Start Service - Broxtowe, Gedling and Rushcliffe Locality

People were protected from harm, neglect and avoidable harm. Risks to people’s safety were discussed with them and acted on by staff. There were sufficient numbers of qualified and experienced staff to support people. Where people needed support with their medicines, staff did so safely. Staff understood how to reduce the risk of the spread of infection. The provider ensured processes were in place to act on and learn from any accidents or incidents.

People were supported in accordance with current best practice guidelines and legislation. Staff were well trained and had the skills needed to support people. Where people needed support with their meals, staff did so effectively to help maintain or improve people’s nutritional health. The service worked in partnership with other health professionals to ensure people received the support they needed. 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 support this practice.

People found the staff to be kind, caring and they were treated with dignity and respect. People were involved with decisions about their support needs. Staff spoke respectfully about the people they supported and helped to maintain people’s privacy. People had access to advocates if they needed them.

People were provided with support in accordance with their personal preferences. Staff took swift action to ensure people’s changing needs could be met. No formal complaints had been received since our last inspection, but processes were in place that enabled these to be responded to appropriately. End of life care was not provided.

The service was managed well by the registered manager with support from provider. There was a clear focus on continued improvement and development and people and staff were involved with this process. Staff felt valued and enjoyed their role. Robust quality assurance processes were in place to help identify good practice and areas for improvement.

Rating at last inspection: Good (report published 11 May 2016)

About the service: Start Service – Broxtowe, Gedling & Rushcliffe Locality provides a short term reablement service. Reablement services support people in their own homes. This service is usually delivered following people’s discharge from hospital. People normally do not use this service for longer than a six-week period. On the day of our inspection there were 54 people using the service.

Why we inspected: This was a planned inspection based on the rating at the last inspection. The service remained rated Good overall.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

The service had a registered manager in place at the time of our inspection. 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 were supported by staff who understood the risks people could face and knew how to make them feel safe. People were given the support they required to regain their independence safely.

People received a flexible service that suited their individual circumstances because staff were available to provide this as planned. People were supported to be responsible for managing their medicines.

People were supported by staff who were trained and given guidance on how to do meet their needs. People’s human right to make decisions for themselves was respected and encouraged.

People were supported to be responsible for ensuring they were able to meet their nutritional and healthcare needs.

People were treated with respect by staff who demonstrated compassion and understanding. They were encouraged to set goals to maximise their strengths and build on their independence.

People were given the support they needed to be responsible for meeting their own needs without being dependent on others. People knew how to raise any concerns if they needed to.

People used a service that was tailored to suit their needs. There were systems in place to monitor the quality of the service and make improvements when needed.

People told us they had been involved in developing their care plan. They said they were clear about the goals which had been set . One person's rehabilitation needed to continue. They told us arrangements had been put in place to continue their rehabilitation with another service. They said they understood the service would only for the early re-enablement lasting up to six weeks.

We found there were arrangements in place to safeguard people from the risk of abuse. Staff were familiar with the signs of abuse and were confident about reporting any concerns to their managers.

Staff felt supported and received regular supervision.

There were effective systems in place to quality assure the service with plans to address the issues identified.

We spoke to three relatives of people who were using the service and one person said, "I have been pleasantly surprised. The staff provide a detailed explanation of what they intend to do. They have been punctual, friendly and caring.'

People told us they felt safe with the support they were being provided. One person said, "I feel safe and I can talk to staff." People told us that they liked the staff and staff were able to meet their needs. They also told us they felt they could speak to the staff and they would be listened to.

We found that staff were supported to provide care that met people's needs. The provider was making appropriate checks before a new member of staff started work. We also found that the provider took steps to assess the quality of the service being provided.