Archived: Scarborough North, Scarborough Central and Scarborough South Reablement Services

This inspection took place on the 13 July 2016 and was announced. Scarborough, Whitby and Ryedale branch (Domiciliary Care Services) (North Yorkshire County Council) provides care and support to people in their own homes and at two extra care housing homes. They work primarily to help people rehabilitate following a hospital stay or illness and to become more independent. This is known as the Short Term Assessment and Reablement Team (START). However, for those people who require assistance beyond the six week period this can be arranged and so there are also people being supported in the community for longer than the START initial support timescale.

A service is offered to adults over 18 years, people with dementia, learning disabilities, sensory impairments and for people who required care and support owing to their mental health care needs. On the day of inspection the service was providing care for 102 people.

The service had a registered manager. 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 using the service told us they felt safe while staff were supporting them with personal care. Staff told us they were confident that if they had any concerns about people's safety, health or welfare then they would know what action to take, which would include reporting their concerns to the registered manager or to relevant external agencies.

Potential risks to people were assessed and used to develop plans of care to protect them from harm while maximising their freedom.

Staff had undergone a robust recruitment process and received training and supervision to enable them to meet people's needs in a safe and timely way.

People's needs were met, which included support with their clinical needs and with meals and drinks when required. Staff liaised with health care services and external agencies where appropriate to meet people's needs.

People's choices and decisions were recorded in their care records and staff gained consent from people before delivering care. Staff promoted the rights and decisions of people and were aware of the principles of the Mental Capacity Act 2005.

People's needs had been assessed prior to them receiving a service and they told us they had been involved in the development and reviewing of their care plans.

People were happy with the care and support they received. People made positive comments about staff and told us they were kind and helpful.

Appropriate information was given to people using the service to ensure they knew how to raise concerns or complaints. Complaints had been addressed and actions had been recorded.

The service responded to people’s individual needs and preferences and care plans reflected the knowledge staff had of each person so that they could be placed in the centre of care. Staff were organised into teams which meant that people most often received care from staff they were familiar with and who knew their needs well.

Systems were in place to check the quality of the service provided. The registered manager sought regular feedback from people in order to develop and improve the service.

Regular staff meetings were held where staff were encouraged to voice their views. Staff told us that communication was effective and that they felt supported by the registered manager.

Below is a summary of what we found. The summary describes what people using the service, their relatives and the staff told us, what we observed and the records we looked at.

As part of this inspection we looked at records for six people who used the agency and records relating to the management of the service. We spoke with seven people who used the service and two representatives by telephone. We also spoke with nine members of staff, including senior staff.

If you want to see the evidence supporting our summary please read our full report.

This is a summary of what we found:

Is the service safe?

People spoke positively about the care they received and about their carers. People said they knew who to speak to if they had any worries or concerns and were confident that action would be taken if they raised any issues. People told us that they always felt safe when then carers visited them. People said 'I feel safe with them they knew what they were doing' and 'I always feel safe with the carers.'

People told us that they felt their rights and dignity were always respected. One person told us 'I have never needed any help until now, I am 84 and the staff were pleasant, cheerful and professional".

Systems were in place to make sure that the manager and staff learnt from accidents and incidents. Audits were being undertaken and people's views were sought. There were policies and procedures in place to deal with any complaints that may arise. This helped to ensure that the service continually improved.

The service had policies and procedures in place in relation to the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). People were assessed prior to a service commencing and on an on-going basis, this helped to ensure their rights were protected.

Procedures were in place for dealing with emergencies and staff were able to explain these to us.

Is the service effective?

People's files contained assessments, which showed that people's health, personal and social care needs were assessed before care was delivered to them at home. When people were identified as being at risk, their support plans showed the actions required to manage these risks.

People we spoke with confirmed they had a support plan in their home, which was followed by carers when they visited. People said that their support plans were up to date and reflected their current needs. Records we saw supported this. One person said 'When they have finished their tasks they take time to talk to me it's like having a friendly neighbour, just what I needed' and 'I can't think of any carer who wasn't nice they have 100% of my support'.

Staff had received training to meet the needs of people they support in the community. They had also completed mandatory training so that they could work safely with people. Staff we spoke with told us they received very 'good support' from the agency.

Is the service caring?

People we spoke with told us that they were well supported by the service. We asked them for their views about the staff that supported them. Feedback from people was very positive. We spoke with seven people who were using the service and one person whose relative used the service. We also checked some of the feedback people had provided. Everyone told us they were satisfied with the care they received and spoke positively about individual care workers. People described carers as being 'brilliant, caring, helpful and efficient.'

Is the service responsive?

People told us their care workers generally arrived on time and they stayed for the correct length of time that had been agreed. People said if they had any problems they contacted the senior carer who would make sure any issues were sorted out. People told us whenever possible they were kept informed about any changes to the usual care workers who attended to them.

There were robust systems in place to deal with complaints. People told us they knew how to make a complaint.

People we spoke with told us they knew how to make a complaint if they were unhappy. Everyone we spoke with told us they would ring the agency office.

People told us they received the care and support they wanted to receive. One person said 'My needs are always kept under assessment. The staff ask me to go through my needs to make sure I am getting the help and support I require.' This helped to ensure that people's needs were being met.

People we spoke with could not tell us about how staff were recruited. However, they said that staff were good to them. A person said 'The staff are very understanding kind people who genuinely want to help. I don't know about the training but they have the skills they need to be able to look after me.'

The quality of the service being provided was being monitored by the management team. Any issues found were acted upon to ensure people receiving a service remained happy. A person said 'The staff ask me all the time if everything is okay for me.' Another person said 'I cannot fault the service I have no complaints. The staff make sure my service is perfect for me.'

We found that there were good systems in place to ensure people's care records contained all the information which helped to protect their health and wellbeing. We saw the provider had good systems in place for handling records which helped to protect all parties.