CQC report explained · a residential care home
What the CQC found at Dimensions 27 Sampson Avenue
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- Inspectors found unhygienic and poorly maintained areas, including parts of the kitchen, a bathroom and a person's room. People received medicines as prescribed, but some medicines records were incomplete and one refrigerated medicine was not securely stored or temperature monitored.
- Effective?
- Good
- Staff assessed people's needs, provided suitable food and drink, supported access to healthcare and followed guidance for people with swallowing difficulties. Staff were trained and supported, and consent and best-interest decisions were handled in line with the law.
- Caring?
- Good
- This question was not inspected during this focused inspection, so no separate rating was given.
- Responsive?
- Good
- This question was not inspected during this focused inspection, so no separate rating was given.
- Well-led?
- Requires improvement
- Managers had quality checks and a clear structure, but these checks did not identify problems with premises, infection control or medicines. Inspectors also found that concerns raised at the previous inspection had not been fully addressed.
What inspectors found, September 2023
Dimensions 27 Sampson Avenue was rated Requires Improvement; inspectors found kind, effective care but serious problems with cleanliness, maintenance and oversight.
This was an unannounced focused inspection on 12 July 2023. One inspector spoke with a resident, staff, visiting healthcare professionals and relatives. Records about care, medicines, staffing, training, accidents and quality checks were also reviewed.
The home was rated Requires Improvement overall. Safe and Well-led were rated Requires Improvement, while Effective remained Good. Inspectors found unhygienic and poorly maintained areas, weaknesses in medicines records and quality checks that had not identified known problems.
There were also positive findings. Staff understood people's needs and risks, supported people with medicines and healthcare, and treated people kindly. The rating fell from Good at the previous inspection, published in 2018.
Staff understood risks
Staff knew people's health and safety risks and followed person-centred risk assessments. Inspectors saw safe support for a person at risk of choking.
“Staff knew people's needs and associated risks well.” from the report
Effective staff support
Staff received induction, refresher training, supervision and appraisals. They said they felt supported in their roles.
“Staff received appropriate support to perform their roles and to learn and develop new skills.” from the report
Healthcare and dietary support
People had access to health checks and specialist support. Staff knew people's dietary needs and followed swallowing guidance.
“People with swallowing difficulties had guidelines in place from the speech and language therapist, which we observed staff to follow during lunch.” from the report
Kind and respectful culture
Inspectors found a positive atmosphere. Staff treated people with kindness and respect, and relatives gave positive feedback.
“There was a positive atmosphere in the service where staff treated people kindly and with respect.” from the report
Poor cleanliness and maintenance
seriousSeveral areas were unhygienic or not adequately maintained. Problems included dirty kitchen surfaces, water around a bathroom drain, fluids on a bedroom wall and unsafe storage of equipment.
“We found several parts of the service were unhygienic and/or not adequately maintained.” from the report
Medicine records
needs fixingPeople received their medicines as prescribed, but records lacked important information and had unexplained gaps. One person's insulin was kept in a refrigerator accessible to people, with no temperature monitoring.
“Some MARs from the previous medicine cycle contained a few unexplained gaps, which meant it was unclear if people had received their medicines on those days.” from the report
- 01What has been done to clean and repair the kitchen, bathroom, bedroom areas and outdoor storage identified in the report?
- 02How are you now checking that cleaning schedules are followed and that maintenance problems are dealt with promptly?
- 03How will you prevent gaps in medicines administration records and make sure records include allergies and other key information?
- 04Where is refrigerated insulin stored now, and how are refrigerator temperatures recorded?
- 05What action plan did you send to the CQC, and how can we see evidence that the improvements have been completed?
This was a focused inspection of Safe, Effective and Well-led; Caring and Responsive were not inspected and the overall rating used the previous ratings for the questions not inspected. This explanation was written from the published report of 15 September 2023 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, September 2018
Dimensions 27 Sampson Avenue was rated Good overall; inspectors found kind, personalised care, but safety checks and choking training were not consistently up to date.
This was an unannounced comprehensive inspection on 3 August 2018. Inspectors spoke with people, relatives, visitors, staff, managers and community professionals. They observed care, looked around the home and checked care, staff and management records.
The home was caring, effective, responsive and well-led. People were treated with kindness, supported to make choices, and helped with health care, communication, activities and relationships. Medicines were safely managed and staffing levels met people's needs.
The home was not consistently safe. Some equipment, fire safety and first aid checks were overdue or not recorded. Choking training was incomplete for some permanent staff, agency training checks had not been followed, and infection control practices were not consistently followed.
The overall rating was Good, but Safe was Requires Improvement. This was the first inspection under the ratings process because the home had been dormant until people moved in during summer 2017. The registered manager sent action plans after the visit, which reduced the seriousness of the findings.
Kind and respectful care
People were treated with kindness, respect and compassion. Inspectors saw friendly interactions and support for people's dignity and appearance.
“The service ensured that people were treated with kindness, respect and compassion and that they were given emotional support when needed.” from the report
Personalised support
Care plans described people's needs, preferences, communication and goals. Staff supported people to follow interests and maintain important relationships.
“People's care files included one-page profiles of their key needs and preferences, plus details of their life histories.” from the report
Good health support
The home worked effectively with community professionals and helped people access treatment and ongoing healthcare.
“The whole service worked in co-operation with other organisations to deliver effective care and support.” from the report
Medicines managed safely
Medicines were securely stored and checks found no discrepancies or gaps in administration records.
“Our checks of medicines stock, against records of medicines coming into the service and being administered, identified no discrepancies.” from the report
Overdue safety checks
seriousSome routine checks were not up to date or were not recorded. This included electrical wiring, fire drills, emergency lighting, wheelchairs and first aid boxes.
“Equipment and premises were not consistently checked to ensure environment safety risks were addressed.” from the report
Incomplete choking training
seriousTwo of twelve permanent staff still needed dysphagia training, even though some people were at risk of choking. Records did not show that agency staff had received this training.
“Training on the prevention of choking was not complete for all permanent staff, despite some people using the service being identified as at risk of choking.” from the report
Infection control shortfalls
seriousInspectors found several infection control risks, including a hand-operated kitchen bin, incorrectly stored defrosting meat and food stains on a chair. No infection control audits had been completed.
“This demonstrated failures to prevent, detect and control the risk of the spread of infection.” from the report
Premises needing improvement
needs fixingSome decoration was worn or incomplete. The dining room was not easy for wheelchair users to use, and the main fridge-freezer had been faulty for over six weeks.
“The decoration of some communal areas of the building to be worn or incomplete.” from the report
- 01Has every permanent and agency staff member who supports people at risk of choking completed dysphagia training?
- 02How are electrical, fire, emergency lighting, wheelchair and first aid checks now recorded and checked?
- 03Have regular infection control audits started, and what action is taken when they identify a problem?
- 04Has the faulty main fridge-freezer been repaired or replaced?
- 05What improvements have been made to the dining room so people using wheelchairs can eat comfortably?
This was an unannounced comprehensive inspection covering all five questions and providing the home's first rating under the CQC ratings process. This explanation was written from the published report of 19 September 2018 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Dimensions 27 Sampson Avenue
2 rated inspections over 5 years: the service has slipped, from Good to Requires improvement.
- September 2023Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
Read what inspectors found at Dimensions 27 Sampson Avenue →
- September 2018GoodSafe: Requires improvementEffective: GoodWell-led: Good
Read what inspectors found at Dimensions 27 Sampson Avenue →
- November 2013
Report published without a new overall rating.
- April 2013
Report published without a new overall rating.
- July 2017
Registered with the Care Quality Commission on 26 July 2017.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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