Dimensions Bracknell & Surrey Domiciliary Care Office was rated Requires Improvement overall following its October 2022 inspection, with regulatory breaches identified in safe recruitment (Reg 19), risk assessment management (Reg 12), and governance (Reg 17). Despite these failings, the service demonstrated strong person-centred care, effective partnership working, and good outcomes for the 49 people receiving personal care.
Concerns (5)
criticalStaffing levels: “Records did not always demonstrate that robust checks in relation to staff conduct in previous care roles had been completed.”
criticalCare planning: “Support plans and risk assessments were last reviewed in May 2019 and had not been updated in accordance with the provider's policy.”
criticalGovernance: “The provider had failed to consistently assess, monitor and improve the quality of the service and to effectively operate systems and processes to ensure compliance with the regulations.”
criticalStaff competency: “Two of the newly appointed staff files supplied by the provider's recruitment team had required information missing and had not been checked effectively.”
moderateRecord keeping: “Records had been updated with handwriting which had not been signed, dated or cross referenced.”
Strengths
· People experienced good continuity and quality of care from staff they knew well, consistently achieving successful outcomes.
· Staff received relevant, high quality training in evidence-based practice including positive behaviour support and human rights.
· Registered managers demonstrated a clear understanding of people's needs and maintained effective partnership working with health and social care professionals.
· Medicines were managed safely with annual competency reassessments and regular audits by registered managers.
· The service demonstrated strong person-centred care, reducing prescribed medicines in line with STOMP and enriching people's quality of life.
Quality-Statement breakdown (25)
safe: Recruitment and staffingRequires improvement
safe: Assessing risk, safety monitoring and managementRequires improvement
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Using medicines safelyGood
safe: Preventing and controlling infectionGood
safe: Learning lessons when things go wrongGood
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawGood
effective: Staff support: induction, training, skills and experienceGood
effective: Supporting people to eat and drink enough to maintain a balanced dietGood
effective: Supporting people to live healthier lives, access healthcare services and supportGood
effective: Ensuring consent to care and treatment in line with law and guidanceGood
caring: Ensuring people are well treated and supported; respecting equality and diversityGood
caring: Supporting people to express their views and be involved in making decisions about their careGood
caring: Respecting and promoting people's privacy, dignity and independenceGood
responsive: Planning personalised care to ensure people have choice and control and to meet their needs and preferencesGood
responsive: Meeting people's communication needsGood
responsive: Supporting people to develop and maintain relationships to avoid social isolationGood
responsive: Improving care quality in response to complaints or concernsGood
responsive: End of life care and supportGood
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsRequires improvement
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringGood
well-led: How the provider understands and acts on the duty of candourGood
well-led: Engaging and involving people using the service, the public and staffGood
well-led: Continuous learning and improving careGood