We carried out a review of the data available to us about Community Rehabilitation Management 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 Community Rehabilitation Management, you can give feedback on this service.
Community Rehabilitation Management is a domiciliary care agency providing personal care to people in their own homes. It specialises in providing long term care packages for people living with acquired brain injury, spinal cord injury and other neurological disorders. At the time of this inspection it was providing personal care to five people based around the country.
People’s experience of using this service:
We found that people received a good service. The provider ensured care was delivered in a safe way, and monitored the care provided closely. People told us they received a good standard of care, and told us the staff were kind and respectful.
People told us they felt the staff were caring. They told us they got on well with staff and described their relationship with staff as positive. One person told us: “They’re a good team, I like them all and we work well together.” People told us the care was tailored to their specific needs, and one said: “Nothing happens without my say so.”
Staff received training which was relevant to their roles. Staff we spoke with told us the training was plentiful and appropriate to their roles. A lot of training was provided in house, which meant it could be tailored to the needs of people using the service.
People’s needs and risks to their safety were assessed, and detailed plans of care drawn up. People told us they felt safe and staff had been trained to recognise and report suspected abuse. A complaints procedure was in place although no formal complaints had been received at the time of the inspection. The approach the registered manager had of maintining a high level of contact with people using the service meant concerns and issues were addressed immediately as they arose.
People were supported in maintaining good health, and staff liaised with external healthcare providers to ensure that care was provided in a way that met people’s needs.
Systems were in place to monitor the quality of care provided and further areas were being developed. People were extremely positive about the care provider and management team and said they were approachable and supportive. One person said: “Any time of day or night I can call [the registered manager] and they’re always there for you or they get straight back to you.”
The service continued to meet the characteristics of good in all domains.
More information is in the full report
Rating at last inspection:
Good. The report was published in November 2016
Why we inspected:
This was a scheduled inspection based on the last rating.
Follow up:
We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.
Derbyshire Community Rehabilitation Management provides personal care for people in their own homes located throughout the country, who are living with acquired brain and spinal cord injury. At the time of our visit, there were four people receiving personal care from the service. There is a named responsible person for the registered provider who is also the manager of the service. This person has a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
At our last inspection in September 2013 we found that the provider’s recruitment procedures were not wholly sufficient to protect people from the risk of unsafe care, harm or abuse. This was a breach of Regulation 21 of the Health and Social Care Act (Regulated Activities) Regulations 2010, which corresponds with Regulation 19 of the Health and Social Care Act (Regulated Activities) Regulations 2014. Following that inspection the provider told us about the action they were taking to rectify the breaches. At this inspection, we found that the required improvements had been made.
The providers systems and arrangements helped to protect people from the risk of harm and abuse. Recognised recruitment procedures were followed and related employment checks were made, to help ensure staffs suitability to provide people’s care. Following their employment, staff were sufficiently deployed to provide people’s care and support.
Risks to people’s safety associated with their health condition, environment and any equipment used for their care were assessed before they received care. Staff understood the care actions required to mitigate any identified risks to people’s safety from this and how to report any changes, concerns or incidents relating to people’s safety in care.
People’s medicines were safely managed. Records showed people received their medicines when they needed them from staff or, where safe to do so, they were supported to manage their own medicines in a way that met with nationally recognised practice.
People’s personal care needs associated with their health conditions, related rehabilitation plans and instructions from external health professionals were understood and followed by staff who, were trained and supervised to ensure this.
People were provided with personal care in line with legislation and guidance in relation to consent. Staff understood and followed the Mental Capacity Act 2005 (MCA) to enable people to make their own decisions or to help them to do so when needed. Account was taken with due regard for any decisions made by external authorities on people’s behalf in relation to their welfare.
People received individualised care from staff who were empathic, caring and knew people well. Staff understood the importance of ensuring people’s autonomy, independence, rights and choices in their care and they were committed to promoting this in their practice.
People felt the service made a difference to their lives. Staff understood and followed people’s known individual daily living routines, lifestyle preferences and personal care requirements related to their health and rehabilitation plans.
Staff knew how to communicate with people and ensured adjustments and equipment use to support people’s mobility, dexterity, communication and independence when required.
People were informed how to make a complaint and the provider regularly sought people’s views about their care. Findings from this were used to inform peoples’ care and to make improvements when required.
People and staff were positive of the management of the service. Staff received the management support they needed and the provider’s operational measures helped to ensure that understood and followed their role and responsibilities for people’s care.
Records for the management and running of the service were accurately maintained and safely stored in line with confidentiality and recognised data protection requirements. The provider met their legal obligations with us by telling us about important events that happened at the service when required.
The provider carried out regular checks of the quality and safety of people’s care. This was done in a way that demonstrated they continuously sought to improve the service and people’s related care experience.
People told us they were involved in planning the care provided to them. We saw people's care needs were documented well and provided staff with sufficient information about to care for people.
People receiving care had complex care needs. We saw there were systems in place to liaise and work with other care providers and agencies. This ensured there was a co-ordinated approach taken to meeting people's needs.
People were actively involved in recruiting the staff who provided their care. However appropriate recruitment procedures were not always followed to ensure staff employed were suitable to work with vulnerable adults.
There were systems in place for asking people for their views and monitoring the quality of the service. Both people we spoke told us that the agency communicated well. One person told us, 'Staff are available at any time and they get back to me as fast as is humanly possible.' We were also told it was, 'not an issue to speak to the manager and you can raise issues or problems at any time.'
People who use the service had undergone a comprehensive needs assessment before they were referred.This assessment involved a neurophysiologist assessment which determined capacity and ability to consent and make decisions. The service met with each person and their carers and provided further assessment of ongoing needs.
Comprehensive risk and moving and handling assessment was undertaken and staff were inducted into each individual care environment. Multi disciplinary team meetings were held and the outcomes of these were passed to the local teams by their team leader. Monthly local team meetings were held to review care and to resolve problems.
During our inspection of staff files and care records we found documentation in place detailing issues such are planned care and staff training, but these were not always signed and dated. nor were review dates present.
The provider had just undertaken their first staff survey and the results were planned to be included within an inaugural newsletter due to be circulated in January. A formal service user survey is in the process of being drafted.