Care service description.

Dimensions Baily Thomas House Haysoms Drive is a respite service for up to six people at a time with a learning disability. People may have associated physical or behavioural difficulties. The service supports a total of 50 people through planned and agreed respite stays.

Rating at last inspection.

At the last inspection in October 2014, the service was rated Good.

At this inspection we found the service remained Good.

Why the service is rated Good.

The service met relevant fundamental standards.

People felt safe and well cared for by staff. Where risks were identified, appropriate steps had been taken to minimise these. Medicines were managed so as to reduce the risk of errors, given the frequency of their transfer between people’s homes and the service. Potential new staff were subject to a robust recruitment process. Once appointed, staff received a thorough induction and training to equip them with the necessary knowledge and skills and were provided with ongoing support and development opportunities.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice. People were supported to be involved in day to day household activities and tasks and had access to a variety of activities and external day services and other resources.

People, relatives and external care professionals felt staff provided consistent and caring support and they worked effectively with external care and health services where necessary. People’s rights were protected and staff always sought consent before providing care. People’s dignity and privacy were maintained in the way staff provided their support. The building was suitably adapted to meet people’s physical needs and was fully accessible to those using wheelchairs.

The service was responsive to people’s wishes with regard to their respite stays and the level of care people wanted. It had provided support in an emergency at times. People and their families were involved in planning their care and care plans were positive and enabling. Staff worked calmly and effectively with people, supporting and respecting their individuality.

The service was well led. People, families and professionals all praised the approach and flexibility of the registered manager and staff. The operation of the service was monitored effectively and people and their families had opportunities to contribute their views about it.

We inspected Dimensions Baily Thomas House Haysoms Drive on 22 October 2014. This was an unannounced inspection.

The service provides respite care support for adults or young people living in the community who have a learning disability. People may also have associated physical or behavioural difficulties. The service provided respite support for a total of 38 people as well as outreach support for 13 people. The home itself can accommodate up to six people for respite care at any one time. There were no concerns identified at the previous inspection in August 3013.

The service had a registered manager in post. 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.

The staff knew how to keep people safe and understood how to report any concerns around safeguarding. Relatives and external healthcare professionals told us people were safe and cared for with dignity and kindness. The people we saw during the inspection were unable to tell us verbally whether they felt safe but their body language, facial expressions and behaviour suggested they felt relaxed and well cared for.

Staffing levels were adjusted to meet the needs of the individuals being supported at any one time and management support or advice was always available. The service had sought external advice and support from health professionals, parents and care managers where necessary, to maintain people’s safety and wellbeing.

Staff recruitment was thorough. Staff received the training and support they needed and medicines were safely managed. Respite care packages were tailored to meet people’s assessed needs. People and their families were involved in planning their care. Care plans were person-centred and identified individual likes, dislikes and preferences. Care plans were amended when necessary to reflect people’s wishes and changing needs.

Communication systems between staff were good and staff knew how to communicate with people and gain their consent to care and support. The home provided people with meals they enjoyed and involved them in its preparation as much as they wished. Staff worked with people in a respectful and caring way, treating them as adults and involving them in decision making. Care plans reflected people needs and wishes.

The home provided flexible care support and responded effectively to crises and emergencies by offering respite at short notice when this was needed. The needs of people and their families were taken into account when planning respite stays. People’s individual cultural or personal preferences were supported. People’s views and those of their families were sought, about the quality of the service and acted upon. The opinions of staff and health professionals were also sought. People were told about and knew how to raise any complaints and any issues raised had been appropriately responded to.

The service was well managed and monitored by the registered manager who responded appropriately to any identified issues. Communication, training and support were all provided effectively by management and staff development was encouraged and supported. Staff and relatives said the registered manager was approachable and supportive. External health professionals, care managers and parents told us that any concerns had been listened to and addressed. The provider also monitored the operation of the service through quarterly audit visits and any identified issues were added to their “service improvement plan” and the action taken was monitored to ensure the issue was addressed.

We found that people’s needs were met and care was delivered as described in their individual care plan. People told us or indicated, by nodding and clapping that they were happy visiting the home. One person said, ''I quite like staying here and I’m quite comfortable''.

We saw that people were offered a varied and balanced diet. Fresh fruit and vegetables were available and people helped choose menus and prepare meals, as appropriate. People told us that the food was ''very good''.

We found that staff understood and were able to explain how they kept people safe from abuse or poor care. A person told us that they felt ''very safe'' and ''protected'' by staff in the home.

We saw that the home was comfortable and well maintained. They took health and safety seriously to make sure that the people who visited the home and others were as safe as possible.

We found that staff were trained and supported to make sure that they could give people the best possible care. Staff described the team as ''very committed'' and the management as ''very supportive''.

The home had ways of looking at the care they offered so that they could make sure they maintained and improved it. People were asked for their views and opinions about the quality of care.

People who used the service referred to themselves as guests. Most guests visited the service for a short stay.

We spoke with a small number of guests visiting the home for respite care; we were not able to speak to other guests visiting the service as they were participating in their day time activities. A guest told us that they were ''looked after very well'' and they ''loved'' visiting the home. We gathered evidence of people’s experiences by examining survey questionnaires and other records. We found that they had been involved in planning their care and what they could do each day. We saw that staff were familiar with people's needs and gave them opportunities to make choices.

The care plans we saw provided individual details of guest's needs, wishes and preferences. Guest's healthcare needs were met. The home sought advice from external healthcare professionals where appropriate. A range of activities were provided and guests could choose whether they wished to take part.

Staff received an appropriate induction and the home had ensured that staff received regular supervision. Staff were also supported through a system of appraisals and regular training. The provider and manager had effective systems in place to monitor the performance of the home.