This inspection took place on 28 and 31 August and was announced. The last Care Quality Commission (CQC) inspection of Epsom Reablement Service was carried out on 2 January 2014, where we found the service was meeting all the regulations we looked at. The primary role of the service is to provide people living in their own homes with personal care and support to enable them to maximise their independent living skills after a person’s physical care needs had changed either after being discharged from hospital or following an accident or illness. Support is offered free of charge usually for up to six weeks while a person’s needs are assessed by the reablement team. Staff providing the majority of the care and support are called ‘reablement assistants’. The provider also works closely with other health and social care professionals, such as occupational therapists, GPs, district nurses, hospital staff and social workers. At the time of our inspection the provider was supporting 38 adults, most of whom were older people who had physical care needs.
The service had a registered manager in post who was also responsible for managing two other reablement services for Surrey County Council. A registered manager is a person who has registered with the CQC to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
People told us they were happy with the standard of care and support they received from the reablement service. People were provided with the support they required in line with their care plans, which included meeting people’s personal care needs and supporting people to become more independent. Staff were respectful of people’s privacy and dignity. Our discussions with people receiving a reablement service, their relatives and community based health and social care professionals supported this.
People told us they felt safe when staff from the reablement team visited them at home. Managers and staff knew what constituted abuse and who to report it to if they suspected people were at risk. They had all received up to date training in protecting children and safeguarding adults at risk. Risks to people’s safety were identified and management plans were in place to minimise those risks. This included ensuring appropriate equipment was in place to support people safely whilst maintaining their independence.
Staff were knowledgeable about the people they supported. This included their personal preferences, daily routines and cultural and religious needs. Managers and staff regularly discussed people’s needs to identify if the level of support they required had changed.
Staff supported people with their nutritional needs. Where the service was responsible for helping people with their food shopping or preparing light meals staff took account of their dietary needs and preferences. Staff were knowledgeable about the signs and symptoms to look out for that indicated a person’s health may be deteriorating. If staff had any concerns about a person’s health, appropriate professional advice and support was sought. Where the service was responsible for supporting people to manage their medicines, staff ensured they received their prescribed medicines at times they needed them.
Staff supported people in line with their preferences and ensured they were involved in decisions about their care. Where appropriate, staff liaised with people’s relatives and involved them in discussions about people’s care needs. Staff were aware of who had the capacity to make decisions and supported people in line with the Mental Capacity Act 2005.
Staff had developed caring and friendly relationships with people they regularly supported. Home visits were coordinated to ensure staff with the right mix of knowledge, skills and experience were matched with people so they could meet their needs and preferences.
Staff received regular training to ensure they could meet people’s needs. Competency assessments were undertaken prior to new staff being able to provide support unsupervised, and their competency was regularly checked through supervision sessions. The management team undertook spot checks to review the quality of support provided and ensure it was in line with people’s care plans. The provider carried out appropriate recruitment checks on all staff to ensure they were fit to work with people receiving a reablement service.
Staff were supported by their colleagues and their managers. They felt comfortable asking for advice and were encouraged to express their views and opinions about the service. The management team used feedback from people using the service, their relatives and staff to adjust the service and improve service delivery so that it met the needs of the local population.
People felt comfortable raising any issues they might have about the service with managers and staff. Complaints or concerns raised about the service were investigated and, where necessary, appropriate action taken to resolve the issue.
The management team demonstrated a strong commitment to delivering a high quality service to people. The management structure showed clear lines of responsibility and leadership. The service had developed effective governance systems and there was a strong emphasis placed on continuous improvement of the service. The service worked closely with GPs, district nurses, occupational therapy teams, hospital staff and social services to ensure people’s health and social care needs were met.