This inspection took place on 6 September and was announced. The provider was given 48 hours’ notice because the location provides a domiciliary care service; we needed to be sure that someone would be in. At our previous inspection on 30 January 2014 we found the provider was meeting the regulations we inspected.Reablement service- London Borough of Tower Hamlets provides assessment, equipment and short term support to people in their own homes, the majority of whom have been discharged from hospital after an admission. The service is usually provided for up to six weeks and aims to help people to learn to live as independently as they can and to assess people's needs for longer term care.
At the time of the inspection there were 87 people receiving support from the service, although they were not all receiving personal care. Staff that went into people’s homes to support them were known as ‘reablement officers’ and we have referred to them as such throughout the report.
There was a registered manager at 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 and their relatives told us they felt safe in the presence of reablement officers and that they were kind and caring towards them. They said that they were supported to regain their independence and that reablement officers had the skills and training to help them achieve their goals.
People told us they received the same reablement officer and did not raise any issues regarding their time keeping. They said when they were running late, they always received a phone call letting them know.
People were given information before they began to use the service, included who to speak to if they wanted to complain. Where complaints had been raised, these were documented and the provider responded to them in a timely manner.
Reablement officers were aware of what to do if they had concerns about people’s safety and who they could contact to report their concerns. We saw that the provider took appropriate steps when concerns were raised. However, there had been some incidents that required a formal CQC notification of which we were not notified.
The provider carried out appropriate checks on staff to ensure they were suitable to work with people. These included criminal record checks. There was a thorough induction programme in place for new starters. The provider had a three year training programme in place for existing staff which included a range of topics which helped to ensure they received training that was appropriate to meet the needs of people using the service. This included health and safety, safeguarding, first aid and reablement training. It also included practical training that was delivered by occupational therapists (OTs) on specialist equipment that was used to mobilise and transfer people.
Staff received regular supervision and yearly appraisals during which they were able to discuss any concerns, identify any training needs and set any personal development objectives for the year.
Referrals to the service were checked by a member of the operations team and then passed onto an independence planner or an OT to carry out an assessment. An independence plan was developed which identified the areas that people needed support with. A goal setting document was also used to identify SMART (specific, measurable, achievable, realistic and timed) goals that people could work towards to improve their independence with regards to their daily living skills. Support typically lasted six weeks or ended when people achieved their goals.
Feedback was sought from people at the end of their support as part of the provider’s quality assurance monitoring. Other audits such as checks on reablement officers, case studies and case file audits were carried out. Feedback from these was shared with the relevant person which enabled learning and improvements to take place.
We found a breach of regulation in relation to notifications. You can see what action we have told the provider to take at the back of the full version of this report.