Dimensions Somerset The Old Police House

About the service

Dimensions Somerset The Old Police House is a residential care home providing personal care to five people at the time of the inspection. The service can support up to eight people.

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

This service was able to demonstrate how they were meeting the underpinning principles of right support, right care, right culture.

Right Support

Staff supported people with their medicines. Some improvements were needed to the way medicines were checked in, and when staff needed to make handwritten amendments to people’s medicines administration charts. This had already been identified by the registered manager.

Staff supported people to have the maximum possible choice, control and independence and to be in control over their own lives; the policies and systems in the service supported this practice.

People were supported to be involved in decisions about their care and support. Staff were observed communicating with people in ways that met their needs and supporting people to make choices.

Staff focused on people’s strengths and promoted what they could do, so people had a fulfilling and meaningful everyday life.

Staff supported people to be occupied at home and pursue interests in their local area if they enjoyed this. People were starting to return to activities that had been paused during the pandemic.

The service gave people care and support in a safe, clean and well-equipped environment that met their sensory and physical needs.

People benefitted from an interactive and stimulating environment. An immersive room had recently been added to the home which provided a multi-sensory experience for people.

People had a choice about their living environment and people’s rooms were observed to be personalised to them.

Staff worked with health professionals to achieve good health outcomes and to avoid people taking unnecessary medicines.

Infection control procedures and measures were in place to protect people from infection control risks associated with COVID-19.

Right Care

People’s care plans and risk assessments reflected their range of needs and this promoted their wellbeing and enjoyment of life. Some risk assessments were found not to have been reviewed. This had already been identified by the registered manager.

People received kind and compassionate care. Staff protected and respected people’s privacy and dignity. They understood and responded to their individual needs. Throughout the inspection we observed kind, relaxed, compassionate and caring interactions between people and staff.

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.

The service had enough appropriately skilled staff to meet people’s needs and keep them safe.

People could communicate with staff and understand information given to them because staff supported them consistently and understood their individual communication needs.

People who had individual ways of communicating, using body language, sounds and pictures interacted comfortably with staff and others involved in their care. This was because staff had the necessary skills to understand them.

Right culture

People received good quality care and support because trained staff could meet their needs and wishes. At the last inspection people with specific health needs were not always being supported by staff who had received up to date training from professionals on specialist techniques. Despite communication with various other professionals to source the training, the service has not yet been able to obtain this.

People led inclusive and empowered lives because of the ethos, values, attitudes and behaviours of the management and staff. Throughout the inspection we observed that staff were respectful of people and took time to offer support and reassurance when needed.

Staff knew and understood people well and were responsive, supporting their aspirations to live a quality life of their choosing.

Staff placed people’s wishes, needs and rights at the heart of everything they did. Staff told us that they “Make [people] the centre of everything they do”.

Staff valued and acted upon people’s views and understood how these were expressed through observations, body language and how people presented themselves.

People and those important to them were involved in planning their care.

The staff, registered manager and peripatetic assistant locality manager were open and transparent throughout our inspection. The registered manager and peripatetic assistant locality manager acted efficiently on queries and feedback throughout the inspection.

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

Rating at last inspection

The rating at the last inspection was Good. (Published August 2018)

Why we inspected

We undertook this inspection to assess that the service is applying the principles of Right support right care right culture.

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.

This report only covers our findings in relation to the Key Questions Safe and Well-led. For those key questions not inspected, we used the ratings awarded at the last inspection, that rated those

key questions, to calculate the overall rating. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Dimensions Somerset The Old Police House on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Dimensions Somerset The Old Police House is a ‘care home’. 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 The Old Police House provides care and accommodation for up to eight people who ¿have a learning disability and other complex health needs. It is operated by Dimensions Somerset ¿Sev Limited, part of a national not for profit organisation providing services for people with ¿learning disabilities, autism and complex needs. Five people were living in the home at the time of ¿our inspection.¿ Some of the people we met were able to verbally communicate with us and others were not. Their opinions were captured through observations, interactions they had with staff and their reactions.

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. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

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.

People told us and indicated they felt safe living at The Old Police House. One relative told us, “If I didn’t think [the person] was safe I would remove them from the home.”

There were processes and practices in place to keep people safe. The provider had a robust recruitment programme which meant all new staff were checked to ensure they were suitable to work with vulnerable people. All staff had received training in safeguarding vulnerable people and children. All staff spoken to were able to tell us what they would look for and how they would report anything they thought put people at risk of harm or abuse.

However we did find that one person could be at risk of burns from water pipes in a cupboard they used should the pipes become hot. During the inspection the pipes were cold. The registered manager took immediate action to find them alternative storage. We also found that some staff had been shown different ways of carrying out a medical procedure. Following the inspection the registered manager confirmed they had arranged for up to date training for all staff.

People received effective care and support from staff who had the skills and knowledge to meet their needs. All staff attended an induction which included the companies’ mandatory training before they started to work with people. However one member of staff had not completed the practical hoist training which meant they had to be supervised by other staff. Staff also received training about the specific needs people had for example, the safe management of epilepsy.

People who were able told us, and we saw, they were cared for by kind and caring staff some of whom went over and above what was expected of them. Staff respected people’s privacy and dignity at all times. Relatives told us they were kept involved in the persons care and they could express an opinion about the care provided and contribute to their care plans.

People received responsive care and support which was personalised to their individual needs and wishes. There was clear guidance for staff on how to communicate with people and how to know when a person was not happy or distressed. The registered manager confirmed that they would only take people if they felt they could meet their needs. For example, one of the empty rooms was upstairs and they were assessing people who would be able to manage the stairs. People were supported to access health care services and see healthcare professionals when necessary.

People were supported by a team that was well led. Everybody spoken to said they thought the service was well led. Staff and people’s relatives said the registered manager was open and approachable. However relatives were anxious about the changes being made by the new providers. The registered manager had arranged for the provider to meet with relatives to allay some of their fears. However relatives told us they felt the changes could be detrimental to their relatives care. One relative said, “I am concerned the changes are not going to be for the better and that will mean staff leaving and lots of changes in the management of the home.” Another relative said, “Although there have been a lot of changes the excellent care has continued. [The person] is looked after by a marvellous team and they have ensured the care they provide has not been affected at all.”

There were systems in place to monitor the quality of the service, ensure staff kept up to date with good practice and to seek people’s views. Records showed the service responded to concerns and complaints and learnt from the issues raised. The provider learnt from issues raised at CQC inspections at other services in the organisation and shared them with the registered managers to ensure improvement was on-going and cascaded through the organisation. The registered manager closely monitored the progress being made in the home with the adoption of the new working practices and kept staff informed.