We carried out an announced inspection on 28 March 2017.

Dimensions Luton Domiciliary Care office provides personal care and support services to adults and younger people with a learning disability living in their own homes, and within shared premises in the Bedfordshire area. At the time of our inspection the provider was supporting up to 65 people.

The service has 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.

The service took safeguarding concerns seriously and followed the local authority policy and guidance when dealing with safeguarding people from harm and the staff we spoke with demonstrated a good understanding of safeguarding issues.

There was a robust recruitment procedure to help ensure the staff recruited were suitable to work with the people using the service. People who used the service were encouraged to participate in the interviewing process for potential employees. This demonstrated the service’s commitment to the culture of inclusion and participation within the service.

Staffing levels were sufficient to provide the level of care required. Arrangements were in place to cover any sickness or absences. Flexible working was encouraged and supported and this helped provide a good work/life balance for staff. It also helped the service to meet the needs of every person who used the service.

Risk assessments were in place and were regularly reviewed and updated. The service endeavoured to balance risks so people could maintain their independence and lead an active life. Staff were trained to administer medicines safely and had undertaken further training to ensure they could deal with a number of health issues. Regular checks were undertaken to help ensure on-going competence in this area.

Staff demonstrated a good understanding of their roles and responsibilities. The service demonstrated a commitment to staff training, which was on-going and regular refreshers were undertaken.

Staff were given positive encouragement to undertake further, more specialised training appropriate to the work, including working towards Qualifications and Credit Framework (QCF), which is a nationally recognised diploma in health and social care.

Supervisions were undertaken regularly and considered important in offering an opportunity for discussion between staff and management about on-going work issues. Professional Development Reviews (PDR) were held annually to ensure learning was reviewed and training needs were met.

Care files were clear and comprehensive and contained relevant health and personal information. They were person-centred and included individuals’ goals, wishes and achievements. The service was flexible and responsive to changing needs, desires and circumstances. Positive outcomes were personal to each individual and were celebrated within care files.

Confidentiality was respected and independence was promoted. Communication with relatives was on-going throughout the duration of their relative’s involvement in the service.

People who used the service were encouraged to pursue their interests. Staff ensured that they treated each person as an individual and tailored activities and support to them.

Comments were encouraged formally and informally and there was a complaints policy in place. Literature given out to families gave the information and opportunity for people to raise concerns or make suggestions.

Best practice guidelines were followed and the service was innovative and creative in its approach to support. The management and staff were not afraid to challenge decisions and advocate fully on behalf of the people they supported in order to further improve people’s lives.

Feedb