CQC report explained · a residential care home
What the CQC found at Dimensions 40 Cody Road
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 incomplete risk assessments, unsafe infection control practices and gaps in food and fire safety records. Medicines and recruitment were managed safely.
- Effective?
- Good
- This key question was not assessed during this focused inspection. Its previous rating was carried forward.
- Caring?
- Good
- This key question was not assessed during this focused inspection. Its previous rating was carried forward.
- Responsive?
- Good
- This key question was not assessed during this focused inspection. Its previous rating was carried forward.
- Well-led?
- Requires improvement
- Inspectors found that activity plans and care records were not consistently person-centred, and quality monitoring had not identified or fixed important shortfalls.
What inspectors found, November 2023
Rated Requires Improvement; inspectors found risks in care planning, consent, infection control, activities and management systems.
This was an unannounced focused inspection in September 2023. Inspectors reviewed Safe and Well-led, spoke with staff and a relative, observed people and staff, and checked care, medicines, recruitment and management records.
The home was not always safe. Risk assessments and care plans were out of date or incomplete. Inspectors also found problems with consent records, infection control, food safety, fire risk information and meaningful activities. Medicines and staff recruitment were managed safely.
The home was rated Requires Improvement overall, with Requires Improvement for Safe and Well-led. The previous overall rating was Good in 2018. The other three key question ratings were not inspected and were carried forward from the previous inspection.
Medicines
Medicines were stored, given and disposed of safely. Staff had training and competency checks before administering medicines alone.
“People's medicines were stored, administered, and disposed of safely.” from the report
Safeguarding
The safeguarding systems were effective. Staff said they would report concerns and felt confident that the manager would act.
“Systems and processes in place to safeguard people from abuse were effective.” from the report
Family communication
A relative said they were kept informed about relevant information and appointments. The report also found that the provider notified CQC appropriately about certain incidents.
“A relative told us when things went wrong, they were informed and kept up to date and where required apologies were made in writing.” from the report
Consent and legal rights
seriousThe home was not consistently following mental capacity law. Some capacity assessments and best-interest decisions were missing or not fully recorded, and legal authority for managing some people's finances was not evidenced.
“People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests” from the report
Risk information
seriousRisk assessments and care plans did not always give staff enough information. Examples included vision problems, blood-thinning medicines, conflicting dietary information and flammable creams.
“Risks to people were not always assessed and mitigated to ensure people would receive safe care.” from the report
Infection control
seriousThe home was dusty, cleaning records were blank and some infection control practices did not follow policy or guidance. Inspectors found a toilet bin without a liner during part of the inspection.
“Infection prevention and control was not managed safely in accordance with the provider's policy and people were not always protected from the risk of infection.” from the report
Activities and community life
needs fixingPeople did not go out regularly and there was little recorded activity. Inspectors did not see people taking part in activities during the inspection, creating a risk of boredom and social isolation.
“This meant people were at risk of boredom, lack of community engagement and social isolation.” from the report
Management oversight
seriousQuality checks had not reliably found or corrected the problems. Some requested audit records were not provided by the time the report was written.
“Effective risk and quality monitoring arrangements were not place.” from the report
- 01What changes have been made to update every person's support plan and risk assessment?
- 02How are mental capacity assessments and best-interest decisions now recorded and checked?
- 03What has been done to improve cleaning records, food safety and infection control?
- 04How often does each person now take part in activities or go into the local community?
- 05What action was taken in response to the Regulation 17 Warning Notice, and how is progress being checked?
This was a focused inspection of Safe and Well-led only; the other three key question ratings were carried forward from the previous inspection. This explanation was written from the published report of 2 November 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, January 2018
Rated Good; inspectors found kind, safe care, but staffing levels could limit one-to-one support and activities.
The inspection was unannounced and took place on 29 November 2017. Inspectors spoke with people, relatives and staff, observed care, read care plans and checked medicines, recruitment and management records.
The home was rated Good overall and received Good ratings for Safe, Effective, Caring, Responsive and Well-led. Inspectors found people were safe, treated kindly, supported with their health needs and involved in activities and decisions where possible.
The home was also rated Good at the previous inspection in March 2016. Inspectors recommended reviewing staffing levels so people could have more one-to-one support and take part in more activities.
Kind and respectful care
Relatives spoke positively about staff. Inspectors saw staff spending time with people, listening and protecting their privacy and dignity.
“People's relatives said people were treated with kindness, respect and compassion.” from the report
Safe medicines systems
Medicines were given at the correct times. Records had no gaps and medicines were stored securely.
“There were no gaps on medicine administration records.” from the report
Good health support
The home worked with a wide range of health and social care professionals. Records of health appointments were kept.
“The service worked closely with a wide range of professionals such as speech and language therapists, learning disability nurses, dentists, chiropodists social workers, opticians and general practitioners” from the report
Detailed care planning
Care plans covered people's health needs, lives, preferences, interests and aspirations. They were reviewed regularly.
“Care plans were detailed and included information about people's physical and mental health care needs and information about their lives before living at the service.” from the report
Teamwork and oversight
Inspectors found clear management arrangements, regular meetings and audits covering care, medicines, safety and property.
“Staff said they worked well as a team and communicated well.” from the report
Staffing and activities
needs fixingInspectors judged staffing levels satisfactory overall but found that two-person care tasks could leave only one staff member for other duties. This limited opportunities for more one-to-one support, activities and outings.
“This limited the possibility of some people participating in a fuller day activities programme, and for example to go out more.” from the report
Discrimination policy
minorThe anti-discrimination policy covered staff but not people using the home. The report says this was going to be reviewed.
“The registered persons' had an anti discrimination policy, but this currently only covered staff.” from the report
- 01What staffing levels are in place now, and how do you make sure people receive enough one-to-one support?
- 02How often can each person go out or take part in activities, and what happens when two staff are needed for personal care or moving and handling?
- 03What changes were made after the recommendation to review staffing levels?
- 04Has the anti-discrimination policy been updated to cover people living in the home?
- 05How are families involved in care plan reviews and decisions made in a person's best interests?
This was an unannounced inspection of the overall service, including the premises and care, and all five CQC questions were rated. This explanation was written from the published report of 4 January 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 40 Cody Road
3 rated inspections over 7 years: the service has slipped, from Good to Requires improvement.
- November 2023Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- January 2018Goodstayed GoodSafe: GoodWell-led: Good
- June 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2013
Report published without a new overall rating.
- November 2012
Report published without a new overall rating.
- January 2012
Registered with the Care Quality Commission on 4 January 2012.
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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