Archived: Homecare Reablement Team

We found that improvements had been made to the service since our last inspection and the service had continued to develop and progress. We found that systems had been implemented to help manage the safety and quality of the service. Improvements had been made to staffing levels of the service and feedback gained from people showed that the service had now improved. Management advised that they are looking to continue to increase the number of staff to ensure they have sufficient available to help meet the needs and care of the people who used the service within an acceptable time frame.

The Homecare Reablement Team (HRT) provides personal care and support to adults who live in their own homes in the geographical areas of Thurrock between the hours of 7am to 11pm. They provide care and support within people’s homes and a reablement service for up to six weeks for people who have been discharged from hospital. The focus of their support is to reable people back to independence. The service is also a ‘provider of last resorts (POLR).’ This means when Thurrock Borough Council are unable to find another contracted service to provide care that HRT will assist with care until another provider can be found. This is aimed to be a short term service and management had been working to organise a separate domiciliary service so that HRT could refer people on quicker who were identified as needing long term support.

The service has a registered manager in post, but on the day of our inspection we were assisted by the deputy manager and service manager, due to the registered manager not being available. 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.

Staff had a good knowledge of safeguarding procedures and were clear about the actions they would take to help protect people. Risk assessments had been completed to help staff to support people with everyday risks and help to keep them safe.

Sufficient recruitment checks had been carried out before staff started work to ensure that they were suitable to work in a care setting. Staff had been provided with regular supervision and training and stated they felt well supported to carry out their work. Effective communication was now in place between staff and management.

The service had safe systems in place to assist people with the management of their medication and to help ensure people received their medication as prescribed. Documentation was in place to clearly record what assistance was needed.

Management had a good understanding of Mental Capacity Act 2005 and who to approach if they had any concerns and the appropriate government body if people were not able to make decisions for themselves. Staff have now been provided with training for the MCA and systems were in place to ensure this was regularly updated.

People received the support they needed to eat and drink sufficient amounts to help meet their nutritional needs. Staff knew who to speak with if they had any concerns around people’s nutrition.

People were supported by staff to maintain good healthcare and were assisted to gain access to healthcare providers where possible. They also had multidisciplinary working within their own team of professionals who assisted people to gain the healthcare they needed.

People had been asked how they would like their care provided and new assessments and care plans were in the process of being developed around each person’s individual needs. People said they had been treated with dignity and respect and that staff provided their care in a kind and caring manner.

People knew who to raise complaints or concerns to. The service had a clear complaints procedure in place and people had been provided with this information as part of the assessment process. This included information on the process and also any timespan for response. We saw that complaints had been appropriately investigated and recorded.

The service had effective quality assurance system and these had been improved since our last inspection and were now effective and provided information about the service and feedback from people regarding their experience of the service.

We found that improvements had been made to the service since our last inspection and the breeches to the regulations and Warning Notice had been met. Systems were now in place to manage the safety and quality of the service, although further work was needed in regards to staffing levels. Although some improvements had been made to staffing levels of the service and management had been constantly recruiting new staff since our last inspection, feedback gained from people showed that there were still insufficient numbers of staff available to help meet the needs of the people who used the service within an acceptable time frame. Further more, due to staffing issues people were not always receiving personalised care that were responsive to their care needs.

The Homecare Reablement Team (HRT) provides personal care and support to adults who live in their own homes in the geographical areas of Thurrock between the hours of 07:00 a.m. and 11:00 p.m. They provide care and support within people’s homes and a reablement service for up to six weeks for people who have been discharged from hospital. The focus of their support is to rehabilitate people back to independence.

The service is also a ‘provider of last resorts (POLR).’ This means when Thurrock Borough Council are unable to find another contracted service to provide care and HRT they will then assist with the care until another provider can be found. This is aimed to be a short term service. Also, management had been working to organise a separate domiciliary service that HRT could refer people who needed long term support.

The service has a registered manager in post, but they have been absent long term. 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. Since our last inspection the deputy manager with management support have been managing the service.

Staff had a good knowledge of safeguarding procedures and were clear about the actions they would take to help protect people. Risk assessments had been completed to help staff to support people with everyday risks and help to keep them safe.

Sufficient recruitment checks had been carried out before staff started work to ensure that they were suitable to work in a care setting. Staff had been provided with regular supervision and training and stated they felt well supported to carry out their work. Effective communication was now in place between staff and management.

Systems were now in place to assist people with the management of their medication and to help ensure people received their medication as prescribed.

Management had a good understanding of Mental Capacity Act 2005 and who to approach if they had any concerns and the appropriate government body if people were not able to make decisions for them. Most staff had now been provided with training for the MCA and further training coursed had been organised.

People received the support they needed to eat and drink sufficient amounts to help meet their nutritional needs. Staff knew who to speak with if they had any concerns around people’s nutrition.

People were supported by staff to maintain good healthcare and were assisted to gain access to healthcare providers where possible.

People had been asked how they would like their care provided and new assessments and care plans had been developed around each person’s individual needs.

People said they had been treated with dignity and respect and that staff provided their care in a kind and caring manner.

People knew who to raise complaints or concerns to. The service had a clear complaints procedure in place and people had been provided with this information as part of the assessment process. This included information on the process and also any timespan for response. We saw that complaints had been appropriately investigated and recorded.

The service now had an effective quality assurance system. The quality assurance systems had been improved and were now effective and provided information about the service and also provided feedback from people regarding their experience of the service.

The Homecare Reablement Team (HRT) provides personal care and support to adults who live in their own homes in the geographical areas of Thurrock between the hours of 07.00 a.m. and 11.00 p.m. They provide care and support within people’s homes and a reablement service for up to six weeks for people who have been discharged from hospital. The focus of their support is to rehabilitate people back to independence.

The service is also a ‘provider of last resorts (POLR).’ This is where Thurrock Borough Council are unable to find another contracted service to provide care and HRT will then assist with the care until another provider can be found. This is aimed to be a short term service.

The service has a registered manager in post. 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.

The were not sufficient numbers of staff, with the right competencies, skills and experience available to help meet the needs of the people who used the service. They are in the process of recruiting more staff to ensure they have sufficient number when staff are on leave, sick or when the work as a POLR increases.

Systems were not in place to assist people with the management of their medication and to help ensure people received their medication as prescribed.

Sufficient recruitment checks had not been carried out before staff started work to ensure that they were suitable to work in a care setting. Staff did not feel well supported to carry out their work and had not received regular support and training.

People were not always receiving the support they needed to eat and drink sufficient amounts to help meet their nutritional needs. Staff knew who to speak with if they had any concerns around people’s nutrition.

People had not always given consent to their care or been involved in the decision making process. They had not been asked how they would like their care provided. Assessments had been carried out and care plans had been developed but these were not always around each persons individual needs.

The registered manager had a good understanding of Mental Capacity Act 2005 and who to approach if they had any concerns and the appropriate government body if people were not able to make decisions for themselves. Staff had not been provided with training for the MCA and had limited knowledge on this subject.

The service did not have an effective quality assurance system. The quality assurance system was not effective and improvements had not been made as a result of learning from people’s views and opinions.

Staff had a good knowledge of safeguarding procedures and were clear about the actions they would take to help protect people. Risk assessments had been completed to help staff to support people with everyday risks and help to keep them safe.

People were supported by staff to maintain good healthcare and were assisted to gain access to healthcare providers where possible.

People said they had been treated with dignity and respect and that staff provided their care in a kind and caring manner.

People knew who to raise complaints or concerns to. The service had a clear complaints procedure in place and people had been provided with this information as part of the assessment process. This included information on the process and also any timespan for response. We saw that complaints had been appropriately investigated and recorded.

The people receiving care were complimentary about the care staff and expressed that they were happy with their care and support. People spoken with did not raise any concerns about the care they received and added that they knew who to speak to if they had any concerns.

The only area of concern raised was around times of care, but the provider was in the process of taking on new care staff to assist with this issue. One person spoken with stated, 'The girls are wonderful and always mindful of my dignity,' and one relative added that the service had 'reduced their anxieties.'

Records viewed showed that support plans covered all aspects of a person's individual circumstances. Questionnaires and end of service evaluations were generally positive and suggested that people were happy with the service and that they liked staff who provided day-to-day-support.

Further improvements are required to ensure that staff receive up to date training and opportunities for regular supervision. Effective quality assurance may assist the provider in recognising where there are gaps and areas for development.