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North Short Term & Urgent Support Requires improvement

Reports


Inspection carried out on 26 March 2019

During a routine inspection

About the service: North Short Term and Urgent Support Team provide a reablement and rapid response service. The reablement service provides people with support for up to six weeks to help them live independently. In some instances, this service may be extended beyond this time frame to enable a permanent care provider to be found. The rapid response service supports people for up to two weeks to prevent admission to hospital or in the event of a breakdown in carer arrangements. At the time of our inspection there were 55 people receiving support with personal care from the service.

People’s experience of using this service:

People told us they felt safe, although we noted a potential safeguarding concern had not been reported to the local authority safeguarding team. Although risks to people’s safety and well-being were assessed risk assessments for all aspects of people’s care and support were not always in place.

Records relating to the management of medicines were not always clear. Steps had been taken to rectify this and were being implemented at the time of the inspection.

Staff were recruited safely, there were sufficient staff employed to meet people’s assessed needs. New staff received an induction and there was a system in place to ensure staff received ongoing training and supervision.

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 staff were caring and kind. Staff respected people’s privacy, maintained their dignity and encouraged them to be as independent as possible.

Care packages were tailored to meet people’s individual needs. Care records included information about people’s routines, the support required and their future goals. We have made a recommendation about the return of care records to the office when a care package has ended.

People were aware of how to complain. There was a system in place to seek feedback from people when their care package ended. Staff enjoyed their job, and the registered manager and all the staff we spoke with were clear about their role and responsibilities.

Not all audits had been completed at regular intervals and they had not been sufficiently robust to ensure all aspects of the service were safe.

Rating at last inspection:

At the last inspection the service was rated good (published 9 September 2016).

Why we inspected:

This was a planned inspection based on the rating awarded at the last inspection.

Follow up:

We will continue to monitor the service to ensure that people receive safe, compassionate, high quality care. Further inspections will be planned for future dates.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Inspection carried out on 18 July 2016

During a routine inspection

The inspection of the North Short Term Urgent Support Service took place on 18 July 2016 and was unannounced. The service has a history of compliance with all health and social care regulations. The last inspection was in February 2014.

The service provides support to people aged over 18 in three main ways. There is a re-ablement service which supports people for up to six weeks to assist them to live as independently as possible, a rapid response service for up to five days to prevent admission to hospital or support in the event of a breakdown in carer arrangements and a support worker service which provides assistance for people living with long term conditions where there may be an acute episode requiring intense, time limited input. On the day we inspected 52 people were using the service. The service operated 24 hours a day, 365 days a year and had an out of hours contact number if an issue arose outside of office working hours.

There was a registered manager in post and we spoke with them during the inspection process. 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 spoke very highly of the professionalism of staff, who balanced their knowledge and experience with friendliness and empathy. Staff were fully aware of the importance of gaining people’s trust as this helped to build relationships and encourage people’s co-operation with more personal tasks.

The service was very responsive to need, with each input specifically designed for that individual. This could include personalised therapy alongside more generic support with daily living tasks. Care records evidenced a detailed assessment and subsequent support plan identifying key objectives and the preferred method of meeting these. These were regularly reviewed, assisting people to reflect on their progress and assist for planning if ongoing support was needed.

Complaints were handled well and in a timely manner, with all resolutions recorded. Lessons learnt were shared with staff and the service used these as a mechanism to improve. The service had received many compliments from people using the service and their informal carers, emphasising how much progress people had made and the value of the service in restoring confidence.

People indicated their appreciation of the service and how supported they had felt from the start to finish. Staff worked with high morale as they felt acknowledged and could see the value of their input. We saw evidence of strong leadership with a clear vision for the service which was reflected in all aspects of service delivery and provision.

Quality assurance was robust and showed the service responded quickly to changes, had capacity to be flexible and was keen to develop so that people had the optimum care and support possible.

People said they felt safe when working with staff as they were confident staff had the necessary knowledge to support them well. Staff knew what constituted a safeguarding concern and how to report such matters. Their knowledge showed a wide understanding of the potential areas for people living in the community.

Risks were managed well with reduction plans in place that sought to provide guidance and information to all staff. Accidents and incidents were logged appropriately with swift action taken where required. This was then absorbed into staff meetings and training so that lessons were learnt from such situations.

The service had a finite number of hours allocated and met the needs of people within this. It was flexible and responsive to people’s needs, and through regular reviews ensured people received an appropriate level of service, enabling their progression through the system.

Medicine management was

Inspection carried out on 29 January and 7 February 2014

During a routine inspection

On the day of our inspection we spoke with the registered manager and two locality managers. Following the inspection we spoke with six home support workers and with 20 people who had either recently used the service or were currently using the service, or where appropriate, their representative.

The registered manager told us the service provided care and support for between 70 and 80 people each week. They told us the provider offered three separate services; a rapid response team integrated with intermediate care, a reablement service and a service for people living with long term conditions requiring short term intervention due to an exacerbation or acute episode. The manager explained most of the service�s referrals came from other health care professionals, for example; social workers and G.P�s.

The manager explained the service had four locality managers. They told us the locality manager role included completing initial assessments, case management and managing a staff team. They said they also employed six home support co-ordinators. Their responsibilities included first line management of staff. The manager told us the service currently employed approximately 81 home support workers who were responsible for the delivery of care and support to people who used the service.

We found people who used the service were encouraged to make decisions about their care and support.

The reablement support plans we looked at provided information about the persons identified support needs.

Effective systems were in place to reduce the risk and spread of infection.

The provider completed a series of pre-employment checks prior to make sure potential candidates were suitable and safe, before they started working with people.

The manager told us they sent out monitoring feedback forms to people using the service. We saw the analysis showed the overall satisfaction with the reablement and support service was 91%.

Comments from the 20 people we spoke with who had either recently used the service or were currently using the service, was all complimentary. Their comments included;

�They are brilliant with mum without exception.�

�100% safe and confident. I trust them entirely. I am still in bed when they come and have a key safe as they come to get me out of bed.�

�They work as a team with other professionals to keep you safe. For example, watching me doing my exercises the physio had left for me.�

Inspection carried out on 8 September 2012

During a routine inspection

We spoke with the relatives of two people who use the service and these are some of the things they told us:

�The service has blown away any nerves we had. The staff are always on time and are very professional. It�s not just a job for the staff.�

�The staff are not doing bad.�

We also looked at the nine compliment letters that the service had received since May 2012 and up to 6 September 2012. These are some of the comments people had made;

�A very good service.�

�I had two very good helpers, no complaints at all. Thank you everyone concerned.�

�I would like to compliment staff for their help and kindness to me, I could not have wished for more.�

�I have nothing but praise for the help I received. The kindness, care and attention they gave me was appreciated very much and merits a very special thank-you.�

�Staff have been kind, pleasant and helpful. I really appreciate all of the help I have had.�

�I found the staff excellent, helpful and encouraging. They found ways around difficulties and certainly helped me to get mobile, much quicker than on my own.�

�I would like to compliment and thank the whole of the tem who made my return from hospital so easy, with their professionalism, skills and positive and friendly conversation.�

�The service is a life line for carers and clients. If it had not been for them my wife would be back in respite care and I would need a carer for me.�

�I would like to compliment all of the carers for their good attitude and demeanour and evident satisfaction they get from doing their job.�

�We wish to thank the team for their kind, considerate support. They always had time for our relative and were very patient.�

�Everyone who has visited was very friendly, helpful and professional.�

We spoke with four members of staff who were all very enthusiastic about the service they provide. They told us they get a great deal of job satisfaction and find their jobs very rewarding.