were receiving personal care.
People’s experience of using this service and what we found
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.
The provider was able to demonstrate how they were meeting most of the underpinning principles of Right support, right care, right culture.
Right Support:
Procedures did not always ensure suitable staff of good character were recruited to safely support autistic people or people living with learning disabilities. Risk assessments did not always assure risks to people had been mitigated.
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.
People experienced good continuity and quality of care from staff they knew well, which consistently achieved successful outcomes. There were enough staff to meet people's care and support needs. Staff had training in relation to safeguarding and knew how to report any concerns.
Staff were focused on people's strengths and promoted their independence, which meant people enjoyed an enriched and fulfilling life. People's needs were assessed, and care plans were developed with them, and their relatives where required. Where people had specialist diets, this was understood, and staff knew how to support people safely in accordance with linked positive behaviour strategies. Staff enabled people to access specialist health and social care support in the community.
Right Care:
People received kind and compassionate care from staff who protected and respected people's privacy and dignity. Staff knew people well and responded to their individual needs, promoting equality and diversity in their daily support for people. We observed warm and caring interactions between people and staff. People's communication needs were clearly explored and documented. People were supported to maintain contact with people who mattered to them and to take part in activities that were meaningful to them.
Staff engaged well with other agencies to ensure people had access to the support they needed for their healthcare and wellbeing needs. The service made referrals and liaised with other healthcare professionals when required. Staff treated people with dignity and respect.
Right Culture:
People were empowered live fulfilled and enriched lives due to the values, attitudes and behaviours of the management and staff. People experienced good quality care and support in relation to the wide range of strengths, impairments or sensitivities people with a learning disability and/or autistic people may have. People's care plans were person centred and reflected how people wanted to receive their care. Effective training and supervision enabled staff to provide compassionate and empowering care that was tailored to meet people’s individual needs. Staff knew and understood people well and were responsive, supporting their aspirations to live a quality life of their choosing. People's wishes, needs and rights were at the heart of everything staff did to support people. People and those important to them were involved in planning their care. Registered managers valued and acted upon people's views. The registered managers had developed an open culture based on mutual trust and respect, inclusivity and improvement, which enhanced the quality of people’s lives. The service ethos built on transparency, respect for equality and diversity ensured the risks of a closed culture developing were minimised.
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 (report published 20 November 2017).
Why we inspected
This inspection was prompted by a review of the information we held about this service.
Enforcement
We identified breaches in relation to recruitment, risk management and quality assurance of the service.
Please see the action we have told the provider to take at the end of this report.
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.
Follow up
We will request an action plan from the provider to understand what they will do to improve the
standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.