This was an unannounced inspection which took place on 29 June 2018.

Dimensions Woodmere is a care home (without nursing) which is registered to provide a service for up to six people with learning disabilities. There were five people living in the home on the day of the inspection. Some people had other associated difficulties such as being on the autistic spectrum.

People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

Dimensions Woodmere accommodates people in a large adapted building. Two people had their own flats and four people shared two flats. The service was run in line with the values that underpin the ‘’registering the right support’’ and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism can lead as ordinary a life as any citizen.

At the last inspection, on 24 May 2016, the service was rated as good in all domains. This meant that the service was rated as overall good. At this inspection we found that all domains remained good. Evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns.

This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Why the service is rated good.

People continued to be protected from all forms of abuse. Staff training in safeguarding people was refreshed regularly and staff continued to understand their responsibilities and what action to take if they identified any concerns. The service identified health and safety, safe working practices and individual risks to people. All aspects of safety were considered and actions were taken to assist people to remain as safe as possible.

People continued to be supported by appropriate staffing ratios. Staff met people’s specific needs, including any relating to diversity, safely. Recruitment systems ensured, that as far as possible, staff recruited were safe and suitable to work with people. People were supported to take their medicines, at the right times and in the right amounts by trained staff whose competency was assessed regularly.

A well-trained and knowledgeable staff team offered people effective care. They met people’s diverse needs including their current and changing health and emotional well-being needs. The service worked closely with health and other professionals to ensure they offered individuals the best care in the most effective and comfortable way.

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 practice.

The service was person centred and remained responsive to people’s diverse, individualised needs and aspirations. Activity programmes met people’s preferences and choices. Care planning was individualised and regularly reviewed which ensured people’s current needs were met and their equality and diversity was respected.

The staff team continued to be caring and were committed to meeting people’s needs with kindness and respect. They ensured they promoted people’s privacy and dignity and communicated with them effectively.

The registered manager was experienced, respected and highly thought of. She and the management team ensured the service continued to be well-led. The registered manager and the staff team offered people person-centred and responsive care. They did not tolerate any form of discrimination relating to staff or people who live in the service. The quality of care the service provided was assessed, reviewed and improved, as necessary.

This was an unannounced inspection which took place on 24 May 2016.

Dimensions Woodmere is a residential care home which provides a service for people with learning and other disabilities, such as people on the autism spectrum. The service is registered to provide care for up to six people. There were six people living there on the day of the visit. People were provided with shared or single, self-contained flats. There were two shared and two single flats with communal facilities such as the garden and the laundry.

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 were kept safe from any form of abuse because staff were properly trained so they knew how to protect people. The service took people’s, staff’s and visitors’ health and safety seriously. Policies and procedures which staff understood were followed to keep people as safe as possible. Any risks were identified and action was taken to reduce them. There were high staff ratios to ensure people were looked after safely. The recruitment procedures were robust and made sure, that as far as possible, staff were safe and suitable to work with the people who live in the home. Medicines were given safely by properly trained staff.

People were supported to stay as healthy and happy as possible. The staff team sought advice from and worked closely with health and other professionals to meet people’s needs in the best way. People’s emotional needs were met to ensure people were able to enjoy their lives as much as they could.

Peoples’ rights were protected by the staff and registered manager of the service. The service understood how the Mental Capacity Act 2005, Deprivation of Liberty Safeguards (DoLS) and consent issues 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 may not have capacity to do so. People were helped to make decisions and choices so they could control as much of their daily lives as possible. People were encouraged to be involved in all aspects of the running of their home.

People were provided with care by a staff team who knew them well and who understood their individual needs. Staff were well trained, understanding and responsive to changes in people’s needs and wishes. People were treated with respect, kindness and dignity at all times. Staff understood what person centred (individualised) care meant and why it was important. They were non-discriminatory and met people’s equality and diversity needs. People were provided with a variety of activities, according to their needs, abilities and preferences.

The service was well-led by a respected registered manager and supportive management team. The service had a positive culture and open management style which encouraged people, staff and others to express their views and opinions. The quality of the care provided was maintained and enhanced as appropriate.

During our inspection we observed a relaxed and welcoming atmosphere from the people living in the home and staff. People expressed their views and were involved in making choices about their care. Relatives told us staff treated the people living at Woodmere with respect and supported them to make their own choices. One person commented that staff “do a very good job, better than I could do.”

We observed staff communicating and listening to people in a respectful and meaningful way. We spoke with staff and looked at people's support plans and supporting documents and found that peoples' needs were assessed, and care and support was planned and delivered in line with their individual support plans and communications passport.

People who live at Woodmere were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening. People living at the home told us they felt safe. Relatives felt that they would be comfortable to raise concerns with the manager.

Staff were supported to deliver care safely and to an appropriate standard. They had attended appropriate training and supervision.The provider had a system of quality monitoring and processes in place to identify, assess and manage risks to the health, safety and welfare of people who use the service and others.

Not all the people using the service were able to tell us their experiences. We used a number of different methods, including observation to help us understand the experiences of the people that use the service. If you wish to see the detailed evidence supporting our summary please read our full report.

We considered our inspection findings to answer questions we always ask;

• Is the service safe?

• Is the service effective?

• Is the service caring?

• Is the service responsive?

• Is the service well-led?

This is a summary of what we found.

Is the service safe?

People who use the service had been cared for in an environment that was safe, clean and hygienic. One relative of a person who uses the service told us “X is cared for in a safe environment.” Guidelines about infection prevention and control were available for staff to follow. All staff had received refresher training in infection prevention and control. A personal evacuation plan was present in each person’s file we looked at. A member of the management team was available on call in case of emergencies.

Since our last inspection on 8 and 9 January 2014 we found the provider had put measures in place to strengthen the recruitment process for the employment of new staff. Existing staff recruitment files had been reviewed to ensure they contained all the information required by the Health and Social Care Act. This meant staff employed to work at the service were suitable and had the skills and experience needed to support people.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards which applies to this type of service. While no applications have needed to be submitted by the provider since 2010, proper policies and procedures were in place. Relevant staff were trained to understand when an application should be made, and how to submit one.

Since our last inspection on 8 and 9 January 2014 we found actions had been taken by the provider to ensure records for people and staff were accurate and fit for purpose. We saw people's records were stored securely and could be located promptly when requested.

People were protected from the risk of inappropriate or unsafe care. This was because the provider had an effective system in place to identify, assess and manage risks to the health, safety and welfare of people who use the service and others in relation to incidents.

Is the service effective?

We spoke with two people and two relatives of people who use the service. They were complimentary about the care received. One person we spoke with said “I am happy here.” It was clear from our observations and from speaking with staff that they had a good understanding of the people’s care and support needs and that they knew them well. One relative told us. “They are providing good care that meets X’s needs.”

Staff had received training to meet the specific needs of the people living at the home. Examples of training included, management of epilepsy. People’s health and care needs were assessed with them. Care to meet these needs was recorded in support plans. Relatives we spoke with told us the support plans reflected their family member’s current needs. We noted people’s involvement in annual reviews of their care.

Is the service caring?

People were supported by kind and supportive staff. All interactions we observed between the staff and people were open, respectful and courteous. We saw that care workers gave encouragement when supporting people. People were able to do things at their own pace and were not rushed. A relative told us "I have no concerns about the care here.” People using the service, their relatives, friends and other professionals involved with the service completed an annual satisfaction survey. Where shortfalls or concerns were raised these were addressed.

People’s preferences, interests, aspirations and diverse needs had been recorded in their support plans. Care and support had been provided in accordance with people’s wishes for example arranging preferred activities, holidays and colour schemes in bedrooms.

Is the service responsive?

People’s needs had been assessed before they moved into the home. People told us they met with their key workers once a week to discuss what was important to them. Records confirmed people’s preferences, interests, aspirations and diverse needs had been recorded. Care and support had been provided in accordance with people’s wishes. People had access to activities that were important to them and had been supported to maintain relationships with their friends and relatives.

Is he service well-led?

The provider had systems in place to regularly assess and monitor the quality of service that people received. The provider carried out quarterly quality audits of the service. The home manager told us a survey went out to staff, people and their relatives annually. This survey asked people what they thought about the quality of support provided. We saw the outcome of the last survey for 2013-14 was available to people in an accessible format. Records seen by us showed people were complementary about the service and any identified shortfalls were addressed promptly. Relatives we spoke with confirmed they had been listened to and provided examples of improvements made to the service following their feedback. As a result the quality of the service was continuingly improving. Staff told us they were clear about their roles and responsibilities. This helped to ensure that people received a good quality service at all times. One relative told us “They provide a very good service for X.”