Care at Home Reablement Service

Care at Home Reablement Service is a domiciliary care agency providing short-term personal care and support to people living in their own homes. Everyone who used the service received personal care. 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 143 people were receiving personal care.

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

People and relatives we spoke with, gave positive feedback about the service and the staff team. A relative discussed their experience of the service provided. They said, "I have felt there is nothing [staff] haven’t done. They are always willing and very accommodating. We feel they are invested in his well-being. We trust them completely.”

People were supported by a consistent staff team who had the relevant training and qualifications to safely support them. Staffing levels were safe and were reviewed regularly by the registered manager. People told us their calls were regular and there was flexibility if they needed to change their visit times to attend health appointments. A relative commented, “[Person] loves talking to [staff], she looks forward to them coming in. She knows them all from a small group that rotates. They are kind and caring, they are friendly she is very comfortable. They always ask, ‘anything else you need’. They are considerate and respectful.”

Risks people may face were fully identified and mitigated. Medicines were safely managed, and the service worked in partnership with other health care professionals to make sure people received a continuous level of support.

People had person-centred care plans which were created from holistic assessments of people's needs. People told us they felt safe with the support provided by staff. Relatives commented that they did not have to worry about people’s safety or well-being, as the staff were very kind and caring.

Staff had a positive relationship with the registered manager and felt able to provide feedback regularly about the service. A staff member told us, “I feel that the registered manager is a proactive manager who is also involved in the day-to-day work as required. She is approachable and cares about the service we provide to adults and the welfare of the staff.” The quality and assurance systems in place allowed for effective monitoring of the service by the registered manager and provider.

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.

Staff had access to PPE and followed best practice guidance and the provider's policy in relation to infection prevention and control. Staff received appropriate training and were positive about the range of training modules available.

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 31 August 2018).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

As a result, we undertook a focused inspection to review the key questions of safe and well-led only. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has remained good based on the findings of this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Care at Home Reablement Service on our website at www.cqc.org.uk.

Follow up

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

This was an ‘inspection using remote technology’. This means we did not visit the office location and instead used technology such as electronic file sharing to gather information, and video and phone calls to engage with people using the service as part of this performance review and assessment.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

There was a registered manager in place with suitable experience and knowledge of 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 felt safe and there were individualised risk assessments in place to ensure staff knew how to keep peoples safe. These were regularly review and information effectively shared where risks changed. All staff were aware of their safeguarding responsibilities and demonstrated a good understanding of the risks people faced.

No concerns were raised by relatives or external professionals, with all expressing confidence in the staff team and the systems and processes in place. Medicines improvements noted at the last inspection were well embedded.

Rota planning included travel time and a system to minimise the risk of missed calls. Out of hours on call arrangements were also in place.

Where incidents, accidents or safeguarding issues occurred, these were documented appropriately and the registered manager ensured lessons were learned.

There was strong and consistent liaison with a range of external teams, such as safeguarding, nursing and occupational therapy, to ensure people’s needs could be met promptly.

People’s independence was supported by staff who valued their individuality and took the time to ensure they were comfortable and consenting to the care plans and actions in place.

Staff were well supported by way of a comprehensive array of induction, shadowing and training. Training was a blend of e-learning and face to face training. The registered managers embraced new training which was based on recognised best practice.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People who used the service and relatives praised the attitudes of staff and how they made them feel at home quickly. Some people felt they did not always know which member of staff would be visiting them, and this could be a source of anxiety.

Staff respected people’s beliefs and treated them in a dignified manner. Colleagues also behaved in a dignified way and we found the provider had successfully ensured the culture was a genuinely caring one.

Questionnaires, ad hoc reviews and progress notes ensured people were able to constantly feed back to staff about their experience.

Care files were brief but sufficiently detailed for their purpose, and regularly reviewed.

All people who used the service and their relatives knew how to raise concerns.

The registered manager led the service well. They had a clear awareness of the service’s strengths and where it could continue to make improvements in the future. They did this through staff engagement, working well with external partners and ensuring they demonstrated the values the service worked towards.

Local oversight of the service was strong, as was the support in place for the registered manager.

Further information is in the detailed findings below.