Background to this inspection
Updated
12 December 2018
The inspection: We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
Inspection team: Two inspectors visited on both days of the inspection. An expert by experience supported the inspection on day one. 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 type: The service is a domiciliary care agency. It provides personal care to people living in their own homes. It provides a service to adults of all ages, people with mental health concerns and those with a learning disability and or autism.
The service has three managers registered with the Care Quality Commission. Each registered manager is responsible for their own geographical area where the service operates. They and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection: This inspection was announced to ensure the provider was available to support the process.
What we did when preparing for and carrying out this inspection:
We reviewed information we had received about the service since the last inspection. This included details about incidents the provider must notify us about, such as abuse. We sought feedback from the local authority and professionals who work with the service. We assessed the information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection.
During the inspection, we spoke with six people who used the service and three relatives over the telephone to ask about their experience of the care provided. On day two we visited two people in their own homes and spoke with one of their relatives.
We spoke with 13 members of staff including the registered managers, team leaders and care workers, service managers, the business development officer and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider.
We reviewed a range of records. This included five people’s care records and multiple medication records. We looked at three staff files in relation to recruitment and six staff member’s supervision records. Multiple records relating to the management of the service and a variety of policies and procedures developed and implemented by the provider were reviewed during and after the inspection.
Updated
12 December 2018
Rating at last inspection: Requires Improvement (report published 26 October 2017)
About the service: The service supports older and younger adults in their own home following a period of ill health or hospitalisation. The aim of the service is to develop people’s skills to become independent in their own home or if needed access longer term support. People accessed the reablement service for up to six weeks to receive focussed support to achieve their goals to independence.
Why we inspected: This was a planned inspection based on the rating at the last inspection. The service improved their rating to good overall.
Overall summary of the inspection:
The role of the reablement service was to provide a short period (up to six weeks) of intensive support to develop people’s skills and confidence following an illness. The goal of the service was to restore people’s independence to enable them to carry on living in their own home. The staff worked well with all agencies involved to provide coordinated support for people. The service had achieved over 80% success in supporting people to become independent. People we spoke with were happy with the service they had received and the positive outcome for them.
Everyone we spoke with told us that staff were kind and caring and that they were treated with respect. Staff showed a genuine motivation to deliver care in a person-centred way, based on people’s preferences and likes. People were observed to have good relationships with the staff team.
People’s health was well managed and staff had positive links with professionals which promoted their wellbeing. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.
Staff had received appropriate training and support to enable them to carry out their role safely, including the management of medicines. The introduction of champion roles had improved staff knowledge of people’s needs in areas such as dementia and dignity.
Staff had a good awareness of how to keep people safe from avoidable harm. However, we recommended that the provider commence using evidence based risk assessment tools to aid staff knowledge.
People benefited from consistent staff, at the right time to enable them to receive care in a timely way. In addition, people were provided with a wide range of information about voluntary agencies in the local community to reduce the risk of social isolation and improve feelings of wellbeing.
Lots of checks were completed by staff, the registered managers and provider to check the quality and safety of the service. The provider had reflected on their approach and planned to make changes to better audit the service.
The registered managers and senior team worked well to lead the staff team in their roles and ensure people received a good service. People, their relatives and staff told us management were approachable and that they listened to them when they had any concerns or ideas. All feedback was used to make continuous improvements to the service.
More information is in Detailed Findings below
Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.