North STSS (Short Term Support Service) Berwick

North STSS (Short Term Support Service) Berwick is provided by Northumberland County Council. It provides three distinct services: reablement, crisis intervention and a 'bridging' service, when people are awaiting longer-term care packages. At the time of the inspection, the service was providing care and support to 18 people in their own homes.

People's experience of using this service and what we found

People experienced consistent, effective and safe care from reablement staff.

The provider had a range of systems and processes in place to monitor and mitigate risk. Records were accurate and reviewed regularly. Specific risks to people were assessed and staff understood them well.

The culture was an open one in which people and staff were safe and well-supported. There was a proactive approach to working with external partners and this had an impact on the health and wellbeing outcomes people experienced.

The registered manager had been at the service for 3 months and had made good progress in that time; they understood the service well and had made positive links inside and outside the service.

The registered manager involved people who used the service and their relatives through regular care plan reviews and surveys. People, relatives, external professionals and staff all spoke highly of the service and the new registered manager.

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.

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 was outstanding (report published 18 August 2017).

Why we inspected

This inspection was prompted by a review of the information we held about this service and the time that had passed since our last inspection.

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 remained outstanding based on the findings of this inspection and existing ratings of key questions.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for North STSS (Short Term Support Service) Berwick on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

North Locality – Berwick is provided by Northumberland County Council. It is part of the Short Term Support Service [STSS] which is managed in partnership with Northumbria Healthcare NHS Foundation Trust. It provides three distinct services; re-ablement, crisis intervention and a ‘bridging' service. Re-ablement concentrated on supporting people following a recent illness, hospital admission, or an exacerbation of a longer term condition, with the aim of getting them back to an optimal level of independence. The crisis intervention service supported those who required immediate support due to a sudden change in their circumstances such as an accident or acute illness. The bridging service supported people until a long-term provider was assigned.

At the time of the inspection, the service was providing care and support to nine people in their own homes.

There was a registered manager in post. A registered manager is a person who has registered with the CQC 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, relatives and health and social care professionals told us that staff were exceptional in enabling people to become independent. This was confirmed by our own observations. People’s care plans documented every small step and improvement in people’s abilities.

People and relatives were extremely positive about the caring nature of staff. People’s care and support was planned proactively with them. Staff used inclusive ways of involving people so they felt consulted, listened to and valued.

People and relatives described the responsiveness of staff as outstanding. Health and social care professionals told us that the service was focused on providing person-centred care and it achieved exceptional results. One health and social care professionals told us, “They are an absolutely invaluable resource and service that we can link into. It’s a service you can access and it’s multi-disciplinary. It’s excellent.”

The service was exceedingly flexible and responsive to people’s individual needs and preferences. Staff explained they were able to be very responsive because times of visits were flexible. One staff member told us, “We have the luxury of time.” A number of research based assessment tools were used to ensure the best possible outcomes for people.

Various inclusive feedback systems were in place. Reviews were carried out once or twice a week by supervisors to monitor people’s plans of care and ensure they were happy with the service provided. People were actively encouraged to give their views and raise concerns or complaints. There was a complaints procedure in place.

People and relatives were exceedingly positive about the service. Comments included, “They really are the complete package” and “It’s outstanding.”

We found the provider’s integrated model of care facilitated hospital discharges, helped avoid unnecessary hospital admissions and reduced the number of people requiring long term care by supporting people to regain their independence.

There was a joined up approach to providing holistic care that met the needs of people. This was enabled by an integrated system of leadership to help ensure people experienced the best possible outcomes which was confirmed by people, relatives and health and social care professionals.

There was a strong emphasis on continually striving to improve. Numerous checks were carried out to monitor the quality and safety of the service and ensure that people were receiving excellent outcomes.

Staff were highly motivated and demonstrated a clear commitment to providing dignified and compassionate care and support. They told us that they enjoyed working at the service and morale was excellent.

People told us they felt safe. There were safeguarding policies and procedures in place. Staff were knowledgeable about what action they would take if abuse was suspected. There was a safe system in place for the management of medicines.

People, relatives and staff told us there were enough staff to meet people’s needs. There was a training programme in place. Staff were trained in safe working practices and to meet the specific needs of people who used the service.

There was no one requiring assistance with eating and drinking at the time of our inspection. Staff had supported people whom we visited to become independent with their dietary needs.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.