Archived: Community Reablement and Response Services

Updated 20 January 2015

This report was written during the testing phase of our new approach to regulating adult social care services. After this testing phase, inspection of consent to care and treatment, restraint, and practice under the Mental Capacity Act 2005 (MCA) was moved from the key question ‘Is the service safe?’ to ‘Is the service effective?’. The ratings for this location were awarded in October 2014. They can be directly compared with any other service we have rated since then, including in relation to consent, restraint, and the MCA under the ‘Effective’ section. Our written findings in relation to these topics, however, can be read in the ‘Is the service safe’ sections of this report.

The inspection team consisted of one inspector and one expert-by-experience who had personal experience of people using home care services. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service. The expert by experience spoke with people who used the service and relatives by telephone.

Before our inspection we gathered and reviewed information we held about the service. This included the provider’s information return. This is information we have asked the provider to send us on how they are meeting the requirements of the five key questions.

We reviewed statutory notifications the provider had sent us. A statutory notification is information about important events which the service is required to send us by law. We also contacted the local authority commissioner who had funding responsibility for people who used the service to obtain their views.

As part of our inspection we spoke with 14 people who used the service and four relatives on the telephone. We also spoke with 15 staff members which included care staff, line managers and the service manager. We looked at five records relating to people’s care, five staff files and records relating to the management of the service. This included policies, accident, incident and safeguarding records, minutes of meetings and a training matrix.

Updated 20 January 2015

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008 and to pilot a new inspection process being introduced by CQC which looks at the overall quality of the service.

The inspection was announced. We told the provider two working days before our visit that we would be coming.

The service did not have a registered manager in post even though there is a requirement for them to have one. The provider is currently recruiting for this role. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.

Community Reablement and Response Services is a domiciliary care service providing short term reablement support to people within the community. People who are referred can use the service for up to six weeks to help them regain skills and independence lost through illness, injury or surgery.

At the time of our inspection the service provided support to 189 people and employed over 100 staff.

Feedback from people’s experience of the service had not been actively sought to help develop the service. We also received feedback from people that the service was not aware of. Some people were not aware of the arrangements with their visits.

We found that although incidents were monitored and responded to in a timely manner there was no record of whether the actions taken had reduced the risk and how effective the actions had been.

Some staff did not have up to date training. Most staff had not undertaken training in the Mental Capacity Act (2005), although this training was booked. The Mental Capacity Act is a law that protects people who are unable to make their own decisions. Staff understood how to support people to make their own decisions but had limited or no knowledge of the Mental Capacity Act or how it would apply to people they supported.

When we spoke with people and their families they provided positive feedback about the quality of support provided by the service.

Systems were in place to ensure that when people were referred to the service their needs were assessed and reablement support was started quickly. Support provided was individual to each person and focused on reablement goals identified during their assessment. These goals were reviewed and updated every two weeks or as required, if sooner. Staff were provided with information which gave clear instruction on people’s goals and how they were to support them safely to achieve their goals.

Staff were passionate about their roles. They spoke with pride about the service they provided in helping people regain their independence.

The service had good links with other teams within Walsall council and also outside organisations. We saw evidence of partnership working which was helping to drive improvements to the service they provided to people.

You can see what action we told the provider to take at the back of the full version of the report.