This was an unannounced inspection which took place on 16 August 2017.

Dimensions- Brambletye is a residential care home which is registered to provide a service for up to five people with learning disabilities. Some people had other associated difficulties such as physical limitations or behaviours that may cause distress to themselves and/or others. The service was home to four people on the day of the visit. All accommodation is provided on one floor in a domestic sized dwelling.

At the last inspection, in, August 2015, the service was rated Good. At this inspection we found the service remained Good.

Why the service is rated Good:

There is a registered manager running the service. 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.

People, staff and visitors to the service continued to be kept as safely as possible. Everyone’s safety was maintained by staff who had been trained in safeguarding vulnerable adults and health and safety policies and procedures. Staff fully understood how to protect people and who to contact if they had any concerns. General risks and risks to individuals were identified and appropriate action was taken to minimise them, as much as possible.

High staffing ratios ensured there were enough staff on duty at all times to meet people’s diverse and individual needs safely. Recruitment systems were in place to make sure, that as far as possible, staff recruited were safe and suitable to work with people. People were given their medicines safely, at the right times and in the right amounts by trained and competent staff.

The service remained effective. Staff continued to be well-trained and supported to make sure they could meet people’s varied well-being and highly complex health needs. They responded very effectively to people’s current and quickly changing needs. The service sought advice from and worked with health and other professionals to ensure they met people’s distinctive needs.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practise.

People continued to be supported by a kind and caring staff team who were responsive to their needs. The staff team were attentive and were able to communicate with people by using individual communication systems. Support planning was highly individualised which ensured people’s equality and diversity was respected. People were provided with activities to enable them to lead as fulfilling a lifestyle as possible.

The registered manager was highly thought of and respected. She was described as approachable, effective and supportive. The quality of care the service provided continued to be assessed, reviewed and improved, as necessary.

This was an unannounced inspection which took place on 10 August 2015.

Dimensions- Brambletye New Mill Road is registered to provide care for up to five people. One bedroom had been re-designed to offer a suite to an individual and the home therefore offered accommodation to four people. The home provides a service for people with learning and associated behavioural and physical disabilities. There were four people living in the service on the day of the visit. The service offered all ground floor accommodation. Two bedrooms had en-suite facilities which included a shower or a bath.

There is a registered manager running the service. 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 home kept people who use the service, staff and visitors as safe as possible. Staff were trained in and understood how to protect people in their care from harm or abuse. The health and safety of people who live in the home was carefully considered and appropriate action was taken. Any general or individual risks were identified and action was taken to minimise them, as far as possible. People were given their medicines safely. The service tried to make sure that staff who worked there were safe to support vulnerable people.

People’s health and well-being needs were met at all times. Staff knew how to communicate with people and helped them to make as many decisions for themselves as they could. People had been provided with appropriate equipment to assure their safety and comfort.

Peoples’ rights were understood, and upheld by the staff and registered manager of the service. The service understood the relevance of the Mental Capacity Act 2005, Deprivation of Liberty Safeguards (DoLS) and consent issues which related to the people in their care. The Mental Capacity Act 2005 legislation provides a legal framework that sets out how to act to support people who do not have capacity to make a specific decision. DoLS provide a lawful way to deprive someone of their liberty, provided it is in their own best interests or is necessary to keep them from harm. Appropriate DoLS applications were made.

People were offered support by a committed and caring staff team. Staff had built strong relationships with the people who live there and their families. Staff members were very knowledgeable about people and their needs. People’s needs were met and their requests for help or attention were responded to immediately. People who had been assessed as requiring special care with enhanced staffing always received it.

A variety of individual and group activities were provided. People’s needs, preferences and wishes were taken into account when planning daily activities. People were treated with dignity and respect at all times. The individualised care planning ensured people’s equality and diversity was respected.

People’s care was overseen by a registered manager and management team who listened to them, their families and the staff team. They maintained and improved the quality of care people received and ensured people had as rewarding a lifestyle as possible.

The four people living at Dimensions Brambletye New Mill Road were not able to communicate with us verbally. People used noise, gesture, body language and facial expressions to express themselves. We used a variety of methods to gain an understanding of their experiences living at the home. Those methods included talking with relatives, observing what people were doing during the day and observing interactions between staff and the people who use the service.

We found, before people received any care, they were asked for their consent and the staff acted in accordance with their wishes. They were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines.

People’s health, safety and welfare was protected when more than one provider was involved in their care and treatment. This was because the staff worked in co-operation with others. One relative told us that staff "have a good knowledge and take prompt actions if there are problems."

People were cared for by staff who were supported to deliver care and support safely and to an appropriate standard. The two relatives we spoke with said they felt staff had the skills they needed when providing care and support to their family member. One relative commented "I think their personal care is excellent" and another said "At the moment there is a good strong staff team, they work well together."

Relatives we spoke with felt their comments and complaints were listened to and acted on effectively. They were aware of the complaints procedure and one relative commented "they always listen if I have any concerns, they are good like that."

The four people who live at Dimensions Brambletye New Mill Road were not able to communicate with us verbally. People used noise, gesture, body language and facial expressions to express themselves. Each person had a communication plan that helped staff, and us, understand and interpret people's choices, moods and feelings.

We used a variety of other methods to gain an understanding of people's experiences. Those methods included talking with staff, looking at records, observing what people were doing during the day and observing interactions between staff and the people who use the service.

We saw staff spoke with and treated people with respect and involved them in everything that was happening. People's privacy and dignity was protected and staff encouraged and enabled people to be as independent as they could be.

Staff we spoke with were able to explain the care each person required and how they met those needs. We saw staff offered support and care to people who use the service in a way that matched the information recorded in their care plans.

All interactions we observed between staff and the people who use the service were positive. We saw staff had an in depth understanding of the people who use the service, their likes and dislikes and how they communicated. People using the service were relaxed and showed trust in the staff supporting them.

We found the provider met the outcomes we inspected and had systems in place to monitor their own compliance.