Archived: STEPS West

Camborne STEPS (Short term enablement and planning service) is a domiciliary care service that provides support to people living in and around the Redruth and Camborne area of Cornwall. The service provides up to six weeks of support to people who are returning from hospital or who are in need of extra support, to enable them to continue to live in their own homes. The service provides support to both older people and younger adults.

On the day of this comprehensive inspection the service was providing personal care for 29 people. Records showed that the service was highly successful in it’s goal of supporting people to regain the skills necessary to live safely at home. In august 96% of people supported by the service had not required ongoing care at the end of their six weeks period of support.

The service is required to have a registered manager and there was a registered manager in post at the time of our inspection. 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 registered manager was responsible for two registered services in the west of Cornwall and was based in the Camborne STEPS office for half of each week.

The registered manager was not normally allocated care visits and was supported by five team leaders who were also supernumerary. Each team leader was responsible for managing a small group of staff and a number of people’s care packages. Team leaders spent at least 2 days per week out of the office completing needs assessments, care plans reviews and staff spot checks. Their remaining time was spent in the service office, updating care plans, reviewing visit schedules and supporting the registered manager. The roles and responsibilities of the registered manager and individual team leaders were well defined and understood by all staff and people who used the service. The registered manager was office based and available to provide support and guidance to team leader sand staff as required.

The staff team were committed to the service aim of supporting people to regain their independence and took pleasure in describing how they had supported people to achieve their goals. Staff said they were well supported by their team leaders and the registered manager who they could contact for advice whenever necessary. Staff comments included, “You never feel there is no back up here. Someone is always comes to help if you need them”, “This is the best company I’ve worked for” and “The best bit is seeing people develop over a short period of time. Seeing that you have helped people recover”.

People and their relatives were highly complementary of the service and report that they would be happy to recommend Camborne STEPS to others. There comments included, “I couldn't cope without them, I would recommend them, it is an amazing service. They deserve all the praise they can get”, “My relative would give them 10 out of 10” and “I couldn’t have done without them, I can’t speak more highly of the service. As far as I am concern the service is absolutely wonderful.” While health professionals told us, “We would just like them to have more capacity as we very much believe in their ethos of re-enablement.”

The service was designed to support people following illness or a period of hospital admission to regain the skills necessary to live safely at home. Staff took pleasure in describing their successes and told us, “The best bit is seeing people develop over a short period of time. Seeing that you have helped people recover” and “I know that we make a difference to people, and this is an excellent service, we receive lots of positive feedback from our service users and lots of thankyou cards.”

People were involved in the development of their care plans and encouraged to identify goals they would like to be supported to achieve. This information was combined with details provided by health professionals to form the person’s care plan. People care plans were detailed and informative and were reviewed and updated each week by team leaders to ensure they accurately reflected the person’s current needs. Staff told us, “The care plans are pretty good, always up to date.”

Staff understood how to protect people from all forms of abuse and avoidable harem and had a good understanding of local safeguarding procedures. Where staff identified concerns in relation to people’s welfare these were reported to team leaders and records showed the service had appropriately raised concerns with the local authority to ensure people’s safety.

Staff were well trained and sufficiently skilled to meet people’s support needs. All new staff completed a 12 week induction programme in accordance with the requirements of the care certificate and training was regularly refreshed. People’s comment in relation to staff skills included, “They are superb, very competent” and “They appeared capable and knew what they were doing, we had great confidence in them.” While staff told us, “We always get lots of training” and “I did 12 weeks of shadowing (when I first started) and I felt quite confident at the end of it.” Recruitment records showed all necessary pre-employment checks had been completed before new staff were permitted to provide support.

The service had appropriate systems and procedures in place to ensure staff safety and that all planned visits were provided. A telephone based call monitoring system was used to enable staff to report their arrival and departure time from each care visit. This information was monitored by office staff and alerts were used to highlight any visit that had not been provided. Records showed care visits were not routinely missed and none of the people we spoke with had experienced a missed visit. However, during the weekend prior to our inspection a planned visit had not been provided. The safety systems had worked as intended and on call staff had been alerted. They had contacted the individual who’s visit had been missed and offered a visit later in the morning but this had been declined. This demonstrated the service had robust system in place to protect people from the risks associated with missed care visits and staff told us, “It was the first time in 12 years it has happened to me. [Missed visits] do not happen often.”

Visit schedules and call monitoring information showed that people normally received their visit on time and for the full planned duration. People told us they never felt rushed and that staff gave them time to try to complete task independently during care visits. Comments from people and their relatives included, “Always been on time and they have never missed”, “There was not one staff member who was impatient and everyone gives my relative time” and “They did their job and they had a chat. They were never too busy to talk.”

People’s feedback was valued and acted upon and the service had appropriate quality assurance system in place. Spot checks of individual staff performance were completed regularly and people were asked to complete and quality assurance questionnaire at the end of their package of support. Records showed people’s feedback was constantly complimentary and that the service had not received and recent complaints. In addition, people had been asked to assess their own wellbeing at the beginning and end of their period of support. These records consistently showed the service’s reablement support had positively impacted on people’s wellbeing.

There were appropriate systems in place for the storage and secure sharing of information with care staff. Where information was shared with staff digitally this was done via a password protected mobile phone application.