Dimensions 1 Michigan Way

Updated 20 December 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

This inspection was carried out by one inspector.

Service and service type

Dimensions 1 Michigan Way is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Dimensions 1 Michigan Way is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

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 was a registered manager in post.

Notice of inspection

We gave the service 48 hours’ notice of the inspection. This was because it is a small home and we needed to be sure that the provider or registered manager would be in the office to support the inspection.

Inspection activity started on 28 October 2022 and ended on 14 November 2022. We visited the location’s service on 28 October 2022 and 3 November 2022.

What we did before the inspection

We reviewed information we held about the home and contacted the local authority. 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 two relatives about their experience of the care provided.

We received feedback from eight members of staff including the registered manager and the nominated individual. The nominated individual is responsible for supervising the management of the home on behalf of the provider. We received written responses from three health and social care professionals.

We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We reviewed a range of records. This included three people's care and support records and two people’s medicine administration records. We looked at three staff files in relation to recruitment and training. We also reviewed a variety of records relating to the management of the home, including policies and procedures, staffing rotas, accident and incident records, safeguarding records and reports.

Updated 20 December 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 1 Michigan Way is a residential care home providing personal care to up to five people. The home is registered to support people who have learning disabilities or autism. The property provides ground floor accommodation and has been adapted to meet the needs of people who may also be living with physical disabilities. At the time of our inspection there were five people using the service.

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

Right Support:

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice. People received care and support in a clean and well-equipped environment that met their physical needs. Staff understood people and their individual needs well. Staff provided kind, caring, person-centred care and support. Staff communicated with people in ways that met their needs. Staff enabled people to access specialist health and social care support in the community. People and their relatives were able to personalise their bedrooms.

Right Care:

Support plans were detailed, and person-centred ensuring people were supported to live full, active lives and encourage them to be as independent as possible. The home had enough staff to keep people safe.

Staff had training on how to recognise and report abuse and they knew how to apply it. Staff employed by the home and agency staff received a robust induction and had specialist training to help them support people.

Right Culture:

The provider's monitoring processes were not always effective in helping to ensure people consistently received good quality care and support. Staff turnover had been high, which meant people were supported by agency staff. Permanent and regular agency staff knew and understood people well and were responsive to their needs. People and those important to them, were involved in planning their care. The registered manager demonstrated joint working with health professionals which provided specialist support to people, involving their families and other professionals as appropriate. Staff demonstrated good understanding around providing people with person centred care and spoke knowledgably about how people preferred their care and support to be given.

Rating at last inspection

The last rating for this service was good (published 18 November 2017).

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

Why we inspected

The inspection was prompted in part due to concerns received about staffing levels. A decision was made for us to inspect and examine those risks. We undertook a focused inspection to review the key questions of safe, effective and well-led only.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

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.

The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

Enforcement

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.

We have identified breaches in relation to safe care and treatment, upholding people’s rights and good governance at this inspection.

Please see the action we have told the provider to take at the end of this report.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

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.