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 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.
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 61 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
Staff were 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.
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.
There were always enough staff on duty. Staff knew people well and understood how to meet people’s needs. Staff were properly trained and made sure people received their medicines safely and on time. Recruitment practices were safe.
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. 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.
Person centred care was an important part of the service and staff made sure people were at the centre of everything they did. 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 kind and caring. 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 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 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.