Dimensions 42 Jubilee Road provides accommodation, care and support to five people with learning disabilities. The home is situated in a residential area with accommodation all on one level.

The inspection took place on 30 January 2017 and was unannounced.

There was a registered manager in post who supported us during the inspection. 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.

At our inspection in October 2015 we found that staff did not have a good understanding of their responsibilities in relation to the Mental Capacity Act 2005 (MCA). People’s legal rights had not always been protected as people’s capacity to make specific decisions was not assessed and decisions taken in their best interests were not recorded. At this inspection we found that improvements had been made and staff were working in accordance with MCA guidance. Staff were knowledgeable about people’s rights, capacity assessments had been completed and best interest decisions recorded.

We also identified that the Care Quality Commission had not always been informed of significant incidents in the service to enable us to monitor the service effectively. At this inspection we found that the registered manager had submitted notifications in line with their responsibilities as a registered person.

People were supported by sufficient staff with the right skills and knowledge to meet their individual needs. We observed that staff were available to support people when required and no one had to wait for their care. Prior to being employed staff underwent a robust recruitment process to ensure they were suitable to work at the service. All staff had completed mandatory training and had an induction into the service to enable them to get to know people and the systems in place. Staff told us they felt supported by the manager and records confirmed that all staff received regular supervision to monitor their professional development.

Risks to people’s personal safety had been assessed and plans were in place to minimise these risks. Staff were knowledgably about the support people required to stay safe. Regular health and safety monitoring was completed and where concerns were identified these were acted upon. A contingency plan had been developed to ensure people would continue to receive their care in the event that the building could not be used.

People received their medicines in line with their prescriptions and safe medicines practices were in place. Records showed relevant healthcare professionals were involved in people’s care. Relatives told us they were informed of any health concerns in a timely manner.

People were supported by staff who knew them well and understood their individual communication styles. Staff treated people with kindness and respected people’s need for privacy. Care plans were person centred and contained details of people’s preferences. Guidance was available to staff on the support people required and we saw that this was followed. People’s nutritional needs were met and choices of food and drinks were available to people. People had access to a range of activities which reflected people’s hobbies and interests.

There was a complaints policy and procedure in place and relatives told us they felt confident any concerns would be dealt with by the registered manager. Records were securely stored and well maintained which meant staff had easy access to the information they required. Quality assurance systems were used to monitor the quality of the service people received and improvement plans were developed to address any shortfalls identified. People and their relatives were given the opportunity to give feedback on the service they recei

This inspection was carried out on the 20 October 2015. Dimensions 42 Jubilee Road provides accommodation for up to five people with learning and physical disabilities. On the day of the inspection there were four people who lived at the service.

On the day of our visit there was a registered manager. A registered manager is a person who has registered with the Care Quality Commission (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. The registered manager is also the provider for the service.

Where people were unable to make specific decisions for themselves staff had not always acted in line with the Mental Capacity Act 2005. Some decisions had been made without their being a meeting to decide it was in their best interests.

Some aspects of recording and reporting of incidents needed to be improved as the registered manager had not always notified the CQC appropriately of incidents . Record keeping in relation to incident and accidents was not recorded so analysis could be completed.

People told us they felt safe and were supported by staff who knew what do if they had concerns about any aspect of the care and treatment that was provided. Risks assessments had been completed fully where appropriate so that people were protected from the risk of avoidable harm wherever possible.

There were sufficient numbers of staff who had been through a robust recruitment process to ensure they were suitable to work with people. The staffing levels were consistent and people were not left waiting for support when they needed it.

People received their medicines when they needed them and there were clear records kept of when they had been administered. All medicines were stored securely and staff had received appropriate training in this area.

Staff told us they received training that was specific to the people who lived in the service and that this enabled them to provide effective care. Health professionals confirmed that they thought staff were knowledgeable about people and their needs. People were able to access external health services appropriately and with staff support, for example GPs or dentists . People’s health was maintained and they were able to enjoy healthy and nutritious meals. Where people had specific dietary requirement this was known by staff and appropriate action taken.

People were cared for by staff who involved them in their care and treated them with dignity and respect. The atmosphere in the home was warm and relaxed and staff clearly knew people and their needs well.

Care plans were clear and detailed and reviewed regularly by staff. There were assessments carried out that clearly recorded how people wanted to be supported and gave a good view of what the person was like and what was important to them. Activities were varied and tailored to what people wanted to do.

There was an effective system of monitoring the quality of the service and making improvements where shortfalls were identified. Staff told us they felt supported in their role by the registered manager. Feedback had been obtained from people and their relatives about the quality of the service and this was being analysed by the provider.

We used a number of different methods to help us understand the experiences of people using the service, because the people using the service had complex needs which meant they were not able to tell us their experiences.

During our visit we saw that people were being treated with dignity and respect and people's independence was encouraged. People were spoken to in a respectful way. One member of staff told us "it is about knowing each person, knowing their likes and dislikes, their routines and following their care plans. We support them to be as independent as possible as long as it is safe to do so".

People chose how to occupy themselves in the service. We observed that people were spending time with staff playing ball games, baking and playing musical instruments. We observed staff spending the majority of their time with people who use the service.

We saw staff supporting people to make their own choices about what they had for lunch and what activities they took part in. Staff knew exactly how each person communicated which meant people's wishes were understood and respected.

The manager told us "we have a very dedicated team. They take a lot of pride in what they do. They are a great team, they are committed and dedicated to the service". A member of staff told us "we have a great staff team and they have all worked here a while. The staff know the people really well and the people know them as well and feel safe with them".

People who lived in this home were limited in their ability to communicate verbally but we saw that they were well cared for and supported. This is because the provider regularly reviewed how care was provided and made changes to improve care and support.

People were involved in planning their care and support so far as possible. When restrictions were in place in the home, these were the minimum necessary to keep people safe.

Where people’s behaviours were challenging and potentially harmful to others, the provider worked with other professionals to minimise the impact this had on people using the service.

The home was well maintained and suitably equipped and laid out for the needs of the people living there