Archived: START North

This was the first comprehensive inspection carried out at Short Term, Assessment and Rehabilitation Services (START), Northampton.

The service provides re-ablement packages which is a short and intensive service, delivered in people’s homes for those who are frail or recovering from an illness or injury. The purpose of re-ablement is to help people who have experienced deterioration in their health and/or have increased support needs to re-learn the skills required to keep them safe and independent at home. In addition, where specialist dementia re-ablement is identified, the START service is supported by specially trained staff to provide support for people living with dementia and their families living in their own homes. At the time of our inspection there were 57 people using the service.

The service had a registered manager. 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 and associated Regulations about how the service is run.

An exceptional service was provided to people and their families who had re-ablement needs and dementia specialist needs. Due to the outstanding care and support people received, admittance to long term residential care had been avoided for many people. People were overwhelmingly positive about the service they received and told us that using this service had meant they had been enabled to stay in their own homes independently and felt that every opportunity had been provided to safely maximise their independence.

Staff supported people to achieve their goals and optimum independence through individualised re-ablement programmes. There was a genuine focus from all staff on enabling people to remain independent. and the team were proactive in exploring assistive technologies to enable people to have as much control as possible in managing their re-ablement.

Through continuous review any changes in people’s needs were quickly identified and their care package amended accordingly. We found the service was very flexible and could change the length of the visits as required to enable people to reach their full level of independence. This meant that changes in people's care and support was identified and changes made swiftly to ensure they received an optimum 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. Care plans contained agreed goals that people wished to achieve and were reviewed and updated as support progressed.

People felt safe. Staff had been provided with safeguarding training to enable them to recognise signs and symptoms of abuse and how to report them. There were risk management plans in place to protect and promote people’s safety. Staffing numbers were appropriate to keep people safe. There were safe recruitment practices in place and these were being followed to ensure staff employed were suitable for their role. People’s medicines were managed safely and in line with best practice guidelines.

Staff received regular training that provided them with the knowledge and skills to meet people’s needs. They were well supported by the registered manager and had regular one to one supervision and annual appraisals.

Staff sought people’s consent before providing any care and support. They were knowledgeable about the requirements of the Mental Capacity Act (MCA) 2005 legislation. Where the service was responsible people were supported by staff to access food and drink of their choice to promote healthy eating. If required, staff supported people to access healthcare services.

People were treated with kindness and compassion by staff; and had established positive and caring relationships with them. People were able to express their views and to be involved in making decisions in relation to their care and support needs. Staff ensured people’s privacy and dignity was promoted.

The service had a complaints procedure to enable people to raise a complaint if the need arose.

The registered manager demonstrated an excellent understanding of the importance of effective governance processes. There was a quality monitoring system to enable checks of the service provided to people and to ensure they were able to express their views so improvements could be made. People expressed a high level of satisfaction with the service. There was strong leadership which put people first and set high expectations for staff. There was an open culture and clear vision and values, which were put into practice. Staff were proud to work for the service and felt valued for their work. A positive culture was demonstrated by the attitudes of staff and management when we talked with them about how they supported people.