Background to this inspection
Updated
12 August 2023
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 Health and Social Care Act 2008.
Inspection team
The inspection was carried out by 2 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 a domiciliary care agency. It provides personal care to people living in their own houses and flats.
Registered Manager
This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations. At the time of our inspection there were 2 registered managers in post.
Notice of inspection
We gave 24 hours’ notice of the inspection. We needed to be sure that the registered manager or provider were available to support the inspection. Inspection activity started on 11 July 2023 and ended on 21 July 2023. We visited the location’s office on 11 July 2023.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.
During the inspection
We looked at 9 people’s records including medication administration records. We spoke with 12 staff including the registered manager, head of service, senior staff and support workers. An Expert by Experience spoke with 5 people and 6 relatives on the telephone about their experience of the care and support provided. We also looked at 3 staff files in relation to recruitment, induction and supervision and a variety of records relating to the management of the service including training records, polices and audits.
Updated
12 August 2023
About the service
Reablement SkILs is a domiciliary care service providing personal care to people living in their own homes. The service focuses on providing short term care and support to assist people to regain their confidence, skills and independence after a stay in hospital. At the time of our inspection there were 110 people using the service.
People’s experience of using this service and what we found
Quality assurance systems were not always robust. Care records were generally clear and well completed but improvements were required to ensure they were regularly audited, and all identified risks were assessed. Improvements were required to how medicines were managed and monitored safely. Accidents and incidents were reported but there was no system in place to analyse any themes and trends.
People and relatives told us they received person-centred care and felt safe and secure. People spoke positively about the support they received to regain their independence and confidence. Recruitment was managed safely and there were enough staff to provide consistent support for people. Staff received induction, supervision, and training to be able to carry out their roles effectively. Call times were generally well organised and coordinated flexibly to ensure they met people’s changing needs.
The registered manager was approachable and supportive. People, relatives and staff said the service was generally well run and managed. The provider responded very promptly to our inspection findings. They commissioned a comprehensive audit and took action to address the shortfalls this identified.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service at the previous premises was good (published 17 August 2017).
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Why we inspected
This inspection was prompted by a review of the date of the last inspection. You can see what action we have asked the provider to take at the end of this full report.
The provider took immediate action to mitigate the risks, including coordinating a full audit of people’s records.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Reablement SkILs on our website at www.cqc.org.uk.
Enforcement
We have identified breaches in relation to good governance at this inspection.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.