STEPS

Updated 31 October 2017

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 inspection took place on 6 September 2017 and was announced. The registered provider was given notice of the visit in line with our current methodology for inspecting domiciliary care agencies. The inspection team consisted of an adult social care inspector 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. The expert by experience conducted telephone interviews with people who used the service and people’s close relatives.

Prior to the inspection visit we gathered information from a number of sources. We looked at the information received about the service from notifications sent to the Care Quality Commission by the registered manager. We had also received a provider information return (PIR) from the registered provider which helped us to prepare for the inspection. This is a form that asks the registered provider to give some key information about the service, what the service does well and improvements they plan to make.

During the inspection we spoke on the telephone with twelve people who used the service and six relatives. This enabled us to gain their views on how the service was delivered and planned. At the office we spoke with the registered manager, a support team manager, two case managers, an administrator and two support staff.

We reviewed a range of records about people’s care and how the domiciliary care agency was managed. These included care records for three people, and other records relating to the management of the service. This included three staff training, support and employment records, quality assurance audits, and minutes of meetings with staff. We looked at the findings from questionnaires and incident reports.

Updated 31 October 2017

This was an announced inspection carried out on 6 September 2017. Our last inspection of the STEPS (Short Term Enablement Programme) team took place on 20, 21 and 23 July 2015. At that time the service was rated Good, including an Outstanding rating in the domain of Responsive.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for ‘STEPS Team’ on our website at www.cqc.org.uk’

Since the last inspection the service has had a name change, to the STEPS and Night Visiting Team. At this inspection we found the service had sustained this quality of service and remained Good, with an Outstanding rating in Responsive.

There was a registered manager who managed the service on a day to day basis. 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.

STEPS and the Night Visiting Team is located in Doncaster and provides care and support for up to six weeks, to people living in their own homes. The service aims to help people regain confidence and independence with daily living tasks such as, personal care, medication management and meal preparation. At the time of this inspection there were 190 people using the service.

The service ensured that people received effective care that met their needs and wishes. People experienced very positive outcomes as a result of the service they received and gave us outstandingly positive feedback about their care and support.

The length of time people had received support from the service varied from five days to six weeks and the care received varied from one visit a day to four visits a day. However, the level of satisfaction people expressed with the service did not vary, with everybody happy with the care and support they received from the staff. People told us they felt safe and that staff enabled them to become independent again. For instance, one person who used the service told us, “I’m very happy. I don’t know what I would do without them.” Everybody found it easy to say something positive about the service and another person commented, “They gave me my confidence back. They are so, so good.” Nobody we spoke with had any negative comments to make.

We also saw very high volumes of positive feedback people had given directly to the service, either in the form of thank you letters and cards, or in the questionnaires they had completed once the programme of re-enablement was completed.

The service managed risks to people well, acting on the information gained at people’s assessment to ensure they were safe when they returned home. All staff were trained to undertake risk assessments which meant there was no delay in identifying equipment to help rehabilitate people who used the service.

The service actively involved people in their assessment which enabled them to make choices about the support they needed to help them back to independence. People were involved in updating their support plans regularly and they were written in a format that was suitable for people to understand.

A continual review of people’s support meant that the service could change the length of the visits to enable people to reach their full level of independence. The service worked in partnership with other organisations, such as healthcare services, to make sure people received the care and support they needed. Staff were also able to signpost people to other agencies, if they felt a person needed ongoing support.

The service was very responsive to people’s changing needs, adjusting visit times at very short notice for those people who required less or more time for each visit. Staff were able to build in ‘quality time’ into their working rota. This meant they could spend additional time with people who may have been socially isolated. The feedback we received from people regarding this was very positive.

Staff knew how to recognise and respond to abuse. Staff told us they felt supported, they could raise any concerns with the registered manager and felt that they were listened to.

People were supported to take their medication safely. The service ensured that priority was given to calls for people who had support with their medication.

Staff were recruited safely and trained to a particularly good standard. They received service specific training which enabled them to rehabilitate people back to their own level of independence. The agency enabled staff to undertake nationally recognised training to help them progress in their work. Staff were actively encouraged to progress into more senior roles within the organisation.

Staff were supported in their roles and attended regular team meetings and staff events. Formal supervision and quality monitoring of their work performance meant staff worked to the values and expectations of the service.

Equality, diversity and human rights were at the forefront of how support was provided. The registered manager and all members of the team were committed to a strong person centred culture. Kindness, respect, compassion and dignity were key principles on which the service was built and these values were reflected in the day-to-day practice of staff.

People told us that staff were very professional and always respected their dignity when undertaking personal care tasks. Staff we spoke with were highly motivated to provide a good, personalised service to people they supported.

Staff demonstrated an in-depth awareness of the principles of the Mental Capacity Act 2005 and put people who used the service at the centre of everything they wanted to achieve.

People were actively encouraged to give their views and raise concerns or complaints. There was a clear, unambiguous complaints policy and procedure that was accessible to everyone. People who had raised concerns told us that they were dealt with swiftly and fairly.

There were effective processes in place to monitor quality and understand the experiences of people who used the service. Where improvements were needed, these were addressed. People’s views were continuously sought, both while they are receiving support and again when they exited the programme. This helped to shape the service for the future.

There was strong emphasis on continual improvement and best practice, which benefited people who used the service and staff. The registered manager demonstrated strong values and a desire to learn about and implement best practice throughout the service. Feedback from people, whether positive or negative, and was used as an opportunity for improvement.