Intermediate Care at Home

Updated 9 August 2018

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, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 10 July 2018 and was announced. We gave the service 48 hours' notice of the inspection visit. One adult social care inspector visited the service on the first day of inspection. On the 23 and 24 July 2018 the inspector telephoned eight people who used the service and two relatives for their feedback.

Before the inspection we contacted the local authority commissioning and safeguarding teams to gain their views on the service. We also looked at the notifications we received from the service and reviewed all the intelligence held by the Care Quality Commission.

We used information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make.

During the inspection we spoke with the nominated individual, registered manager, the business administrator, two admission and discharge coordinators, two schedulers, two assistant practitioners, ten care workers and three health and social care professionals. Following the inspection, we received feedback via email from four social care professionals.

We looked at five people’s care files and their medication administration records. We also looked at a selection of documentation pertaining to the management and running of the service. This included quality assurance information, staff rotas, training, supervision and appraisal records, minutes of meetings, accident and incident records, complaints, recruitment information and a selection of the provider’s policies and procedures.

Updated 9 August 2018

This inspection took place on 10 July 2018 and was announced.

Intermediate Care at Home generally provides short-term personal care services to people in their own home. The service focuses on promoting self-care and enabling people to reach or regain an optimum level of independence. Three separate teams make up the service. The Crisis Support Team provides more urgent and personal care support lasting up to seven days and if people require longer support the Peri Team manage this. The Short Term and Reablement Team (START) provide support for up to six weeks. At the time of the inspection the service was supporting 32 people.

At our last inspection we rated the service outstanding. At this inspection we found the evidence continued to support the rating of outstanding and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

We received outstanding feedback about Intermediate Care at Home. All comments from people who used the service, relatives, health and social care professionals were extremely complimentary and consistent stating they were really happy with the care, treatment and support the service provided. We also saw very high volumes of positive feedback people had given directly to the service, either in the form of thank you letters and cards, or in the questionnaires they had completed once the programme of reablement was completed.

The service was exceptionally well-led. The registered manager was well-respected by the staff team and partner agencies and had fostered a very open and transparent culture. They placed a strong emphasis on providing a high-quality service and looked for ways to continually improve to benefit people and to meet the demands of a changing local health and social care picture. Staff were proud to work for the service and felt valued for their work and their contribution to continuous improvement.

There were very effective processes in place to monitor quality and understand the experiences of people who used the service. Where improvements were needed, these were addressed. People's views were continuously sought, they felt listened to and assured any complaints they made would be taken seriously and acted upon.

Personalised reablement programmes with varying degrees of intervention and flexible staffing arrangements continued to enable people to reach or regain an optimum level of independence.

Through continuous review, any changes in people’s needs were quickly identified and their care package amended accordingly. The service was flexible and responsive, any additional support was provided where necessary, including assistance with nutrition and hydration. People received very positive outcomes as a result of the high quality and effective care they received which helped reduce avoidable hospital and care home admissions.

People were at the heart of the service. Staff worked in partnership with people, their families and other agencies to support them to reach their full potential. Support plans were personalised and contained agreed goals that people wished to achieve, which were reviewed and updated as support progressed. People had good access to a range of aids and equipment which supported their safety and return to independence.

Equality, diversity and human rights were at the forefront of how support was provided. The strong person-centred culture apparent at our previous inspection continued through the exceptionally kind, caring and compassionate approach from the registered manager and all members of the team.

Staff were creative in overcoming obstacles and finding opportunities to go ‘over and above’ to promote people’s independence and wellbeing. People told us that staff were very professional and always respected their dignity when undertaking personal care tasks. People were signposted to access local community groups to promote inclusion, independence and a healthy lifestyle.

The service was committed to providing a learning and development programme that nurtured staff’s knowledge, skill and professional development. Staff felt well supported and were highly motivated to provide a very personalised service to people they supported.

The safety of people who used the service was taken very seriously and managers and staff were well aware of their responsibility to protect people’s health and wellbeing. Positive risk taking was promoted so people could have full control over their lives. Staff understood the various types of abuse and knew who to report any concerns to. People were supported to take their medicines safely. A robust recruitment and selection process was in place which ensured prospective new staff had the right skills and were suitable to work with people who used the service.

People who used the service were encouraged to make their own decisions. Staff followed the principles of the Mental Capacity Act 2005 when there were concerns people lacked capacity and important decisions needed to be made.

Further information is in the detailed findings below