Dimensions 21 Searing Way is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection. Dimensions 21 Searing Way provides accommodation and personal care to a maximum of five people who live with a learning disability, autism and/or associated health needs, who may experience behaviours that challenge staff. At the time of the inspection there were five people living at the home.

The inspection took place on 27 February 2018 and was unannounced. Which meant the staff and provider did not know we would be visiting.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Policies, procedures and staff training were in place to protect people from avoidable harm and

abuse. Staff had identified risks to people and these were managed safely. Recruitment

processes were followed to ensure suitable staffing levels and the provider had thorough pre-employment checks in place to determine prospective candidates’ character and skills. This was to ensure staff were suitable to support people with a learning disability. Where agency staff were used the provider ensured people received good consistency and continuity of care by deploying the same staff. Arrangements were in place to receive, record, store and handle medicines safely and securely.

People were cared for by staff who had received appropriate training, support and supervision in their role. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. People were supported to eat and drink sufficiently for their needs. Staff supported people to see a range of healthcare professionals in order to maintain good health and wellbeing.

Staff treated people with kindness and compassion, they cared about people. Staff supported

people to make choices about their lives. Staff treated people with respect and upheld their dignity

and human rights when delivering their care.

People had a comprehensive assessment of their support needs and guidelines were produced for staff about how to meet their individual needs and preferences. Support plans were reviewed with people and their families and relevant changes made where needed. Staff encouraged people to be as independent as possible. Activities that were appropriate to each person were offered and encouraged. Processes were in place to enable people to make complaints and these were responded to appropriately.

The service had clear and effective governance in place. The provider encouraged people, their families, staff and professionals to be actively involved in the development and continuous improvement of the home. The provider had robust quality assurance systems which were operated across all levels of the service. Staff had worked effectively in partnership with other agencies to promote positive outcomes for people.

Further information is in the detailed findings below

The people living in 21 Searing Way had complex needs and as such not all were able to communicate with us verbally. We observed that people appeared happy and relaxed. We saw that people were offered choices and that, in most cases, staff waited for a response before acting.

The care plans were detailed and gave staff information on how best to offer support to each person living in the house. Independence and community involvement were encouraged through participation in activities.

There were suitable processes in place to ensure the safe storage and administration of medication.

The recruitment process ensured that staff were suitable, skilled, qualified and experienced.

There was a complaints policy readily available in a variety of formats. Making a complaint or raising a concern was discussed regularly with the people living in the home and their families.

The people living at 21 Searing Way had complex needs and as such were not able to talk with us. We met with four of the people living in the house and observed them spending time with staff members. They appeared happy and relaxed and were involved in activities with the staff. We saw staff communicating with each person in the most appropriate way for them, and waiting for the person to respond.

Each person had a detailed support plan which they had been involved in writing. The plans contained detailed information which informed staff on how best to support them.

All staff had completed their training. We spoke with three staff and the manager and they all told us that they felt supported. They said that they were confident they could raise any issue and that it would be dealt with. All staff members had completed safeguarding training and those we spoke with were able to demonstrate a good understanding of abuse issues.

The manager regularly reviewed all aspects of the home and where improvements were required an action plan was completed and followed through.

The inspection took place on 7 and 9 July 2015 and was unannounced. Dimensions 21 Searing Way provides residential care and accommodation for up to five people with learning disabilities and/or autistic spectrum disorder. At the time of our inspection five people were living in the home.

The home was a single storey building, with wide corridors and hand rails throughout to provide safe access for wheelchairs and to support those with mobility needs.

The home had a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the service is run.

At the last inspection on 18 and 23 June 2014 we identified a breach of the regulations. We required the provider to take action to make improvements to ensure that risk assessments and plans of care were updated to reflect people’s current needs.

The provider had taken steps to ensure people’s support plans had been reviewed and regularly updated as changes were identified. Risk assessments had been completed and reviewed to ensure all risks identified were addressed to promote people’s safety. People’s support plans included staff guidance to ensure they understood people’s needs and wishes, including emergency support when required.

People were protected from potential harm, as the provider had completed all the recruitment checks required for new staff. However, the provider’s recruitment policy was not sufficiently robust to ensure these checks would always be completed in line with the requirements of the Regulations. The provider assured us they would review their recruitment policy to ensure it met these requirements.

People were protected from the risk of abuse, because training ensured staff were able to identify indicators of abuse. Staff understood and followed the provider’s safeguarding policy, and had confidence that concerns would be addressed appropriately to protect people from potential harm.

Risks that may affect the safety of people, staff or others had been identified, and measures put into place to reduce the risk of harm. Regular checks and servicing ensured equipment used was safe for use, and staff followed guidance to ensure they used equipment safely.

People’s needs had been assessed to identify a suitable staffing level to ensure their safe support. Rosters were managed to provide a balance of staff skills and experience to meet people’s needs safely.

Medicines were stored and administered safely. Staff training, competency checks, audits and procedures ensured that staff followed safe practices when administering people’s medicines.

The provider’s training programme ensured staff had the skills to meet people’s needs effectively. This included training specific to people’s identified needs, such as awareness of epilepsy and safe use of hoists. The provider ensured staff demonstrated the skills required to support people through competency assessments.

Staff were supported through a programme of meetings and appraisals to discuss concerns and aspirations. Comments from relatives and peers were shared to enable staff to reflect on the impact of their actions on others.

Staff understood and implemented the principles of the Mental Capacity Act 2005. A decision-making agreement ensured staff involved people appropriately in decisions about their health and support, including day to day decision-making. The registered manager had applied for Deprivation of Liberty Safeguards for people in accordance with legal requirements.

People were supported to maintain a healthy diet. Preferences and needs were met to ensure people’s nutrition was sufficient, and dietary requirements and health professional guidance were followed to ensure people were supported to eat safely.

People’s health and wellbeing was promoted through regular and as required health appointments. Staff followed guidance and instruction from health professionals to ensure they effectively supported people to maintain their health.

Relatives stated staff were caring, and staff spoke of people with affection. They took care to involve people in decisions as much as possible, and supported people to maintain friendships that were meaningful to them. They promoted people’s dignity through respectful interactions.

People were supported to participate in a range of activities in the home and local community. Relatives were welcomed into the home, and informal gatherings and meetings arranged for people and their relatives to encourage feedback. Complaints were managed in accordance with the provider’s complaints policy. An electronic complaints log ensured accountability and resolution of concerns raised.

Staff described the registered manager and assistant locality manager as supportive and available. Senior management supported the registered manager to resolve issues, and audits were used to identify and address areas of improvement required. Staff shared learning and experience to drive ambitions to provide high quality care for people.