Dimensions 1 Michigan Way is located in a residential area and provides accommodation, care and support to a maximum of five people with a learning disability. The service provides support to mainly older adults.

This inspection took place on 19 September 2017 and was unannounced. There were five people living in the home.

The service had a registered manager in post. A registered manager is a person who has registered with 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.

There was a friendly atmosphere in the home and staff supported people in a kind and caring way that took account of their individual needs and preferences.

Staff understood how to identify, report and manage any concerns related to people’s safety and welfare. There were systems and processes in place to protect people from harm, while promoting their independence.

Safe recruitment practices were followed and appropriate checks had been undertaken, which made sure only suitable staff were employed to care for people in the home.

There were suitable systems in place to ensure the safe storage and administration of medicines. Medicines were administered by staff who had received appropriate training and competency assessments.

People were supported by staff who had received an induction into the home and appropriate training, professional development and supervision to enable them to meet people’s individual needs.

Staff followed legislation designed to protect people’s rights and ensure decisions were the least restrictive and made in their best interests.

People were supported to eat and drink enough to meet their needs and to make informed choices about what they ate.

People and their relatives or representatives were involved in planning the care and support provided by the service. Staff listened to people and understood and respected their needs and wishes.

The service was responsive to people’s needs and there were systems in place to help ensure any concerns or complaints were responded to appropriately. Healthcare professionals were involved in people’s care when necessary.

The provider and the registered manager were promoting an open and inclusive culture and continued to look for ways to improve the service. There was a range of systems in place to assess and monitor the quality and safety of the service and to help ensure people were receiving appropriate support.

The inspection of 1 Michigan way took place on 22 and 23 February 2016 and was unannounced.

Dimensions are a specialist provider of a range of services for people with learning disabilities and people who experience autism. This service provided care and support for up to five people with a learning disability. At the time of our inspection there were four people using the service. Their home is a single storey building, consisting of five bedrooms, a dining and kitchen area, a laundry room and a level access shower room. The home is fully accessible to wheelchair users. The home has a large accessible garden with parking to the front.

At the time of our inspection the registered manager was not overseeing the day to day running of the service. The provider had put interim management arrangements in place while they recruited a registered manager. 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.

We found improvements were required with the quality assurance system in place as this did not always show what actions had been taken, when areas for improvement were identified through incidents or accidents.

We found that risks some people had in relation to dysphagia had not been reviewed recently even though there had been a recent significant incident within the home.

Positive interactions were observed between staff and the people they cared for. People's privacy and dignity was respected and staff supported people to be independent and to make their own choices. Staff provided information to people and included them in decisions about their support and care. When people were assessed by staff as not having the capacity to make their own decisions, meetings were held with relevant others to discuss options and make decisions in the person's best interest.

We found there were policies and procedures in place to guide staff in how to safeguard people from harm and abuse. Staff received safeguarding training and knew how to protect people from abuse.

People lived in a safe environment and staff ensured equipment used within the service was regularly checked and maintained.

Recruitment and selection procedures were in place and appropriate checks were carried out before staff started work. This included obtaining references from previous employers and disclosure and disbarring checks (DBS) to show staff employed were safe to work with vulnerable people. Sufficient staff were deployed to ensure people's needs were met.

There was a complaints procedure in place which was available in a suitable format which enabled people who used the service to access this if needed. People and relatives we spoke with knew how to make a complaint and told us they had no concerns about raising issues with the staff team.

We met the four people that used the service, who had complex needs which meant they were not able to tell us about their experiences. We observed that staff communicated well with people who used the service and promoted a supportive environment. We spoke with three members of staff and the Assistant Operations Director. The Registered Manager was on leave at the time of this inspection.

We saw that systems were in place to gain and review consent from people who used the service, and to act on their wishes. Staff we spoke with demonstrated a clear understanding of the care planning process and of individual’s needs. We saw that appropriate records were maintained and that suitable arrangements were in place for supporting people with medicines. There were enough qualified, skilled and experienced staff to meet people’s needs.

During this inspection visit we met the four people using the service and spoke with the registered manager and five members of staff. We used different methods to help us understand the experiences of people using the service, because the people using the service had complex needs which meant they were not able to tell us their experiences. We spoke with a relative, observed the care and support being given and how staff interacted with people.

A person’s relative told us that staff respected people for who they were and involved them in making decisions. We observed staff supporting a person in a way that matched the person’s preferences as recorded in their care plan. Staff we spoke with demonstrated their understanding of the care planning process and of the outcomes they were supporting people to achieve. We observed that there were opportunities offered throughout the day for people to take part in home or community based activities, such as trips out for shopping or lunch. A person’s relative praised the service for the care and support it provided and said “I know he’s well looked after”. They told us that staff “Really are good. I don’t think anybody could do a better job. Nothing is too much trouble”. They told us that they were consulted and kept well informed by the service.