Background to this inspection
Updated
6 November 2020
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
Inspection team
The inspection was carried out by one inspector.
Service and service type
This service is registered as a domiciliary care agency. It provides personal care to people living in their own houses, flats and specialist housing.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided. However, the registered manager was absent at the time of our inspection.
Notice of inspection
We gave the service 24 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.
Inspection activity started on 22 September 2020 and ended on 30 September 2020. We visited the office location on 22 September 2020.
What we did before the inspection
We reviewed information we had received about the service since their registration. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all of this information to plan our inspection.
During the inspection
We spoke with five people who used the service about their experience of the care provided. We spoke with six members of staff including the head of the service, the interim service manager and support workers.
We reviewed a range of records during the site visit. This included five people’s care records and four medication records. We looked at a variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We reviewed training data, policies and care documentation sent to us; including newly introduced care assessment plans.
Updated
6 November 2020
About the service
The Reablement and Community Home Support (Reach) service is a multi-disciplinary team providing care and support in people’s own homes. The service provides short-term support for people who need help to regain their confidence and independence. The team is made up of professionals from both the NHS and Stockport Metropolitan Borough Council. At the time of the inspection the service was supporting approximately 110 people.
Not 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.
People’s experience of using this service and what we found
We found the administration and management of medicines was not always safe. Improvements to individual risk management had been made since the last inspection. However, we found the service had not always assessed the individual risks to people’s health and wellbeing.
Improvements in audits had been made since the last inspection. However, audit systems and processes were not always robust enough to ensure compliance with the regulations regarding medicines and risk assessments. The report of actions submitted to CQC as a result of the last inspection had not been fully completed.
Staff told us they felt very supported in their role. Training was not always up-to-date due to Covid-19 restrictions. However, staff we spoke with were knowledgeable and passionate about providing good care.People received a person-centred service from staff who felt very supported in their role.
People we spoke with were extremely complimentary about the care and support they received from the service. One person told us, “I have absolutely no qualms. They [staff] will do anything I ask. They are lovely people. I am very happy.”
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 requires improvement (published 3 December 2019). The service remains rated requires improvement. This service has been rated requires improvement for the last two inspections. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection enough improvement had not been made and the provider was still in breach of the regulations.
Why we inspected
We received concerns in relation to the safe management of medicines. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.
We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.
The overall rating for the service remained requires improvement. This is based on the findings at this inspection.
We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report.
You can see what action we have asked the provider to take at the end of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for REaCH on our website at www.cqc.org.uk.
Follow up
We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.