Background to this inspection
Updated
27 August 2021
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
Inspection team
The inspection was carried out by two inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
This service is registered with us as a domiciliary care agency. However, it provides assessment, and reablement support to people living in their own houses and flats. Some people may receive assistance with their personal care needs.
Notice of inspection
We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection. Inspection activity started on 4 August 2021 and ended on 17 August 2021. We visited the office location on 11 August 2021.
What we did before the inspection
We reviewed information we held and had received about the service since the last inspection. We sought feedback from the local authority, safeguarding team and other professionals who work with the service. We checked information held by Companies House and the Information Commissioner’s Office. We checked for any online reviews and relevant social media, and we looked at the content of the provider’s website. We asked the registered manager to send some documents in advance of visiting the service’s office. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all of this information to plan our inspection.
During the inspection
We spoke with two people and five relatives about their experience of the assessment process and the reablement support. We spoke with the nominated individual about their oversight of the service. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We spoke with provider’s head of regulated services, the registered manager, the governance and quality assurance manager and one senior care worker. We received written feedback from six other care workers and four social workers. We contacted the local authority and received a further written reply. We reviewed a range of records. This included two people’s care records and medicines administration records. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We requested and received quality assurance and other governance records. We continued written communication with the provider’s head of regulated services and the registered manager.
Updated
27 August 2021
About the service
START stands for the Short-Term Assessment and Reablement Team. START is a community reablement service, providing assessment and goal-based support to people living in their own homes. Assessment and support are usually provided for up to six weeks, often after a person is discharged from an acute hospital setting. The service supported 11 people at the time of inspection. The service sets their own limits about how many people they are able to support at any one time.
Optalis Limited (the provider) provides adult social care in partnership with the Royal Borough of Windsor and Maidenhead and Wokingham Borough Council. People’s reablement packages delivered by START are entirely funded by the local authority. START only provides assessment and reablement services to people who live within the boundaries of Wokingham Borough Council.
Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks such as those related to personal hygiene and eating. Where they do, we also consider any wider social care provided.
People’s experience of using this service and what we found
Improvements to safety were made since the last inspection. People were protected against abuse and neglect. People's risks were satisfactorily assessed. Medicines were safely managed. Personnel files contained all the required documents and checks to ensure safe staffing recruitment. People are protected against the risk of infections, especially during the pandemic.
People's preferences were assessed and documented. Staff were well supported and the training, supervisions and performance appraisals were up to date. People's nutrition and hydration were monitored to ensure they received enough to eat and drink. People’s healthcare or social care issues needing support were referred to external healthcare professionals, to ensure joined up care.
Staff identified themselves as kind and caring, and this was confirmed by people, relatives and community social workers. There was good engagement between staff and people who use the service. There was evidence of people's and relatives' involvement in the care planning. Reviews were undertaken in an ongoing manner. People's dignity and privacy was respected.
There were very detailed reablement plans, and these were person-centred and people's preferences were well-documented. There was a complaints system in place. Information is presented in line with the principles of the Accessible Information Standard. Some continued AIS work is required for people with learning disabilities, autism and dementia. We made a recommendation about this.
Improvements to governance were made since the last inspection. There was a positive workplace culture. The provider and the registered manager had robust quality assurance systems in place. Actions were taken when improvements were required. There was good engagement with people, relatives and staff. The service has adapted their aims and objectives to ensure the focus is increasing people’s independence. The staff and management team have embedded continuous learning and improving care into everyday practice.
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 requires improvement (published 22 October 2019). 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 and the provider was no longer in breach of regulations.
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.