Archived: The Royal Borough of Kensington and Chelsea

The Royal Borough of Kensington and Chelsea is a reablement service for adults aged 18 and above. The service supports people for up to six weeks to regain their independent living skills and confidence, usually following a hospital admission or after a short period of care and treatment from community healthcare professionals in their own home. There were 45 people using the service at the time of this inspection.

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

People spoke extremely positively about the quality of care and support they received from the service. Comments included, “They are better than 100%, terrific” and “I never thought I would be as independent as I am now and can go out, managing with a bit of help from my family for the heavier jobs indoors.” People told us the service gave them confidence and new ways of coping following ill health, and they would not hesitate to recommend the service to others.

People were involved as much as possible with the planning of their reablement goals. Each person was provided with an individual plan of care, which reflected their own aims, preferences and unique circumstances. There was individual guidance to mitigate any risks to people's safety.

People benefitted from receiving their care and support from a dedicated, experienced and well qualified staff team. Staffing levels were arranged to ensure people had the time they needed to work towards meeting their goals. Staff told us they found their roles immensely rewarding and they felt appreciated by people and their relatives, and their employer.

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.

The service was forward thinking and innovative. The provider continuously looked for ways of improving their partnership working with the community NHS Trust and other organisations, so that people received excellent outcomes. For example, people could receive overnight care in their own homes if required, so that they could leave hospital and commence reablement without any unnecessary delays.

People, and their relatives where applicable, were asked to provide their views through questionnaires and surveys. There were also local forums organised by the provider which people could choose to take part in. Complaints and concerns raised by people or other relevant parties were taken seriously by the service.

People and their relatives thought the service was exceptionally well managed. This view was also expressed by external local health care professionals who were very pleased with how the service operated and capably met people’s needs.

Rating at last inspection

The last rating for this service was good (published 22 March 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor the 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.

The service specialises in providing care for people recently discharged from hospital with rehabilitation potential. Care is commissioned by Kensington and Chelsea health and social care services. 53 people were using the service at the time of our inspection although they were not all receiving support with personal care. Staff that went into people's homes to support them were known as 'community independence assistants’(CIAs).

There was a registered manager in post. 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.

We received positive feedback from people using the service who felt they were supported to regain their independence and that staff had the skills and training to help them achieve their goals.

People were assessed prior to using the service and care records were comprehensive and person-centred, providing staff with the information they needed about people to care for them effectively. Risk assessments had been carried out to address each area of risk to individuals.

Each person had an independence plan which identified the areas that people needed support with. A goal setting document was also used to identify SMART (specific, measurable, achievable, realistic and timed) goals that people could work towards to improve their independence with regards to their daily living skills. Support typically lasted six weeks or ended when people achieved their goals.

The registered manager understood their responsibilities in line with the requirements of the Mental Capacity Act (MCA) 2005. People’s capacity to make decisions about their care and support had been assessed and people were encouraged to maintain as much independence as they were able and to make decisions for themselves.

Staff recruitment procedures were in place and were being followed to ensure suitable staff were employed by the service. The service employed enough staff to ensure people’s needs were being met.

Staff understood safeguarding and whistleblowing procedures and were clear about the process to follow when reporting concerns.

Staff received training in medicines management and people received their medicines safely.

Staff knew how to respond to medical emergencies or significant changes in a person’s health and systems were in place to manage emergencies and to provide continuity of care to people.

Staff received regular supervision and yearly appraisals during which they were able to discuss any concerns, identify any training needs and set any personal development objectives for the year.

Feedback was sought from people during and at the end of their support as part of the provider's quality assurance monitoring.

Complaints procedures were in place and people said they would feel able to raise any issues so they could be addressed.

The provider recognised the importance of monitoring and improving the service.

Consent was obtained appropriately. People were asked for their consent before staff delivered any care or treatment. We saw signed consent forms on people's records.

There was a safeguarding policy in place that outlined what abuse was and how it should be reported. A log of all safeguarding incidents were kept in the team as well as being logged centrally with the safeguarding team. The provider responded appropriately to any allegation of abuse.

Staff received appropriate professional development. Staff received an induction in line with the organisation's policy and appropriate training was provided. Staff felt well supported to carry out their duties, they received supervision every 4-6 weeks. Topics covered included staff development and training needs and workloads.

There were measures in place to assess the quality of the service. Managers carried out spot checks to audit staff and quality checks were conducted in people's homes. Complaints were dealt with in line the organisation's policy.