St Edmunds

Updated 24 April 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 was a comprehensive inspection. We gave the service 48 hours’ notice of the inspection visit because the location provides a domiciliary care service, and we needed to be sure people would be available to support us with the inspection. The first day was spent at the location office. The second day was spent accompanying staff on visits to people’s homes and contacting people receiving a service and staff by telephone to gather their views of the service. The inspection was timed to link with a larger inspection being carried out of the Trust services.

Prior to the inspection we reviewed the information that we held about the service and the

service provider. On the inspection visits we spoke with both the registered managers at the registered location. We spoke on the telephone with four people or their relatives who received a service from the Torbay re-ablement team and visited three people in their own homes with their permission, along with the staff supporting their care. On the home visits we saw how people were supported, talked with people about the service and looked at the records that were kept in their homes. We spoke with seven members of staff about working for the teams, the care they gave people and the training and support they received.

We attended a daily team meeting and a staff handover. We observed a care co-ordinator taking referrals for the rapid response team and discussed with them how the systems worked.

We reviewed a range of records about people’s care and how the teams were managed. These included looking at care records for four people held at St Edmunds, and three files in people’s homes; four staff files and other records relating to the management of the service, including training and supervision records, policies and procedures, audits, and service development plans.

Updated 24 April 2018

St Edmunds is the location for the regulated activity of personal care operated by Torbay and Southern Devon NHS Foundation Trust. Personal care services are provided from the base at St Edmunds to people living in their own homes, through teams providing rapid response care and re-ablement services.

This inspection which took place on 14 and 16 February 2018 was announced and focussed on the rapid response service and Torbay re-ablement team. At our last inspection in February 2016 we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and on-going 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.

Why the service is rated Good.

Services located at St Edmunds included the rapid response service and Torbay re-ablement team. Another team provided similar support to Devon and was due to move to a new location, so did not form part of this inspection.

The rapid response service situated at St Edmunds aimed to provide short term personal care to people in their own home for up to 7 days until a longer term care package could be sourced for a person. This service also provided some end of life care, in conjunction with other teams such as the local hospice at home team.

The Torbay re-ablement team provided support and personal care for a period for up to six weeks of intensive rehabilitation in people’s homes with an aim to returning people to independence. This might be following a hospital admission or intermediate care placement. People’s care and support goals for re-ablement were agreed with them in advance, including a timescale to aim for.

The services were well run. People understood what the services they were receiving were for and were given information about what they could expect to receive. People were involved in developing their care plans and setting goals for their increasing independence. Support was flexible and tailored to people’s needs. For example, for the rapid response service this might just include one visit to support a person during a crises. Staff were skilled at carrying out assessments and making decisions around people’s care. Staff understood when to call for additional support or escalate issues to other agencies or for medical support, and we saw and heard this happening during the inspection.

People told us they had benefitted from the service. They told us “I can’t fault them…..they just sorted it all out and made it all work. I couldn’t thank them enough” and “I am a very satisfied customer.”

People were supported by sufficient numbers of well trained staff. Staff us they enjoyed working at the services, enjoyed the variety of people and their needs they supported. They felt they had the training and support they needed to do their job well. There were enough staff to support the activities being undertaken, and a need had been identified to expand the services. New staff were being recruited to meet the expected increase in demand. Safe systems for staff recruitment were in place, and staff performance was monitored through spot checks, registered managers working alongside staff and feedback from questionnaires.

People could expect to receive their medicines safely, or to be supported to do so until they were independently safe. Risks from people’s care were identified and security, including for lone workers was considered for each visit. People’s risk assessments included assessments of the property such as narrow passageways or uneven stairs. Risk assessments also included any areas of the person’s physical well-being such as risks associated with long term health conditions, pressure ulcers or concerns over their moving and positioning. Staff followed good practice in infection control, including the use of protective equipment such as gloves and aprons.

People could expect to receive high quality, safe support because the organisation had clear and effective systems in place to manage quality and safety. Audits were carried out of the service and any changes identified through the audits, questionnaires, team meetings or feedback was used to support learning and the development of the service. Services linked to similar wider local and national services to ensure good practice was shared.

Records relating to the service and people’s care were well maintained. Information was available to people in accessible formats, including easy read, large print or in alternative languages to English, including sign language. Information on the service’s policy on anti-discriminatory practice was detailed in their information handbook, which was left in people’s homes. Policies on bullying and harassment were in place and re-enforced through team meetings and supervision.

Further information is in the detailed findings below