CQC report explained · a residential care home
What the CQC found at Dimensions The Mulberries
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, October 2023
Dimensions The Mulberries is rated Requires Improvement; inspectors found risks in medicines, cleanliness, records and dignity, and issued a warning notice.
Inspectors visited on 20 and 21 June 2023 without giving notice. They spoke with relatives, staff, the registered manager and a health professional. They observed care and checked care plans, medicines records, safety records, training, recruitment and quality checks.
The home was not always safe. Inspectors found problems with medicines records and guidance, hot water checks, cleanliness and out-of-date risk assessments. They also saw people were not always treated with dignity, including one person waiting for 45 minutes without staff interaction.
Responsive care was rated Good. People had personalised support, activities, community visits and help to keep family relationships. Safe, Caring and Well-led were rated Requires Improvement because the home did not consistently manage risks, respect people's dignity or use its checks and records effectively.
The previous rating was Good, published in December 2018. This inspection began as a focused inspection of Safe, Responsive and Well-led, then Caring was added after inspectors found concerns about dignity and respect. The report says the provider must send an action plan and that CQC will monitor progress.
Personalised support
Support plans included people's life histories, routines, preferences and care needs. Staff knew about people's favourite activities, programmes and songs.
“Support plans set out person-centred information about people and what was important to them, including their day and night time routines.” from the report
Activities and community access
People took part in activities at home and went out regularly for swimming, cinema visits, shopping and walks.
“Staff supported people to go out and about regularly. These included going swimming, to the cinema, shopping and walks in the local area.” from the report
Safeguarding and staffing
Staff knew how to recognise and report abuse. Inspectors found enough staff on shift at the time of the visit and appropriate recruitment checks were in place.
“Staff had completed training on how to recognise and report abuse. Staff and the registered manager knew how to raise concerns, including using whistleblowing processes.” from the report
Family and advocacy involvement
Relatives and advocates were involved in care planning and reviews. People could access independent advocacy support.
“The service involved them in planning and reviewing people's care. This gave them opportunities to help make decisions about people's care.” from the report
Medicines were not always managed safely
seriousThere was unclear guidance and recording for medicine patches, a discrepancy about how often patches should be applied, and no evidence that giving medicine with yoghurt had been checked by a health professional. Some hospital information was also out of date.
“The provider's processes to support people to take their prescribed medicines safely were not always implemented effectively at all times.” from the report
Safety and cleanliness checks were not consistent
seriousSome kitchen and bathroom areas were dirty. Hot water readings were above the stated safety level without recorded action, and some risk assessments had not been reviewed recently.
“Risks to people's safety and well-being not always managed consistently so as to support people to stay safe at all times.” from the report
Dignity and interaction
seriousOne person waited 45 minutes at lunchtime without staff interaction. Inspectors also saw people moved in wheelchairs or staff searching a wheelchair bag without explaining what they were doing.
“The issues we found indicated people were not always treated with dignity or respect and their independence was not always promoted.” from the report
Records and quality checks
seriousSome daily records gave little detail about people's wellbeing, and some shifts had no record of the support provided. The home's audits had not found or fixed some of the problems inspectors identified.
“These issues indicated systems were not used robustly enough to demonstrate safety and quality was effectively managed.” from the report
Communication with families
needs fixingRelatives and staff gave mixed feedback about communication and involvement. Some relatives reported fewer family meetings, fewer social events and no recent feedback questionnaires.
“Some relatives felt the registered manager did not always proactively engage with them.” from the report
Mealtime experience
needs fixingStaff supported people to eat one after another rather than giving some people the chance to enjoy mealtimes together. CQC recommended that the provider review guidance and update its practice.
“We recommend the provider consider current guidance on promoting positive mealtime experiences in adult social care settings and take action to update their practice accordingly.” from the report
- 01What changes have been made to medicines records, patch guidance, storage temperature checks and hospital passports since the inspection?
- 02How are hot water temperatures, cleanliness and people's risk assessments now checked and acted on?
- 03What training or supervision has been introduced to make sure staff explain what they are doing and protect people's dignity when providing care?
- 04How do managers check that every shift records the support given and the person's wellbeing?
- 05When will family meetings, social events and regular feedback questionnaires resume, and how can relatives raise concerns?
This was an unannounced focused inspection of Safe, Responsive and Well-led, widened to include Caring; the report says ratings for questions not inspected were carried over from the previous inspection. This explanation was written from the published report of 24 October 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, December 2018
Dimensions The Mulberries was rated Good; inspectors found safe, kind and personalised care across all five areas.
This was an unannounced comprehensive inspection on 13 November 2018. Two inspectors reviewed the home, including care records, risk assessments, medicines records, staff recruitment and training documents. They also observed care and spoke with four relatives and health and social care professionals.
The home supported seven people with complex needs, including physical and learning disabilities. Inspectors found enough staff, safe medicines practices, suitable training and systems to reduce risks. People were treated with kindness and respect, and staff understood their individual needs and ways of communicating.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. This means the inspection found the service met the required standards overall. The rating was unchanged from the previous inspection on 18 April 2016.
Enough staff
Inspectors saw that people did not wait for support and that extra staff were available when two people were needed.
“There were enough staff to meet people's care needs” from the report
Safe medicines
Medicines were stored securely and administration records were complete. Staff also had clear guidance for medicines given when needed.
“All of the Medicines Administration Record (sheets) staff completed were up to date with no errors or omissions.” from the report
Kind and respectful care
Staff understood people well and responded to their choices, comfort and distress. Privacy and dignity were promoted during personal care.
“Staff treated people with respect and affection.” from the report
Personalised support
Care plans included individual preferences and communication methods. People were supported with meaningful activities, relationships, holidays and community access.
“People had care plans that were tailored to meet their individual needs.” from the report
Learning and improvement
The provider used incidents, audits and feedback to make changes, including clearer hospital discharge guidance and improvements to equipment.
“The provider had systems in place to monitor quality in the service and make improvements.” from the report
Inspectors raised no specific concerns in this report.
- 01How will management cover be arranged when the registered manager is away, and who will be responsible for decisions about my relative's care?
- 02How will you assess and record my relative's communication preferences and make sure all staff follow them?
- 03What equipment, including hoists, will be available for my relative, and is the planned equipment programme complete?
- 04How will you support my relative to take part in activities at home and in the community?
- 05How will you manage my relative's dietary, swallowing, PEG feeding or other healthcare needs?
This was an unannounced comprehensive inspection covering all five CQC questions and the care, accommodation and management of the home. This explanation was written from the published report of 13 December 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 The Mulberries
4 rated inspections over 8 years: the service has held its Requires improvement rating throughout.
- October 2023Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: GoodCaring: Requires improvementResponsive: GoodWell-led: Requires improvement
- December 2018Goodstayed GoodSafe: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2016Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- April 2014
Report published without a new overall rating.
- June 2013
Report published without a new overall rating.
- December 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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