This was an unannounced inspection which took place on 06 June 2017.

Dimensions - The Laurels is a residential care home which is registered to provide a service for up to six people with learning disabilities. Some people have other associated difficulties including needing support with behaviours which could be distressing and/or harmful. There were three people living in the home on the day of the visit. The service offered ground and first floor accommodation in six bedrooms. One bedroom was on the first floor and two rooms had fully en-suite facilities.

At the last inspection, on 20 May 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 continued to be kept as safe as possible from abuse and harm by staff who had been trained in safeguarding vulnerable adults and health and safety policies and procedures. The staff team’s knowledge and understanding of how to keep people and themselves safe contributed to ensuring people lived in a safe and secure environment. Staffing ratios ensured people were supported safely and the recruitment procedures were effective in making sure appointees were suitable and safe to work with people. People were given their medicines in safely.

The staff team continued to respond effectively to people's current and changing needs. They ensured their health and well-being needs were met in a timely way. The service worked closely with health and other professionals to ensure they met people’s needs.

People continued to be 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 staff team remained kind, caring and committed and were knowledgeable about people’s needs. People continued to benefit from individualised care planning which ensured staff used a person centred approach. The staff team respected people’s equality and diverse needs.

People received good care from a well led service. The registered manager was experienced and qualified and listened and responded to people, staff and others. The management team were described as approachable and very supportive. The quality of care the service provided was assessed, reviewed, improved and developed as necessary.

This was an unannounced inspection which took place on 20 May 2015.

Dimensions- The Laurels 3 Nine Mile Ride is registered to provide care for up to six 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 had ground and first floor accommodation and two of the six bedrooms were fully en-suite.

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 had a variety of ways to keep people as safe as possible. Care workers were trained in and understood how to protect people in their care from harm or abuse. People interacted with staff in a relaxed way. Health and safety was dealt with as a matter of importance and all necessary actions were taken to keep people, staff and visitors as safe as possible. Individual and general risks to people were identified and managed appropriately. The service had a recruitment process which tried to ensure the staff employed in the home were suitable and safe to work there. Staff members had an in-depth knowledge of people and their needs. The staff team were well supported by the management team to ensure they were able to offer good quality care to people.

The service had taken any necessary action to ensure they were working in a way which recognised and maintained people’s rights. They 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 referrals were made to the local authority, if the service felt they were depriving people of their liberty.

People were supported and encouraged to look after their health. Staff worked closely with other professionals to ensure people were supported to be as healthy, both physically and emotionally, as possible. Staff were very skilled in communicating with people and in helping them to make as many decisions for themselves as they could. People were encouraged to be as independent as they were able to be, while being kept as safe as possible.

People were given the opportunity to participate in a variety of activities both individually and with others. People were treated with dignity and respect at all times. They were involved in all aspects of daily life and helped to meet any spiritual, behavioural or emotional needs. Their diversity was recognised in the individualised care planning.

The house was well kept, very clean and comfortable. People’s rooms reflected their individual preferences and tastes, as did the communal areas of the home.

Staff and family members told us the home was very well managed with an open and positive culture. The service kept detailed and accurate records which were well maintained. People, staff and families were able to contribute to the maintenance and development of the quality of care the service offered people.

Most of the people who use the service had limited verbal communication. We spoke with one person, and observed support and care provided to all the people who were at the home during our inspection. We saw people were treated with respect. One relative told us people were offered choices “all the time. They can choose meals each week, and are offered various activities. It’s up to them.”

People’s care plans were person-centred. Information detailed people’s physical and emotional care needs. Staff told us communication worked well, and there were robust methods in place to ensure all staff were aware of updates to people’s care support. Relatives said staff regularly discussed people’s care with them. One relative said “It’s a lovely environment, there’s always lots of laughter. Staff are very caring and supportive. They do the best for people, I’m very impressed and pleased with the staff.”

Staff understood the procedure to report safeguarding concerns. The safeguarding policy was available in a suitable format for people who use the service. One person who uses the service told us they felt safe in the home. We spoke with four relatives of people who use the service. They were aware of how to raise concerns, but told us they had no concerns about the care provided for their loved ones.

Relatives we spoke with could not recall completing the provider’s annual survey, but told us they felt “very much” involved in the care of their loved ones as staff spoke with them regularly. We saw the provider conducted quarterly compliance audits of the service to ensure care was provided appropriately. The service addressed any issues identified to ensure people were supported safely and their views were taken into account.

We found the provider had a suitable training programme in place, and staff were supported to attain further qualifications. We spoke with three care workers, who all told us they felt encouraged to learn, and had training and support to help them care for people who use the service appropriately. One care worker said “the new manager is happy to help us when it’s needed.”

When we visited the home there were five people living there. We were unable to speak to people using the service but we did speak to their relatives. They told us that they “couldn’t fault the staff” and people living at the home “were very happy”. The residents were supported to live as independently as possible.

We saw person-centred care plans noting people’s preferences and methods of communication. We were told this helped staff to understand and encourage people’s decision-making. We saw staff supporting people to make choices.

There were systems in place to get consent from people before providing care. The home was clean and well maintained. Where equipment broke down, it was fixed quickly.

Staff were able to explain the recruitment procedure, and the pre-employment checks they had. We saw evidence the staff recruitment process was followed. We saw training records showed the training staff had taken. However, there were some areas where staff required further training. These included handling difficult or challenging behaviour, and fire evacuation procedures. Complaints were recorded and addressed.