This was an unannounced inspection which took place on 09 May 2017.

Dimensions Loddon Court 289 Wokingham Road is registered to provide care for up to eight people, at any one time. The home provides a respite service for 40 people (currently) with learning and associated behavioural and physical disabilities. People generally stay in the service for an average of two nights, although this is flexible depending on the circumstances and their individual, assessed needs.

There were five people (called house guests) staying in the service, on the day of the visit. An outreach service is run from the same building. However, this report only relates to the provider's provision of residential respite care. The outreach services do not provide personal care and consequently fall outside the regulatory remit of the Care Quality Commission (CQC) and were not assessed as part of this inspection.

At the last inspection, on 29 April 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.

The service remained safe. Staff who had been trained in safeguarding vulnerable adults and health and safety policies and procedures kept people as safe as possible. Staff understood how to protect people and followed the relevant procedures. General risks and risks to individuals were identified and action was taken to reduce them.

People’s needs were met and they were supported safely by large numbers of staff who provided excellent staffing ratios. The service made sure, that as far as possible, staff were recruited safely and were suitable to work with the people who live in the home. People were given their medicines safely, at the right times and in the right amounts by trained and competent staff.

The service continued to be effective. People’s health and well-being needs were met by staff who were well trained and responded to people’s current and changing needs. The service sought advice from and worked with health and other professionals to ensure they met people’s health and well-being needs.

People were supported to have maximum choice and control of their lives. Staff offered them care in the least restrictive way possible, the policies and systems in the service supported this practice.

The service continued to provide care with kindness and respect. Care staff remained attentive, responsive and knowledgeable about the needs of individuals. Individualised care planning ensured people’s equality and diversity was respected. People were provided with activities, as appropriate, according to their needs, abilities and preferences.

People, staff, other professionals and families continued to describe the registered manager as good. Staff said she was approachable and supportive. The service sustained the procedures with regard to continually assessing, reviewing and improving the quality of the care provided.

This was an unannounced inspection which took place on 29 April 2015.

Dimensions- Loddon Court 289 Wokingham Road is registered to provide care for up to eight people, at any one time. The home provides a respite service for people with learning and associated behavioural and physical disabilities. People generally stay in the service for an average of two nights, although this is flexible depending on the circumstances and their needs. There were seven people (called house guests) staying in the service on the day of the visit. The service was split into two areas with four bedrooms in each. All accommodation was on one floor. People had access to hand wash basins in their rooms but there were no other en-suite facilities.

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 home were kept as safe as possible by using a variety of methods. Staff were trained in and understood how to protect people in their care from harm or abuse. Relatives of people who use the service told us the registered manager was open and approachable. Specific risks to individuals were identified and managed to reduce the likelihood of harm. General risk assessments were in place to make sure the health and safety of anyone staying in or visiting the home was protected, as far as possible. The home had a robust recruitment process to try to ensure the staff they employed were suitable and safe to work there. The staff team were well supported by the registered manager to ensure they were able to offer good care to people.

Peoples’ rights were recognised and maintained. 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. DoLS applications were made when the service believed that they may be depriving people of their liberty.

Peoples’ healthcare needs were met when they were staying in the home. Advice was sought from specialists to ensure staff knew how to deal with particular health needs such as diabetes and epilepsy. People were provided with specialist equipment to keep them safe and comfortable. Some areas of the building were not well maintained and a relative described areas of the environment as, ‘‘shabby’’. People who had behaviours that could cause distress or harm were supported by appropriately trained and experienced staff.

Staff were described as, ‘‘very trustworthy, kind and caring’’ by relatives and visiting professionals. The service had developed good working relationships with people and their families. Staff maintained people’s privacy and dignity and respected their diversity and cultural choices.

People were offered much individualised care. They were fully assessed and the service worked with all other interested parties to ensure the care they provided met their specific needs. People’s families knew how to make a complaint and were confident they would be listened to and action would be taken.

People told us the manager was good. Staff and relatives of people told us the home was very well managed and that the registered manager was very open and approachable. The manager was registered in October 2014, staff and relatives said there had been many improvements since she had been in post. The home had a variety of ways of making sure they maintained and improved the standard of care they offered people.

At the time of the visit there were no people staying at the home for respite care. We were therefore unable to speak to people who use the service. We were able to speak later with relatives and carers of people who stayed at the home for respite care. We spoke with the local authority and local commissioning team. Relatives we spoke with, the local authority and commissioning team had no concerns about the care and service provided by the home. One relative told us "they are aware of individual needs and get to know what people like and dislike." Another told us their relative "likes it there and that is the main thing."

We looked at the safety and suitability of the home, and found that both the building and grounds were kept in good order. Most people we spoke with thought the home was adequate in its design but some had concerns of the size of the communal living areas. One person told us "the bedrooms are a good size but the lounges are too small if there are several wheelchair users in there."

Care workers were supported by the home to enable them to deliver care at an appropriate standard. Care workers had regular supervision and appraisals and had access to regular training.

The home had effective systems in place to monitor the performance of the service. People staying at the home, their relatives or carers were given opportunities to feed back to the manager about the service being provided and concerns raised were acted upon.

In this report the name of a registered manager appears who was not in post and not managing the regulated activities at this location at the time of the inspection. Their name appears because they were still a registered manager on our register at the time of this inspection. We have advised the provider of what they need to do to remove the individual's name from our register.

At the time of the visit there were two people living in the home on respite care who had limited verbal communication skills. We spent time observing interactions between people living in the home and care workers.

People who were living in the home were happy and relaxed. We observed people being treated with dignity and respect. We saw people making choices and being encouraged to be as independent as they were able. Likes, dislikes, abilities and goals were considered in relation to the support that people received and this was evidenced in their care plans.

The provider had ensured that appropriate staff were recruited and care workers were confident to recognise and report abuse. Care workers spoken with had a good understanding of safeguarding and had training in the safeguarding of vulnerable adults.

People living at the home and their families were supported when making complaints or concerns and the manager ensured that correct procedures were followed and outcomes used to enhance the service.