Re-enabled Support

About the service

Re-Enabled Support provides personal care to people in their own homes, some of whom may have a learning disability and mental health needs. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided. At the time of the inspection there were 2 people receiving personal care.

People’s experience of using this service and what we found.

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the statutory guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

At our last inspection, the provider was not able to demonstrate how they were meeting the underpinning principles of Right support, Right care, Right culture. This inspection found that improvements had been made.

Right Support: Staff were now safely recruited with appropriate checks in place. Risk assessments now held sufficient information for staff to meet people's assessed care and health needs. Safeguarding processes now protected people from harm. Incidents and accidents were now better analysed to prevent future re-occurrence. People were now supported to have maximum choice and control of their lives.

Right Care: People’s assessed needs and care plans were in place and better outlined the risks they faced in their daily lives, their accommodation and wider community. Care plans were now more person-centred and contained all the details needed for them to be successfully supported. Information was provided to people through methods in line with their specific communication needs. Enough competent, well trained, and supervised staff supported people to meet their needs and to keep them safe.

Right Culture: Governance systems were effective and the provider had implemented systems to assess, monitor and improve the service. Staff now received support through training, supervision and meetings to ensure they had the knowledge and skills to meet people's needs. Lessons were now learned from accidents and incidents to drive improvements.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was inadequate (published 15 December 2022) and there were multiple breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve.

At this inspection we found improvements had been made.

This service has been in Special Measures since 15 December 2022. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

At our last inspection we recommended the provider consider current guidance on supporting people to access healthcare services, maintain accurate records and take action to update their practice accordingly. We also recommended the provider follows current guidance on meeting people's communication needs and take action to update their practice accordingly. At this inspection we found the service had maintained effective communication with people and assisted people to access healthcare agencies.

Why we inspected

We undertook this focused inspection to check whether the Warning Notices we previously served in relation to Regulation 12 and 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 had been met.

The overall rating for the service has changed from inadequate to good based on the findings of this inspection.

You can read the report from our last inspection, by selecting the 'all reports' link for Re enabled Support on our website at www.cqc.org.uk.

Recommendations

We have made one recommendation in relation to improving the services notification processes.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

About the service

Re-Enabled Support provides personal care to people in their own homes within supported living and domiciliary care settings. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided. At the time of the inspection there were 9 people receiving personal care, some of whom may have a learning disability, autism, mental health needs, sensory impairments or physical disability.

People’s experience of using this service and what we found

The provider was not able to demonstrate how they were meeting the underpinning principles of Right support, Right care, Right culture.

Right Support:

Staff were not all safely recruited and did not all have a DBS in place. Risk assessments did not hold sufficient information for staff to meet people’s assessed care and health needs. The provider had not fully protected people from the risk of abuse and improper treatment. Incidents and accidents involving people were not consistently reported, recorded and investigated.

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; the policies and systems in the service did not support this practice.

Right Care:

Assessments of people’s individual needs had not been consistently recorded and did not consider best outcomes for people. Care plans were not person centred and did not hold sufficient information to guide staff when supporting people. The provider had not fully explored how to present information in an accessible way to meet individual needs. The provider failed to ensure there were enough trained and competent staff to meet people’s needs and keep them safe.

Right Culture:

Governance systems were ineffective. The provider had failed to implement systems to assess, monitor and improve the service. Staff did not receive support through training, supervision and meetings to ensure they have the knowledge and skills to meet people’s needs. We found the language used in some people’s care plans to be disrespectful and undignified. Lessons were not learned from accidents and incidents to drive improvement.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

This service was registered with us on 31 May 2022, and this is the first inspection.

Why we inspected

The inspection was prompted in part due to concerns received about safe staff recruitment, staff training and lack of person centred care plans. A decision was made for us to inspect and examine those risks.

Enforcement and Recommendations

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to person centred care, need for consent, safe care, medicines management, safeguarding, staffing and governance at this inspection.

We have made recommendations about meeting peoples communication and health needs and ensuring appropriate records are in place.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help to inform when we next inspect.

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it, and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.