Archived: Middlesbrough Intermediate Care Reablement Team

At our last inspection we rated the service as 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.

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 a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People told us they felt safe when staff from the reablement team visited them at home. The registered manager and staff knew what constituted abuse and who to report it to if they suspected people were at risk. Risks to people’s safety were identified and plans were in place to minimise those risks. This included ensuring appropriate equipment was in place to support people safely whilst maintaining their independence.

Medicines were managed safely with an effective system in place. Staff competencies, around administering medication, were regularly checked. Staff received training in infection prevention and control and were provided with a plentiful supply of aprons and gloves.

Pre-employment checks were made to reduce the likelihood of employing staff who were unsuitable to work with people.

The registered manager had systems in place for reporting, recording, and monitoring significant events, incidents and accidents. The registered manager told us that lessons were learnt when they reviewed complaints and any accidents and incidents to determine any themes or trends.

People were supported by a regular team of staff who were knowledgeable about people’s likes, dislikes and preferences. A training plan was in place and staff were suitably trained and received all the support they needed to perform their roles.

If needed, staff supported people to be independent with meal preparation and cooking. People were able to choose the food they wanted to eat.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People told us they were happy with the standard of care and support they received from the reablement service. People were provided with the support they required in line with their care plans, which included meeting people’s personal care needs and supporting people to become more independent. People's care plans set realistic goals and were very regularly reviewed. Staff were respectful of people’s privacy and dignity.

People received information which detailed the complaints procedure. They told us they were confident that if they were required to make a complaint, the management would respond and resolve their issue promptly.

The registered manager was aware of the Accessible Information Standard that was introduced in 2016. The Accessible Information Standard is a law which aims to make sure people with a disability or sensory loss are given information they can understand, and the communication support they need. The registered manager told us they provided and accessed information for people that was understandable to them.

The management team demonstrated a strong commitment to delivering a high quality service to people. Staff told us they enjoyed working at the service and felt supported by the registered manager and senior staff. Quality assurance processes were in place to monitor and improve the quality of the service.

Middlesbrough Intermediate Care Reablement Team provides assessment and rehabilitation services for people in their own homes to promote their daily living skills and independence. People are referred to the service following a stay in Middlesbrough Intermediate Care Centre. Middlesbrough Intermediate Care Centre provided residential intensive led therapy led rehabilitation. On discharge from Middlesbrough Intermediate Care Centre the reablement team provide ongoing support to people in their own homes for up to two weeks. During this time their ongoing needs (if any) are reassessed.

The service had a registered manager in place. 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.

The registered manager completed audits; however, records were not always kept. Senior management visited the service on a regular basis as part of quality monitoring, but records of this visit or actions needed were not kept.

Risks to people’s safety had been assessed by staff and records of these assessments had been reviewed. Staff were aware of how to keep people safe; however, some risk assessments contained limited information. This meant that staff did not always have the written guidance they needed to keep people safe.

There were systems and processes in place to protect people from the risk of harm. Staff were able to tell us about different types of abuse and were aware of action they should take if abuse was suspected. Staff we spoke with were able to describe how they ensured the welfare of vulnerable people was protected through the organisation’s whistle blowing and safeguarding procedures.

We saw that staff had received supervision on a regular basis and an annual appraisal.

People told us they were cared and supported to regain their independence by experienced and knowledgeable staff. People told us staff were reliable. Staff had been trained and had the skills and knowledge to provide support to the people. The registered manager had identified any gaps in training and was arranging for training to take place. There were enough staff employed to meet the needs of people who used the service at the time of the inspection and if there was to be an increase in demand.

The registered manager told us all people who used the service would need to have capacity. The service did not cater for people living with advanced dementia as they would not benefit from the service provided. Staff we spoke with understood how to gain consent and ensure people had choice. People and their relatives told us they were involved in discussions about their care.

The service did not have a high turnover of staff. Most staff had worked at the service for many years, with the last person recruited in 2012. The registered manager was able to talk us through the safe recruitment and selection procedures they would follow if they were to recruit any new staff.

Appropriate systems were in place for the management of medicines so that people received their medicines safely. Weekly checks of the medication administration records were completed but there wasn’t a formal auditing tool which detailed checks that had been undertaken and the findings.

People told us staff treated them with dignity and respect and their independence was encouraged. People told us that they were happy and felt very well cared for.

People told us they were supported to prepare food and drinks of their choice. This helped to ensure that nutritional needs were met. People told us they were encouraged and supported to be independent with meal preparation

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People were supported to maintain good health and had access to healthcare professionals and services. People received the support they needed from physiotherapists and occupational therapists within the service. Where needed, referrals were made to dietician or speech and language therapy

People’s care plans described the care, support and rehabilitation they needed; however; some of these were brief and could be more person centred. Meetings took place regularly to review people’s progress and new goals were set. People told us they were involved in all aspects of their care and rehabilitation.

The registered provider had a system in place for responding to people’s concerns and complaints. People were regularly asked for their views. People said that they would talk to the registered manager or staff if they were unhappy or had any concerns.

People were provided with the care and support they needed and told us their views were taken into account in the assessment and care planning process. Staff treated people with dignity and respect.

The office environment staff worked in was clean, well maintained and safe. Systems were in place to manage any risks associated with infections.

We saw the service had a complaints procedure in place and this was accessible to people.

The people we spoke with confirmed that they had been involved in discussions and decisions about their care and support needs. Staff treated people with dignity and respect.

People were provided with the care they needed and told us their views were taken into account in the assessment and care planning process.

People who used the service were protected from the risk of abuse and told us they felt comfortable and safe with staff.

Staff received appropriate training and had regular supervision and appraisals.

The quality of the service was monitored and systems were being developed to ensure it was done on a regular basis.