Archived: Homecare Reablement Team

Updated 27 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.

The inspection was announced and took place on the 2, 3, 4 and 10 October 2017. The inspection team consisted of two inspectors.

Before the inspection we reviewed the information we held about the service. This included notifications, which are documents submitted to us to advise of events that have happened in the service and the provider is required to tell us about. We used this information to plan what we were going to focus on during our inspection.

During our inspection we spoke with the service manager and deputy manager. We also made seven telephone calls to gain the views of people who received a service. People’s comments and feedback have been added to the report where possible. As part of the inspection we contacted 18 staff and six chose to contact us to give their views about working for the service. We also spoke with a number of office staff.

As part of the inspection we reviewed six people’s care records, including their care plans and risk assessments. We also looked at the files of two staff members and their induction and staff support records. We reviewed the service’s policies, their audits, staff work sheets, complaint and compliment records, medication records and training and supervision records.

Updated 27 October 2017

This inspection took place over a number of days and included 2, 3, 4 and 10 October 2017. We inspected this service in November 2016 and although no breeches of regulations were found we did identify that improvements were required in the areas of Safe and Responsive. The service submitted an action plan and this inspection was to establish whether this had been fully implemented and what improvements had been made to the service.

We found that improvements had been made to the service since our last inspection and the service had continued to develop and progress. We found that systems had been implemented to help manage the safety and quality of the service. Improvements had been made to staffing levels of the service and feedback gained from people showed that the service had now improved. Management advised that they are looking to continue to increase the number of staff to ensure they have sufficient available to help meet the needs and care of the people who used the service within an acceptable time frame.

The Homecare Reablement Team (HRT) provides personal care and support to adults who live in their own homes in the geographical areas of Thurrock between the hours of 7am to 11pm. They provide care and support within people’s homes and a reablement service for up to six weeks for people who have been discharged from hospital. The focus of their support is to reable people back to independence. The service is also a ‘provider of last resorts (POLR).’ This means when Thurrock Borough Council are unable to find another contracted service to provide care that HRT will assist with care until another provider can be found. This is aimed to be a short term service and management had been working to organise a separate domiciliary service so that HRT could refer people on quicker who were identified as needing long term support.

The service has a registered manager in post, but on the day of our inspection we were assisted by the deputy manager and service manager, due to the registered manager not being available. 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.

Staff had a good knowledge of safeguarding procedures and were clear about the actions they would take to help protect people. Risk assessments had been completed to help staff to support people with everyday risks and help to keep them safe.

Sufficient recruitment checks had been carried out before staff started work to ensure that they were suitable to work in a care setting. Staff had been provided with regular supervision and training and stated they felt well supported to carry out their work. Effective communication was now in place between staff and management.

The service had safe systems in place to assist people with the management of their medication and to help ensure people received their medication as prescribed. Documentation was in place to clearly record what assistance was needed.

Management had a good understanding of Mental Capacity Act 2005 and who to approach if they had any concerns and the appropriate government body if people were not able to make decisions for themselves. Staff have now been provided with training for the MCA and systems were in place to ensure this was regularly updated.

People received the support they needed to eat and drink sufficient amounts to help meet their nutritional needs. Staff knew who to speak with if they had any concerns around people’s nutrition.

People were supported by staff to maintain good healthcare and were assisted to gain access to healthcare providers where possible. They also had multidisciplinary working within their own team of professionals who assisted people to gain the healthcare they needed.

People had been asked how they would like their care provided and new assessments and care plans were in the process of being developed around each person’s individual needs. People said they had been treated with dignity and respect and that staff provided their care in a kind and caring manner.

People knew who to raise complaints or concerns to. The service had a clear complaints procedure in place and people had been provided with this information as part of the assessment process. This included information on the process and also any timespan for response. We saw that complaints had been appropriately investigated and recorded.

The service had effective quality assurance system and these had been improved since our last inspection and were now effective and provided information about the service and feedback from people regarding their experience of the service.