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Inspection carried out on 7 December 2017

During a routine inspection

Bletchley Community Hospital reablement at home team are part of the Milton Keynes Reablement and Rehabilitation Service (Intermediate Care). The service provides short term support with personal care to people in their own homes. The service usually works with people for a maximum of 6 weeks to enable them to reach their short term goals and become more independent. At the time of our inspection 89 people were receiving support from the service.

At the last inspection, on 16, 17 and 18 December 2015, the service was rated Good. At this inspection we found that the service remained Good.

Staff had an understanding of abuse and the safeguarding procedures that should be followed to report abuse. Risk assessments were in place to manage risk within a person's life. There were arrangements in place for the service to make sure that action was taken and lessons learned when things went wrong, to improve safety across the service.

People received their medicines as prescribed and staff supported people to access support from healthcare professionals when required. The service worked with other organisations to ensure that people received coordinated and person-centred care and support.

Staff recruitment procedures ensured that appropriate pre-employment checks were carried out to ensure only suitable staff worked at the service. Adequate staffing levels were in place.

Staff induction training and on-going training was provided to ensure that staff had the skills, knowledge and support they needed to perform their roles. Staff were well supported by the senior management team and had regular one to one supervisions.

Staff demonstrated their understanding of the Mental Capacity Act, 2005 (MCA) and they gained people's consent before providing support.

People were involved in planning how their support would be provided and staff took time to understand people’s needs and preferences. Care documentation provided staff with appropriate guidance regarding the care and support people needed to regain their independence. Staff treated people with kindness, dignity and respect and spent time getting to know them and their specific needs and wishes.

People, relatives and staff were encouraged to provide feedback about the service and it was used to drive continuous improvement. The provider had systems in place to monitor the quality of the service and had a process in place which ensured people could raise any complaints or concerns.

The service notified the Care Quality Commission of certain events and incidents, as required.

Inspection carried out on 16, 17 and 18 December 2015

During a routine inspection

Bletchley Community Hospital is part of the Milton Keynes Intermediate Care Team. They provide personal care to people in their own homes, to enable them to become more independent. People are supported to achieve goals they set for themselves to enable to improve their independence and confidence at home. The service provides short term support, usually up to six weeks, by which time people are independent or are referred to more long term care provision. At the time of our inspection, care was being provided to approximately 50 people.

The inspection was announced and took place on 16, 17 and 18 December 2015.

The service had a registered manager in post. They had been on maternity leave prior to our inspection, so in the interim, management cover had been provided by an acting senior practitioner. 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 and associated Regulations about how the service is run.

People felt safe using the service and were protected from harm or abuse by staff that were aware of the principles of safeguarding and reporting procedures. Systems were in place to identify and manage risks within people’s homes. Staff recruitment procedures were in place and were being followed to ensure only suitable staff were employed at the service. There were appropriate numbers of staff available to provide the care and support each person required. People were encouraged to be independent with medicines management and staff understood how to support them with this.

Staff had received training and demonstrated an understanding of people’s individual choices and needs and how to meet them. Staff understood the importance of treating people with dignity and respect and people confirmed this. We found the service to be meeting the requirements of the Mental Capacity Act 2005 (MCA). People using the service had capacity to make decisions for themselves and the registered manager and the staff understood their responsibilities in line with the MCA requirements.

People received the support they required to meet their nutritional needs. Input from health and social care professionals could be accessed as part of the reablement process and systems were in place to respond to people’s healthcare needs.

People were content with the care they received from staff. They were treated with kindness and compassion. They were respectful of the decisions people made.

Care records reflected the care and support people needed to regain their independence. Staff understood the importance of meeting people’s individual needs and provided the care and support they required. The service had systems to obtain people’s feedback and provide them with opportunities to raise concerns.

There was an open and positive culture at the service, with a clear set of values which people, staff and the management all worked towards. Quality control systems were in place to ensure care was delivered to a high standard and identify areas for development.

Inspection carried out on 11 December 2013

During a routine inspection

We spoke with eight people that used the service and they all told us they were happy with the service they received. People told us that staff were polite, friendly and kind. One person told us “I’m very happy with the service, all of the staff are polite, friendly and helpful”. Another person told us “I can’t fault them”.

We spoke with two relatives of people that used the service. They told us that they found the service to be very good. We spoke with three members of staff from the service who enjoyed their work and felt well supported in their roles.

We found that people’s needs were assessed and a care plan was put in place to ensure that their needs were met. We found that staff from the service carried out the assessment and ensured that people consented to the care described in the plan. We found that where additional services where involved in people’s care that appropriate information was shared and where referrals to other services were required that the staff ensured that these were made.

We found that appropriate checks were carried out on staff before they started work and that there was a detailed complaints policy in place and that a copy of it was given to people when they started to use the service. We found that people were asked for feedback about the service and that the provider took action to address any areas for improvement that had been identified.

Inspection carried out on 8 January 2013

During a routine inspection

We spoke with four people who used the service. They all spoke positively about the service and told us that they felt well supported. One person told us "They are very, very good" and another person told us, "They are always friendly and polite".

We spoke with two relatives of people who used the service who told us "We're very pleased with them" and "We're very satisfied".

We spoke with four staff members who all told us that they felt well supported. One staff member told us "I'm proud of the service that we offer". We found that staff attended a handover meeting at the beginning of their shift which enabled them to be kept up to date with information and provide any feed back to the team leaders.

We found that people received an initial assessment where the aims and objectives of their care were discussed and identified. A care plan was then put in place to ensure that their needs were met. We saw that the provider took appropriate steps to ensure that peoples welfare and safety.

We found that the provider ensured that staff received suitable training and support during their employment. We found that people who used the service were asked for their feedback about their care and support.