Warwickshire Reablement Service

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

Well-led – this means we looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture.

At our last assessment we rated this key question good. At this assessment the rating has changed to outstanding. This meant service leadership was exceptional and distinctive. Leaders and the culture they created drove and improved high-quality, person-centred care.

This service scored 89 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a shared vision, strategy and culture. This was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and understanding challenges and the needs of people and their communities. The leadership from the provider and staff contributed to a culture at the service which was focused on providing good care to people.

It was evident there existed a positive, ‘no blame’ culture and a culture that learnt from each other and new technologies that improved people’s experiences. The registered manager and nominated individual took their roles and responsibilities seriously. Staff were clear of their own roles and those of others. People and relatives feedback to us was overwhelmingly positive. One person said, “They were a big help, especially at first. As the days went on, I got better and I didn’t need them so much.” Another person said, “Thanks to them I’ve come on in leaps and bounds.”

Staff described how working in accordance with the vision and ethos of the service was personally fulfilling and ensured people received effective and responsive care. Staff conversations showed they took their role seriously and they were supported to develop their own knowledge and learning, as well as being empowered to share that with others. For example, staff made a video to promote the benefits of an app-based system which they sourced and implemented to monitor people’s movements in a way that was not intrusive. A staff member told us they were sharing this video with other services to promote this technology that benefitted people’s lives. Staff worked closely with each other, senior staff and management to provide the best care outcomes, as well as other health professionals and multi-disciplinary teams. A staff member said a strength of the service was, “So much innovation. Our team push constantly. We are innovative and we are embracing AI (artificial intelligence) to support families. We invested in ‘Total mobile’ (system to allocate care call management) and we did product testing to see which suits our needs. It is impressive. We made sure it does what we want, designed for us and the provider paid for that piece of work.”

The nominated individual told us they completed the provider information return (yearly document CQC requests from providers). They said they used this document to remind themselves and showcase their strengths to evidence positive outcomes for people. In this return, the provider said, “We are founded on the principle that effective communication is central to delivering successful outcomes. We are committed to ensuring that every individual we support is heard, understood, and empowered to participate fully in their care, recovery and Reablement journey.” Feedback we had from people that used the service, or who worked alongside the service to support people, echoed those sentiments.

Staff said without exception, they felt supported by their team, immediate line management and they were supported and encouraged to perform well for people, but also within the organisation. Staff said there was a positive and empowered culture where professionalism was rewarded.

The provider had inclusive leaders at all levels who understood the context in which they delivered care, treatment and support and embodied the culture and values of their workforce and organisation. Leaders had the skills, knowledge, experience and credibility to lead effectively. They did so with integrity, openness and honesty.

A culture had been fostered where people and their family members were seen as important partners in their care. This encouraged an honest and transparent dialogue where the right care and support could be provided from the start. People felt comfortable and confident to raise anything, their voice was heard and respected. People were listened to, respected and treated with fairness.

The provider developed new technologies to support and include the person and family members. A staff member gave us an example of how relatives were kept up to date with events through the customer portal. Relatives said they were able to see what had happened by seeing what staff had written about their family members at visits. Other relatives felt sensor and assistive technologies was helpful and they felt the provider understood their needs as a family member which helped reduce their anxiety.

Staff felt included in how the service was run and they felt the leaders were supportive and valued them in how care was provided to people. Staff said there was a positive culture, and they spoke of a service that wanted to be better and improve, rather than look to blame.

The provider fostered a positive culture where people felt they could speak up and their voice would be heard.

Staff were confident to speak up and share concerns and suggestions. Staff said the registered manager was approachable and they had regular opportunities for speaking with them to share any feedback. Regular staff meetings provided an opportunity for learning, as well as a chance to raise any feedback or concerns. Staff we spoke with felt confident and comfortable to speak up and call out anything they felt was not professional or that put people at risk. Staff were confident speaking to us and their knowledge of what they would share or escalate was what we expected. The registered manager said they had a whistle blowing policy and there were internal teams who would support staff.

The provider valued diversity in their workforce. They worked towards an inclusive and fair culture by improving equality and equity for people who worked for them.

The providers information return to us said, ‘Training and development remain central to our success. In addition to refresher training for a reablement service’ the launch of new in house training modules has been instrumental in refreshing staff’s existing knowledge. Training alongside CPD sessions, regular meetings and supervisions, and Peer groups support the team to deliver high-quality care. We have also revitalised our reablement pledge, which reflects our values and working practices’. The registered manager said they held a review of the year that was a celebration of staff achievements. The provider had a thorough understanding of equality, diversity and inclusion and the protected characteristics as defined by the Equality Act. People, relatives and staff feedback to us showed everyone felt included and their individual and diverse needs were met.

The provider had clear responsibilities, roles, systems of accountability and good governance. They used these to manage and deliver good quality, sustainable care, treatment and support. They acted on the best information about risk, performance and outcomes and shared this securely with others when appropriate.

The provider operated a governance and management structure that checked and identified where improvements were required. Regular checks through observed practice, medicine competency checks, quality of daily records and care call allocation, helped ensure a good quality service. Ongoing monitoring and checks in between planned audits continued to keep people safe.

Management, staff and support staff were clear of their individual roles and those of others. Staff continued to have their knowledge, skills and training reviewed, while some staff took on extra responsibilities to continue to promote good quality care through new initiatives and technologies. In addition to mandatory training, additional support was given to staff, for example workshops to support staff using assistive equipment.Overview and performance of the service was completed regularly which helped the service to deliver on its ambition and ethos. Feedback from people, relatives and external agencies all agreed the service was well led and operated at a high level.

The nominated individual showed us an internal report where they had supported the provider with an external review of their service. Warwickshire Reablement was named as a key contributor, and their successes were included within that report that supported a positive rating. Contingency planning was in place and a staff member explained to us, in the event of a disruption to their service, for example through bad weather, they had prioritised care calls based on individual circumstances. For example, someone with time critical medicines or a person who lived alone would be visited as a priority to ensure they remained as safe as possible.

The provider clearly understood and carried out their duty to collaborate and worked in partnership, and services worked seamlessly for people. They always shared information and learning with partners and collaborated for improvement.

Partnership working and collaborating with important stakeholders and agencies was central to people receiving positive outcomes, which they did. People and relatives as we have referred to, shared incredibly positive examples with us about the difference, staff at Warwickshire Reablement made to them. At the heart of that support was partnership and community support. We have written how Warwickshire Reablement used partnerships as a catalyst to support innovative practices. Examples included joint design and co production of assessments and improving continuity between services. Co production is now embedded in governance with the service designed around people’s needs and strengthened by consistently positive feedback from people and families.

The management team and staff engaged with people, their relatives, local community networks as well as acute and health and social care partners. Multi-disciplinary meetings and discussions with equipment providers helped share learning and opportunities to deliver what people needed. Without exception, people received the support they needed. In many cases, the use of specialist equipment and the speed in which it was put in place was what people praised.

The provider had a strong focus on continuous learning, innovation and improvement across the organisation and local system. They always encouraged creative ways of delivering equality of experience, outcome and quality of life for people. They actively contributed to safe, effective practice and research.

Through their own learning and evaluation, the provider continued to make strides to improve the service. The registered manager was confident the service delivery had improved. The registered manager reflected on the changes made and said, “We have more autonomy, we have all this technology to help our core focus, so we have more to offer.” They told us measuring some of that success around dignity and respect, they scored 100%. They reviewed the support that gave people from the start and end of their reablement journey. They established over 77% of people they supported did not need any additional long-term care.

The nominated individual said they had learnt lessons and improved certain aspects of the service. They introduced new electronic systems which they co-designed that helped the service become more agile and responsive. Feedback from health professionals was extremely positive and reflected a service that was engaging and on the side of the people they supported.

Investing in staff, their training and their development created a learning environment that was embedded across the service. Staff described to us a culture where improvement was everyone’s responsibility. From conversations with staff and management, we saw leaders promoted openness that enabled staff to share any concerns or insights to improve the service. From reviewing the systems and conversations with management, the provider demonstrated strong analytical capability and understanding to evidence early identification of emerging issues and to provide swift responses. For example, early assessment processes to put in place, any adaptions to support positive outcomes.