Dimensions Somerset Bridgewater Domiciliary Care Office was rated Good overall across all five key questions following an inspection in March 2019 prompted by concerns that were not substantiated. Minor issues around fridge medicine storage, gaps in specialist staff training, and inconsistent care plan reviews were identified but promptly addressed by responsive management.
Concerns (4)
moderate
Medication management
: “medicine requiring storage in the fridge in two settings was not managed safely. Fridge temperatures were not consistently being checked daily.”
moderateStaff training: “in one home a person had medicine controlled epilepsy with no seizures for many years. Not all new staff had training though to be able to identify if this changed.”
minorCare planning: “there were inconsistencies across the supported living settings about how frequently people's needs were reviewed. Some of this was in relation to the stability of management.”
minorCommunication with families: “Relatives knew who to raise their concern with at a local level. However, they did not always appear to know who to raise concerns with at provider level.”
Strengths
· People felt safe and staff demonstrated strong knowledge of how to recognise and report potential abuse.
· Personalised care plans contained a wealth of detail including hospital passports and accessible information formats.
· Staff were kind, caring and knew people incredibly well, respecting dignity, diversity and communication needs.
· Proactive approach to learning from incidents with a central logging system and 'never events' framework.
· Strong multi-agency working with health and social care professionals to meet complex needs.
Dimensions Somerset Taunton Domiciliary Care Office was rated Good across all five key questions at its first inspection since being taken over by Dimensions in April 2017, demonstrating safe, person-centred care for people with learning disabilities and/or autism. One notable issue was identified regarding staff holding service users' personal contact details on personal mobile phones, which the provider addressed immediately during the inspection.
Concerns (3)
moderateRecord keeping: “Staff told us they held peoples contact details on their own personal phones. The provider had not identified this, which meant staff were not following the provider's confidentiality policy”
minorGovernance: “Not everyone we spoke with knew who the registered manager was. One person said, 'The manager used to be (person's name), but I'm not sure who it is now?'”
minorCommunication with families: “Team meetings were not consistent across the service. One staff member told us, 'I haven't been to any team meetings yet.'”
Strengths
· Safe recruitment procedures including DBS checks and references were in place, minimising risk of unsuitable staff.
· People received medicines safely with accurate MAR records, competency-checked staff, and appropriate storage.
· Staff demonstrated enthusiasm, compassion, and person-centred values; people and relatives spoke positively about care.
· Detailed, easy-to-read support plans reflected individual preferences, routines, likes/dislikes, and communication needs.
· Robust incident management including a 'never event' panel to share lessons learned and drive improvement.
Quality-Statement breakdown (25)
safe: Safeguarding systems and risk assessmentsGood
safe: Safe recruitment proceduresGood
safe: Staffing levels and agency staff managementGood
safe: Medicines managementGood
safe: Incident and accident managementGood
safe: Infection control practicesGood
effective: Needs assessment and care planningGood
effective: Staff training, induction and competencyGood
effective: Mental Capacity Act and Deprivation of Liberty SafeguardsGood
effective: Access to healthcare professionalsGood
effective: Nutrition and hydration supportGood
caring: Kindness and compassion of staffGood
caring: Respect for privacy and dignityGood
caring: Involvement in care and decision-makingGood
caring: Communication support and advocacyGood
responsive: Person-centred care planning and reviewGood
responsive: Community involvement and activitiesGood
responsive: Complaints handlingGood
responsive: Accessible information and communicationGood
responsive: End of life care planningGood
well-led: Governance and confidentiality systemsGood
well-led: Staff supervision, appraisal and developmentGood
well-led: Continuous learning and quality assuranceGood
well-led: Leadership visibility and staff communicationGood
well-led: External collaboration and statutory notificationsGood