Background to this inspection
Updated
11 January 2019
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
This was a comprehensive inspection. The inspection took place on 5 December 2018 and was announced. We gave the service 24 hours’ notice of the inspection visit because the location provides a domiciliary care service and staff are often out during the day. The manager was on annual leave and we were met by the service manager, who was the former registered manager.
The inspection was carried out by a single inspector. After the inspection an expert by experience telephoned people and their relatives to get their opinion of the service. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service for example elderly, dementia and palliative care.
Before our inspection we reviewed information we held about the service. This included statutory notifications received from the provider since the last inspection and the Provider Information Return (PIR). The PIR is a form we asked the provider to complete prior to our visit which gives us some key information about the service, including what the service does well, what the service could do better and improvements they plan to make.
Before the inspection CQC emailed a questionnaire to 41 staff, 12 people who used the service and 12 relatives and seven healthcare professionals.
During the inspection we spoke with the service manager, the assistant director of adult social care and seven members of staff. We also spoke with staff from Age UK and the Wimbledon Guild. We looked at a range of records including four people's support plans, staff supervision files and other records relating to the management of the service.
After the inspection an expert by experience telephoned 10 people and two relatives to ask for their opinion of the service they were receiving. We emailed a short questionnaire to nine care staff and six healthcare professionals.
We have included comments from all the responses we received in our report.
Updated
11 January 2019
London Borough of Merton – MILES provides personal care and support to people in their own homes. The service is run by the local authority and specialises in providing a reablement service to people when they leave hospital. This is when people need support to learn or relearn skills to help them live independently at home following an illness. The service is provided, free of charge, for up to six weeks. At the time of this inspection there were twenty eight people using this service.
Since our last inspection the service has changed its name to London Borough of Merton Reablement Service. The local authority has not yet applied formally to CQC for this change of name to be included on this report. But we will refer to the service in this report as the ‘reablement service.’
At our last inspection we rated the service 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.
People remained safe using the reablement service. The provider managed risks associated with people’s independency and mobility in their own homes. There were enough staff to meet people’s needs. Recruitment practices remained safe. Medicines continued to be administered safely. The checks we made confirmed that people were receiving their medicines as prescribed by staff qualified to administer medicines.
People continued to be supported by staff who received appropriate training and support. Staff had the skills, experience and a good understanding of how to meet people’s needs. People had access to a range of healthcare professionals.
People are 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 support this practice.
People said staff continued to be caring and gave them the privacy, respect and dignity they needed, while supporting them to be independent.
People’s needs were assessed and support was planned and delivered in response to their needs. The provider had arrangements in place to respond appropriately to people’s concerns and complaints.
We observed during our visit to the providers office that management were approachable and responsive to staff needs. Systems were in place to monitor and improve the quality of the service.
Further information is in the detailed findings below.