Archived: Reablement Services South Team

The Reablement Services South Team supports people in their own homes to achieve their pre-treatment, or pre-hospitalisation, level of independence within six weeks of support. At the time of our inspection, 78 people were supported with care.

The service had a registered manager. 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.

People and their relatives told us they felt safe with the staff who supported them. Staff received training to safeguard people from abuse. They were supported by the provider, who acted on concerns raised and ensured staff followed safeguarding policies and procedures. Staff understood what action they should take in order to protect people from abuse. Risks to people’s safety were identified and staff were aware of current risks, and how they should be managed.

People were administered medicines by staff who were trained and assessed as competent to give medicines safely. Records indicated people’s medicines were given in a timely way and as prescribed. Checks were in place to ensure medicines were managed safely.

There were enough staff to meet people’s needs effectively, and people told us they had a consistent and small group of staff who supported them, which they appreciated. The provider conducted pre-employment checks prior to staff starting work, to ensure their suitability to support people who lived in their homes.

Staff asked people for their consent before undertaking any care tasks. The provider supported people who were able to make their own decisions, and staff respected their right to do so. Staff and the registered manager had a good understanding of the Mental Capacity Act.

People and relatives told us staff treated people with dignity, kindness and respect. People’s privacy was maintained. People were supported to make choices about their day to day lives.

People saw health professionals when needed, and the care and support provided was in line with what they had recommended. People’s care records were written in a way which helped staff to deliver personalised care and gave staff information about people’s communication needs, their likes, dislikes and preferences. Care plans focussed on the outcomes people wanted to achieve to regain their independence, and were regularly reviewed to ensure this happened effectively.

People and relatives told us they felt able to raise any concerns with the registered manager. They felt these would be listened to and responded to effectively and in a timely way. Staff told us the registered manager and senior staff were approachable and responsive to their ideas and suggestions. There were systems in place to monitor the quality of the support provided, and the provider regularly sought feedback from people and their relatives with a view to improving the service.

We visited their administrative office on 6 May 2014. We spoke with the manager, a supervisor and two care staff, known as, reablement assistants. We looked at paper and electronic records. We spoke with three reablement assistants, two people who used the service and three relatives by telephone, the following day.

We looked at five outcomes to answer the following questions. Is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well led?

Below is a summary of what we found. If you would like to see the evidence supporting our summary please read the full report.

Is the service safe?

People's needs were assessed by a reablement assessment officer (RAO) before they returned to their homes. The officers completed Independent Reablement Support Plans (IRSP) that explained how staff should support people to achieve their previous independence. A reablement assistant told us, 'The reablement officer and occupational therapist talk to people and fill in all the paperwork.'

We found that people's medicines were managed and administered safely. A reablement assistant told us, 'I am confident to do it (administer medicines) because we have training and have to pass the test and the medicines administration records (MAR) are filled out well by the RAO.'

The three staff personnel records we looked contained all the information required by the Health and Social Care Act 2008. The provider checked staff were suitable to work with vulnerable people and ensured they had appropriate skills and experience to support people in their own homes.

Is the service effective?

The support plans we looked at identified the frequency of calls and the equipment needed to support the person. The support plans included an assessment of whether the person was likely to achieve their previous level of independence within six weeks, or whether they might need to be referred to a long term service provider.

Everyone we spoke with recognised the level of independence they had achieved since receiving the service. People told us, 'I expected progress to be slow', 'X is improving' and 'It is the care that she has had that has contributed enormously.'

Is the service caring?

People we spoke with told us the staff treated them with respect. People said, 'The service is absolutely fantastic. We could not be more pleased with it', 'It's better than I could ever have expected. We can't praise them enough' and 'They are very polite, very friendly in a professional way.'

Reablement assessment officers visited people and asked for feedback about the service every two weeks. People were asked if they felt involved in their progress and whether they had any suggestions or comments.

Is the service responsive?

A reablement assistant told us they could ask the office staff to rearrange their scheduled call times to suit people's preferences. Reablement assistants told us, 'We receive texts, 'please phone the office re X', if anything unexpected happens' and 'If someone improves, we might change from four to two calls. It changes constantly.'

We found that the service continued to support people who had not achieved their previous independence by the final review date, until a long term service provider was commissioned. The provider co-operated with other agencies and service providers to ensure that people received continuous care and support.

Is the service well led?

The manager had an effective quality monitoring system. They told us about the changes they had made in response to feedback from people who used the service and staff. One relative told us, 'We have a review booked for tomorrow to check how we are getting on.'

We found that responsibilities were delegated effectively to reablement supervisors, to ensure that reablement assistants received regular supervision, training and observation in practice. Staff we spoke with felt well informed about the service and any planned changes.