Archived: Buckinghamshire Care Reablement Service

Updated 6 December 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check 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. This was the first inspection the service had received.

The inspection took place on the 25, 26 October 2016 and 7 November 2016 and was announced. The provider was given 48 hours’ notice because the location provides a domiciliary care service and we needed to ensure someone would be available to help with the inspection. The inspection was carried out by one inspector.

Before the inspection the provider completed a Provider Information Return (PIR). The PIR is a form that the provider submits to the Commission which gives us key information about the service, what it does well and what improvements they plan to make. We reviewed notifications and other information we had received. A notification is information about important events which the service is required to send us by law.

Prior to the inspection, we sent a number of surveys to people who used the service, and relatives or friends of people. We received 17 survey responses back from people and their relatives. At the site visit we spoke with the registered manager, the quality and safeguarding co-ordinator and four staff. We reviewed four recruitment files for staff in depth and two further staff files. We read 10 peoples care plans and risk assessments. We checked practice against the provider’s own policies and procedures.

Following the site visit we made contact with six people who use the service and contacted 20 staff to receive feedback.

We also contacted social care and healthcare professionals with knowledge of the service. This included people who commission care on behalf of the local authority and health or social care professionals responsible for people who were supported by the service.

Updated 6 December 2016

This inspection took place on 25, 26 October 2016 and 7 November 2016. It was an announced visit to the service.

Buckinghamshire Care Reablement Service is registered to provide personal care. It supports people in their own homes across Buckinghamshire. The service has two separate functions. One part of the service provides time limited support to people who require support to regain independence lost by an event like a fall or a hospital admission. The other part of the service provides long term support in the more traditional style of home care. The head office is located in the town centre of High Wycombe. It has satellite offices based within the county’s acute hospitals and an area office in Aylesbury. At the time of our inspection the service was supporting approximately 120 people.

The service had 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 and staff. Comments included “I like all the carers, they make me feel comfortable” and “They (staff) are lovely, I get everything I ask for, they (staff) are brilliant.”

People were not always protected from unsafe practices around the administration of medicines. We found gaps in records. This meant we could not be sure if people had received their medicines on time. There were inconsistencies in the way medicine administration records (MAR) were completed. This could have led to people not receiving their medicine when needed.

Potential risks to people were assessed, however the outcome of the risk assessments relating to the support people required with moving and positioning did not always state if a person required one or two staff to support them. We have made a recommendation about this in the report.

Care plans detailed how people wished to be supported, their likes and dislikes. Where reviews took place, care plans were updated. However we found inconsistencies in this. People being supported by the reablement service did not always have their care plan updated within their home. However staff received updated information on their mobile telephone via a secure ‘App’. We have made a recommendation about this in the report.

The service had a complaints policy and an electronic system to record them. We found not all complaints received had been entered onto the system, which meant the management did not have full oversight of trends in complaints. We have made a recommendation about this in the report.

People told us they had developed a meaningful and professional relationship with the staff who supported them. Comments included “I have known the girls a long time; I should like to think we know each other well.” Another person told us “I really look forward to seeing them (staff), we have a laugh and a chat, and it is the best company I have ever had.”

People were protected from abuse, as staff had received training on how to recognise signs of abuse. Staff were confident how they would handle any concerns and would not hesitate to report any concern.

Staff received training in order to support them in their role. People felt staff were well trained and provided a caring and compassionate service.

There was a clear vision in the organisation; this was shared with people who were supported and with staff. The registered manager was fully aware of their responsibilities.

We found breaches of the Regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.