Dimensions Lincolnshire Domiciliary Care Office

Staff supported people to reduce the risk of avoidable harm while still encouraging them to take informed risks where appropriate, to further develop their skills or independence. Any restrictions were implemented in-line with the mental capacity act principles and used a best interest approach to ensure they were the least restrictive. However, we found some staff would benefit from refresher training on awareness of how to identify restrictions and understand how they impact people they are supporting.

People were supported to safely manage and review prescribed medicines including reductions in-line with guidance to stop the over prescribing of medicines for people with learning disabilities (STOMP). The provider had recruitment and induction processes in place to ensure there were sufficient numbers of skilled staff employed who had a good awareness of people’s needs and how to raise concerns. People’s homes were kept safe and measures were in place to reduce the risk of infection.

People’s needs and preferences were fully assessed and included physical and mental health, social and cultural needs. Assessments included all people important to the person and liaison with relevant health professionals where required for guidance or equipment. Staff worked together with other agencies to ensure people were supported to live healthy lifestyles and access services. Health outcomes were monitored and regularly reviewed. Consent to care had been sought at point of initial assessment and was reviewed annually or when changes to people’s care arose.

People told us staff treated them with kindness and were happy with their care. People’s diverse interests and beliefs were taken into account when providing care to ensure these were respected. While overall, observation of practice and people’s feedback was positive, some practice in terms of language used did not always uphold people’s dignity and privacy, this was addressed immediately for review and further development by senior managers.

People’s choices were respected and their right’s promoted. The registered managers had led some very specific and complex pieces of work in order to respond to people’s changing needs which had led to positive outcomes and improved quality of life. The provider was pro-active in considering staff well-being and supporting staff during personal difficulties by implementing flexible working practices and reasonable adjustments.

Care was planned to promote people’s aspirations and ensure staff understood people’s preferences. People’s rights to choice and independence were supported in line with the principles of CQC’s Right Support, right care, right culture policy. Staff used a flexible approach to care to ensure people had access to all relevant services and local facilities.

People were listened to and their views reviewed and used to drive improvements. Information was provided to people in a way they understood using a variety of methods. Staff recorded people’s wishes for planning their health needs, including their preferences in the event of serious illness or at the end of their life.

We found there was good, compassionate leadership in place who were all passionate about providing quality person centred care and ensuring the wellbeing of their staff teams. People and staff felt able to speak up and make suggestions or raise concerns.

Staff shared similar values the provider employed the services of family consultants to help shape the future of the organisation while ensuring people first. The provider worked hard to promote awareness of the risks of closed cultures and how to prevent them.

Diversity of workforce, equality and inclusion of all was actively encouraged and incorporated into the providers policy and procedures. There was good partnership working and system in place to ensure oversight of quality of care at all levels.