We carried out a review of the data available to us about Joint Community Rehabilitation Service on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Joint Community Rehabilitation Service, you can give feedback on this service.
The Joint Community Rehabilitation Service (JCR) provides reablement and rehabilitation for people in their own homes. It is a partnership between the local authority and East Sussex Healthcare NHS Trust. The service provides support for people for up to six weeks, in most cases following discharge from hospital following an accident of illness. Some people were referred to the service from GP’s or other health care professionals. The service aims to maximise people’s chance of continuing to live independently in their homes. The service was supporting 60 people at the time of the inspection.
People’s experience of using this service and what we found
People told us they felt safe when receiving care and support. Staff had completed safeguarding training and were able to tell us what they would do if they identified risks to people. Accidents and incidents were recorded, investigated and audited with any patterns and lessons learned taken forward. Risk assessments relevant to people and their home environments were in place and were reviewed weekly. Staff had enough time to complete calls and contingencies were in place in the event of an unexpected delay to staff arriving at a call. Staff were recruited safely. Most people were either independent with their medicines or were helped by relatives or loved ones. In some cases, people were supported and this was done safely and by suitably trained staff.
New members of staff undertook a thorough induction process with opportunities to shadow experienced staff and fortnightly supervision meetings throughout a probationary period. Support continued for staff with monthly supervisions and annual appraisals. Training was comprehensive with areas covered that were relevant to people’s needs. Staff could choose training for their own personal development. Staff supported people to access health and social care professionals and visits were adjusted to fit around people’s appointments. Some people using the service experienced variable mental capacity due to an early diagnosis of dementia or following a stroke. Staff had been trained in mental capacity and told us about the importance of providing choice to people and seeking consent. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
People were treated with dignity and respect. People’s privacy was respected but people were never placed at risk, staff whilst promoting independence always remained close to provide support if needed. The primary function of the service was to support people in regaining confidence and independence to enable them to live independently in their homes. Staff knew this and supported people in a caring way.
We looked at numerous care plans both at the office of the service and at people’s homes. Care plans were person -centred, focussing on individual aims and goals that were reviewed and assessed weekly. The service had a complaints policy which was accessible to everyone, a copy being placed in people’s care plan folder in their homes. Minor issues and concerns were recorded separately. All issues that were raised were dealt with appropriately with apologies offered if appropriate. Staff had received training in end of life care. Provision of end of life care was not routine but staff knew the important elements of care provision at that important time.
The service demonstrated strong leadership. A positive culture was evident throughout the service and by everyone we spoke with. A staff member said, “Working here is like a breath of fresh air.” A professional told us, “It really works well, we receive consistently positive feedback.” The registered manger understood the duty of candour and promoted an ethos of openness and honesty whilst constantly learning lessons and driving forward with improvements. This was evident with the service quality assurance process where all areas of the service were overseen and monitored by the registered manager and senior managers from the local authority. Everyone associated with the service were provided opportunities to provide feedback. JCR had established positive working relationships with their partners for example, GP’s district nurses and hospitals. A professional said, “I thoroughly enjoy working with JCR. The team have a wealth of knowledge and a genuine pride in delivering exceptional service.”
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
Good. (Report published 3 August 2017)
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our reinspection programme. If we receive any concerning information we may inspect sooner.
Joint Community Rehab Service (JCR) provides a reablement and rehabilitation service to people in their own homes. It is a partnership between the local authority and East Sussex Healthcare NHS Trust (ESHT). They provide short term support of up to six weeks to people, usually following discharge from hospital after and illness or accident. The aim of the service is to maximise people’s ability to live independent lives, improve their health, well-being and confidence and on occasion, prevent admission to hospital. People can also be referred urgently to the service by a GP or other healthcare professional, to help prevent them being admitted to hospital. The service was supporting 50 people at the time of this inspection.
There is a registered manager at the service. 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 experienced good care and support. Staff knew how to safeguard people from abuse and what they should do if they thought someone was at risk. Risks to individuals were well managed and people were able to stay safe without having their freedoms restricted. Managers and staff promoted peoples independence and encouraged positive risk taking. If an incident or accident did occur, they were well reported and investigated. Staff understood the importance of learning from incidents, so they could make sure they did not happen again
There was always enough staff on duty. Staffing levels were regularly assessed and care workers were flexible about the hours they worked. Staff knew people well and understood how to meet people’s needs. Recruitment practices were robust. People’s medicines were well managed. Staff were properly trained and people received their medicines safely and on time.
The registered manager and staff had a good understanding of the Mental Capacity Act (2015) (MCA) and made sure they gained people’s consent in line with legislation.
Staff were extremely caring and always ensured they treated people with dignity and respect. They had an excellent understanding of the care and support needs of people using the service. People told us staff had supported them with goal setting and working with them to achieve their goals. They also told us staff had enabled them to regain their confidence to do things they had previously done. People’s care was personalised to reflect their wishes and what was important to them.
Staff were well supported with training, supervision and appraisal which helped them to ensure they provided effective care for people. Staff also received additional specialist training in relation to the rehabilitation of people. Staff competencies were assessed before they were able to support people unsupervised.
People and those important to them, such as their relatives, were asked for feedback about the quality of the service. Any feedback received was acted on, and any concerns were dealt with quickly before the formal complaints procedure was needed. The registered manager and staff knew what they should do if anyone made a complaint.
Person centred care was fundamental to the service and staff made sure people were at the centre of their practice. Care plans focused on the whole person, and assessments and plans were regularly updated. People’s individual preferences, needs and choices were always taken into account by the caring and compassionate staff. When required, people were well supported to eat and drink enough. Staff understood the importance of good nutrition to help people’s recovery.
The service was very well led. There was a clear set of values in place which all of the staff put into practice. The registered manager and provider regularly completed very robust quality assurance checks, to make sure the high standards of care were maintained. There was an open culture and staff said they felt well motivated and valued by all of the managers.