Background to this inspection
Updated
13 October 2018
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, and to provide a rating for the service under the Care Act 2014.
One adult social care inspector carried out this inspection.
Prior to the inspection we looked at information we had about the service. This information included the statutory notifications that the provider had sent to CQC. A notification is information about important events which the service is required to send us by law.
On the first day of the inspection we met with the registered manager, two senior reablement assistants and the referral care coordinator. On the second day we attended the weekly staff meeting, met with three other senior reablement assistants and 11 reablement assistants.
We spoke with five people who had either used the service in the recent past or were currently using the service. We also spoke with two relatives whose family member was using the service. We looked at care records, staff files and other records relating to the running of the service. This included the policies and procedures, quality assurance and audit systems and letters of compliments that had been received by the service.
We received feedback from one healthcare professional who worked closely with the service.
Updated
13 October 2018
This inspection started on 20 August and then completed on 20 September 2018 and was announced. We gave the service 48 hours’ notice of the start of our inspection because we wanted key people to be available. The inspection was carried out by one adult social care inspector.
At the time of this inspection the service were providing a short term reablement service to 54 people in their own homes. The staff team was made up of 44 reablement and senior reablement assistants. Throughout the report we have just referred to these as reablement staff. The aim of the service is to provide a six- week domiciliary care service to people in their home, either after discharge from hospital or to prevent a hospital admission. The reablement staff will work with people to help them regain their independence or regain as much as possible and determine the level of ongoing support needed.
There was a registered manager in post and they were available when this inspection took place. 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.
The last inspection of the service was completed in August 2016 and we rated the service overall as Good. There were no breaches of the regulations. Since this inspection the service no longer provides a residential rehabilitation service, just a community based service.
The feedback we received from people who used the service, relatives and reablement staff was positive and has been detailed in the full report. Satisfaction was expressed regarding the quality of the staff and their ability to “get them back on their feet”. As a result of this inspection, we have rated the service as Good.
People received a service that was safe. The reablement staff were aware of their responsibility to protect people’s health and wellbeing and had received safeguarding adults training. They knew how to report concerns and how to safeguard people from harm. Risk assessments and management plans ensured any potential risks to people’s safety and wellbeing were identified and action taken to reduce or eliminate the risk.
Where required people were supported with their medicines. Staff were trained to do this safely. There were sufficient staff employed and new provision of care and support to a person was only organised when the staff team had the capacity to meet needs. Staff were recruited safely to ensure unsuitable staff were not employed.
People received an effective service. Their care and support needs were assessed and goals were set, to be achieved by the end of the six week period. Progress in meeting those goals was reviewed each week and included the views of the person. Where people needed help with meal and hot drink preparation, the reablement staff would assist them to regain the skills to do this independently. The reablement staff worked with other health and social care professionals to ensure people’s health and wellbeing was maintained.
Staff received the appropriate training to do their jobs well and were well supported. They were regularly supervised. This meant they had the necessary skills and knowledge to care for people correctly.
The aim of this service was to help people be independent again following a period of ill health or as independent as possible. People were involved in making decisions and making their own choices about their care and support. People were asked to consent before care and support was delivered. The service was meeting the requirements of the Mental Capacity Act 2005.
The service was caring and feedback we received evidenced that people were treated with dignity, respect and kindness. The reablement staff formed good working relationships with the people they were assisting. They understood their role in assisting people to regain independence. The staff good team worked well together.
The service was responsive. The level of support each person received was based upon their own needs and was reduced as they made progress in achieving the goal of being independent or as independent as possible. People were provided with information about the service and were informed about the provider’s complaints procedure should they need to raise any concerns. People were encouraged to provide feedback about the service they received and action was taken where necessary.
The service was well led. The staff team was led by a registered manager with many of the staff having worked together for many years. There was good leadership and management in place. Review meetings and staff meetings ensured the staff team all worked together to achieve the aims of the service. Staff meetings also ensured reablement workers were kept up to date with changes and developments in the service. The provider had reporting systems in place to ensure they were aware of how things were running in the service and a programme of audits was completed to check on the quality and safety of the service.