Joint Community Rehabilitation Service

Updated 28 March 2020

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

The inspection was carried out by one inspector.

Service and service type

The Joint Community Rehabilitation (JCR) service provides reablement and rehabilitation for people in their own homes. It is an East Sussex County Council (ESCC) service run in partnership with the East Sussex Healthcare NHS Trust (ESHT). Short term support of up to six weeks is provided to people, usually following discharge from hospital after an illness or accident. Rehabilitation including personal care is provided to people to maximise their ability to live independently. An urgent referral process is also in place from GP’s or healthcare professionals to prevent a person being re-admitted to hospital. There were 50 people being supported by the service at the time of the inspection.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

We gave 24 hours’ notice of the inspection so that the manager could arrange home visits from an inspector.

What we did before the inspection

The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. Providers are legally obliged to inform us about significant incidents that happen at their service. We examined these reports. We took this into account when we inspected the service and made the judgements in this report. We used all of this information to plan our inspection.

During the inspection

On the first day of the inspection we visited the provider’s office. We spoke to the registered manager, the deputy manager, the practice manager, three senior support workers and two support workers. We reviewed six care plans and related documents, for example risk assessments and medication records. We examined records relating to the running of the service including, training records, four personnel files, complaints, quality assurance and auditing processes.

On the second day of the inspection we carried out two home visits speaking to two people who used the service, one relative and one support worker. We returned to the provider’s office where we spoke with one senior support worker and one support worker.

After the inspection

We continued to seek clarification from the provider to validate evidence we found. We spoke to five people, two relatives and contacted five professionals who had regular contact with the service.

Updated 28 March 2020

About the 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 or 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 own homes. The service was supporting 50 people at the time of the inspection.

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

People told us that they were supported safely. People were protected from abuse and harm and all staff had completed safeguarding training and were able to tell us what steps they would take if they had concerns. Accidents and incidents were reported, recorded and dealt with appropriately with any learning being taken forward and shared with staff. Risk assessments were personalised to individual needs and were reviewed weekly. There were sufficient numbers of trained staff to cover all visits to people. Calls were never missed and were rarely late. If a staff member was delayed in reaching a visit, a contingency plan enabled other staff to cover. Staff were recruited safely. Some people were supported with taking medicines and this was done safely.

Staff induction was comprehensive and involved staff completing a probationary year before being fully signed off. Ongoing support was provided through supervision and appraisal meetings. Ongoing training was provided and in addition to mandatory courses, staff were able to choose training courses that they felt would help them develop. People were supported to access health and social care professionals and care calls were adapted to fit around people’s appointments.

Staff had been trained in mental capacity and were aware of the importance of consent and choice. 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 using the service were treated with respect and dignity. Comments from people included: “Went well beyond what I’d expected,” “They are 100%. Perfect” and “Without their help I wouldn’t be at home now.” People’s privacy was respected but their safety never compromised. Staff supported people to regain their confidence and independence with personal care and tasks around their homes.

Despite the relatively quick turnover of people using the service, staff knew people well. Care and support were person-centred, and this was reflected in people’s care plans. A complaints process was in place and accessible to everyone using the service, a copy of the policy and process was left in people’s homes. There was a process for dealing with minor issues and concerns and those received had been dealt with appropriately. Staff had received training in end of life care.

The registered manager fostered a positive culture across the service. They were aware of their responsibilities under the duty of candour. A new computer system was being introduced which made recording visits much more efficient for staff. People and staff were provided a variety of ways to feed back about the service and we saw that the service management listened to feedback and made changes when appropriate. Audits were carried out and often these were done across all three JCR services in East Sussex which provided managers an opportunity for sharing best practice across the service. JCR had established positive working relationships with local hospitals, GP’s community nurses and other key local authority services.

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 28 July 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.