The inspection took place on 7 and 8 November 2016 and was announced.

Dimensions Kent Limited provides supported living services to people living in their own homes. At the time of this inspection fourteen people were being supported who had high complex needs and required a one to one bespoke service. It is a specialist service for people that have anxious or emotional behaviour that has limited their quality of life and experiences. .Each person had a tenancy agreement for their property and received 24 hour support in all aspects of their care to enable them to remain as independent as possible. People lived in several properties in the East Kent area in their own flats, with communal areas. The care and support people received was overseen by a manager (who was applying to be registered), and two locality managers, who were in day to day charge of the service.

The previous registered manager had left the service on 31 October 2016. The organisation had taken prompt action and appointed a new manager who had experience in covering these types of services in other areas of the same organisation. They commenced their duties on 1 November 2016 and their application to become the registered manager was currently being processed by the Care Quality Commission. If a service does not have a registered manager in post at the time of the inspection the rating in the well led domain is restricted to being judged as requires improvement. At this inspection as the registered manager’s application was being processed by CQC and the evidence in well led was positive we having taken a proportional and balanced view to rate the domain as good. A registered manager is a person who has registered with CQC 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, staff and relatives spoke highly of the management and staff. They told us that it was an excellent service where people were supported to enjoy their lives to the full. The management team and staff were passionate and committed to supporting people with person centred care to have meaningful lives, and reach their full potential. The management team visions and values were imaginative and person-centred, and made sure people were at the heart of the service. The culture of the service was extremely positive, with a clear vision of providing high quality care to people. The management team sustained high quality practice, with the ethos of development and continuous improvement of the service. Everyone we spoke with were highly motivated and actively involved in the service to ensure that people received consistent high quality care.

Staff understood the importance of making people feel safe and protected from harm. Staff treated people with respect at all times; they were patient and kind, and gently encouraged people to take their time to communicate their needs. Detailed plans about individual’s communication needs enabled people to express themselves in ways that were understood by staff. People showed affection towards staff who listened and acted on what they said or needed.

People were encouraged to live their lives to the full and risks were managed proactively. When activities did not go as planned the staff reviewed the risk assessments and made adjustments so people could continue with their chosen activity safely. When people’s behaviours impacted on their day to day lives, detailed guidance was available to staff to support them to manage their anxieties. People’s finances were protected and checked to make sure people could access their monies when they wanted to.

Systems were in place to record accidents or incidents, with a clear process to investigate, review and look for patterns and trends to reduce the risk of re-occurrence. The provider had a busin

In this report the name of a registered manager appears who was not in post and not managing the regulatory activities at this location at the time of the inspection. Their name appears because they were still a Registered Manager on our register at the time. At the time of our inspection a new manager was going through the registration process.

On the day of our inspection, we met with one of the service managers and the local administrator. We also visited a purpose built complex made up of five flats and a communal/staff area. We spoke with people living at the site, staff members and family members. The five flats were all fitted and decorated to a high standard. One was fitted wholly to meet the needs of the one person. The others were all very personalised and showed a good reflection of themselves.

Staff spoken with stated the provider was very supportive and were very committed to high quality care and to the training of all staff. One person using the service told us they were very happy with their life now, as the package of care in place was fully controlled by them. The stated that the staff supported them in any way they required it and adapted to their changing needs well. One told us they felt very safe in their home and staff were always on hand if required even throughout the night. One told us they were (with assistance from a staff member) planning a series of evening meals for everyone with food from different countries.

People spoke positively about the staff and felt their care needs were supported. People said that the staff spoke with them in a respectful way, respected their privacy and encouraged their independence. One person told us "The staff are absolutely brilliant." A relative said "There are some wonderful staff at the service, my relatives life has improved tremendously with their help."

People and their relatives told us that care was personalised to their needs. People said their preferred names were always used. One person told us "If I need a little extra help one day they are always happy to help me."

People were aware of their care plan aand said that they and their relatives had been involved in the decisions about their care and support.

People felt that the staff had received the training and necessary skills required in order to meet their needs.

People told us they felt safe when staff visited. They told us that if they had any concerns about the staff they would speak with a relative or the manager. People were confident that any concerns raised would be listened to and addressed.