Home Support Reablement Service

Home Support Reablement Service is a domiciliary care service providing a time limited period of assessment and rehabilitation for in their own houses and flats in the community for support with personal care. At the time of our inspection there were 106 people using the service. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided. At the time of inspection, the service was providing personal care to 106 people.

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

People felt safe and staff knew what to do if they thought people were at risk. Staff managed people's medication safely. Staff recruitment processes were robust and staffing levels ensured people’s needs were met by familiar staff. The provider followed current infection prevention and control guidance.

The provider had recently implemented innovative discharge planning processes to reduce the risks of people being readmitted to hospital, through joint working groups which included healthcare professionals. People's health and nutrition needs were supported, and staff were aware of their responsibility to promote people's rights. The provider had access to a range of services to support people’s communication needs.

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's needs were reviewed throughout their rehabilitation programme, and staff were trained to provide support whilst promoting independence and assessing for on-going support needs. Staff approaches promoted dignity & respect. People were involved in decisions about their support needs.

People were happy with their support and felt they could talk to staff if they had concerns. The provider had systems in place to learn from issues as they arose, and outcomes were communicated to staff. People had ongoing access to healthcare professionals, and guidance was shared with staff in a timely manner.

Systems were in place to monitor quality and safety. The registered manager audited support records, including accidents and incidents, to assure themselves of quality. The provider sought regular feedback from people to improve their support. Lessons were learned when concerns were raised, and these outcomes were communicated to staff. Staff worked well in partnership with other agencies to deliver effective support.

At the time of the inspection, the location did not care or support anyone with a learning disability or autistic people. However, we assessed the care provision under Right Support, Right Care, Right Culture, as it is registered as a specialist service for this population group.

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 good (published 14 November 2017).

Why we inspected

This inspection was a planned inspection based on the date the service was last inspected.

Follow up

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

Home Support Reablement Service is a short term reablement service provided by Bolton Council. Personal care is provided in people's home to support them, following a hospital admission, to return to independent living.

There was a registered manager in place. 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.

The recruitment procedure was robust and sufficient staff were in place to meet the needs of people who currently used the service.

There was an appropriate safeguarding policy, staff had undertaken training and safeguarding issues were logged on the system and followed up appropriately. There was an appropriate health and safety policy in place and individual and general risk assessments were in place.

An appropriate medicines policy was in place, staff received training and regular competence checks and medicines were managed well within the service.

The induction programme was thorough and training was on-going. We saw evidence of close partnership working within the service’s multi-agency team and appropriate referrals were made to agencies outside the team.

We saw evidence of regular staff supervision sessions and annual personal development reviews. The service was working within the legal requirements of the Mental Capacity Act (2005) (MCA).

People who used the service told us the staff were kind and caring and understood the importance of respecting privacy and dignity. People were involved in care planning and reviews of support and we saw that people who used the service were encouraged to be as independent as possible.

Information given to new users of the service was clear and informative. Feedback was encouraged and used to inform improvements to the service.

People we spoke with told us the service was flexible and responsive. The aim of the service was to provide a response time, within the agreed timeframes.

The service was person-centred and care files we looked at evidenced that people’s preferences, likes and dislikes were documented.

There was an appropriate complaints policy, which people who used the service that we spoke with were aware of. Concerns or minor complaints were dealt with in a timely manner and complaints and incidents were logged and investigated appropriately.

The service had regular multi-disciplinary team meetings, handovers and safety huddles. There were regular team meetings and the minutes were available.

The service undertook a number of regular audits, spot checks and competence checks. Action plans were produced and progress monitored to help ensure continual improvement.

The service was subject to an annual audit by the quality assurance team. Any service changes were added to the service’s continual improvement action plans.