London Borough of Merton - 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 remained good. This meant the service was consistently managed and well-led. Leaders and the culture they created promoted high-quality, person-centred care.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service had a shared vision, strategy and culture. This was based on promoting people’s independence and helping them to achieve their goals with regards to activities of daily living.

Feedback from people and staff indicated there was a good culture within the service. A staff member said, “I really enjoy working here. I like the flexibility in terms of not being micromanaged.” Another said, “The team is excellent. Everyone is really supportive – from the OT, other teams.”

People using the service, staff and healthcare professionals praised the culture within the service, “The reablement service he had was very very good and they were always happy to liaise with me about anything.”

A healthcare professional told us, “The culture within the service is positive, respectful, and focused on continuous improvement. With my view that the team is deeply committed to delivering safe, effective, and empowering care.”

The provider had a culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

The provider had systems in place to record any incidents and accidents. The registered manager told us, “We have an incidents and accidents log that we monitor.” Support workers explained the process they used when reporting any incidents.

We reviewed the incidents log with the registered manager, which showed the incidents that had taken place, any action taken and lessons learnt.

Any lessons learnt or themes were discussed in Multi-Disciplinary Team (MDT) meetings which helped to ensure these were embedded in future practice.

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

People were given the opportunity to feedback throughout their time with the provider either through spot checks or also through ‘customer feedback’ which were sent to them afterwards. We reviewed a sample if these and saw that people were satisfied with the service they had received.

The provider valued and listened to the views of staff. Staff told us they were given opportunities to provide feedback about the service and their opinion was valued. A staff member said, “The daily meetings are handovers with the team to discuss anything that has happened to our residents – that includes the OT’s and managers. The weekly MDT meeting go through each client, their care plans what’s going well and what isn’t.”

The provider promoted an open and inclusive culture which sought the views of people using the service and staff, through informal and formal methods such as one to ones, staff meetings and spot checks.

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 provider operated an equal opportunity recruitment process. The staff team were diverse and were provided support through relevant training and supervision to inform their knowledge and understanding of equality, inclusivity and fairness in the workplace.

The provider offered unconscious bias and cultural competence training. Staff were recruited from diverse backgrounds to reflect the communities they served.

The registered manager told us that there were safe spaces for staff to share experiences and raise concerns outside of the service through the local authority. This helped to build a team culture where staff felt valued and equipped to deliver inclusive care.

The provider had clear responsibilities, roles, systems of accountability and good governance. They act on the best information about risk, performance and outcomes, or share this securely with others when appropriate.

The registered manager was aware of their legal responsibility to notify CQC of certain events and confirmed that none had been required at the time of our assessment.

There was a system of audits in place to monitor the quality of service and provide assurance around governance. Reablement officers carried out spot checks which were reviewed by either the registered or deputy manager. Spot checks were announced or unannounced and included whether reablement officers arrived on time, were dressed appropriately, how they interacted with people, if they followed and supported people with regards to their reablement goals and ensuring people were safe before they left.

Both an OT and a reablement officer case audit was also completed which included identifying areas of improvement and good practice.

The provider kept a tracker in relation to staffing issues such as training, supervision and appraisal compliance.

Other governance checks included analysing the number of referrals into the reablement service and completed reablement packages of care on a month to month basis. This was used to see if the service was working well.

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

Managers and staff told us they worked closely in an integrated workforce with various external health and social care professionals and bodies who they regularly consulted and welcomed their views and advice.

The provider recognised the importance of continuous learning and improvement across the organisation.

The registered manager told us there were plans to increase the scale of the service so that more people could benefit from reablement and alleviate pressures on hospital stays. In preparation for this expansion, the provider had started a recruitment campaign to recruit more reablement officers and OTs to meet the demands of the planned business model.

As part of the quality assurance process, a sample of case files were audited which included identifying areas of improvement and themes for future learning and improvement. The registered manager told us they maintained a log to monitor incidents and safeguarding and learn from to improve the service.

Responses from feedback surveys were also analysed and actions for improvement were drawn out from these to improve the service.

A ‘You said, We did’ response was put together which demonstrated the providers commitment to learning and improving based on feedback received.