Archived: Peripatetic Service

The Peripatetic service provides support to other council services who support people following hospital discharge to help ensure these services continued to function, do not become overloaded and do not compromise the flow of patients out of hospital. It was also available to assist and manage care packages in other crisis situations such as private provider failure. At the time of the inspection, the service was working closely with the reablement team, managing some of their stable packages to allow the reablement service to pick up new care packages. The peripatetic service provided short term care for a period from a few days to a few weeks, visiting them in their homes to provide personal care and support.

The inspection took place between 16 November and 4 December 2018 and was announced. At the time of the inspection there were 7 people using the service.

The service was last inspected in March 2016 and awarded a rating of Good. However, the service had changed considerably since the last inspection with a large part of its operations being re-registered as two additional services which are now inspected separately.

At this inspection we rated the service Requires Improvement. People and relatives all provided good feedback about the service and said care and support was good. However, since the service had changed its function, it had not adapted its governance systems including policies, operational procedures and statement of purpose to reflect the new way the service was operating. People were unclear they were receiving care from the peripatetic service and there was a lack of information provided to people to inform them who they were being care for by.

A registered manager was in place. 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 said they felt safe using the service. Risk assessment documents were in place which staff followed to help keep people safe. There were enough staff deployed to ensure people received reliable and consistent care.

Staff were recruited safely. Staff received a good range of training and told us they felt well supported. People said staff were appropriately skilled.

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 supported this practice.

The service worked with other council services to ensure people’s needs were assessed and appropriate care provided. They liaised with a range of health and social care professionals to meet people’s needs.

People consistently said staff were kind and caring and treated them with dignity and respect. People said they felt listened to by staff and involved in their care.

A system was in place to log, investigate and respond to complaints, however there was no separation of complaints systems between the peripatetic service and reablement service to ensure people were clear what they were complaining about.

People’s feedback was sought on the service, but again there was no separation of feedback between the reablement and peripatetic service meaning the service was unable to measure user satisfaction specifically to the peripatetic service.

People, relatives and staff praised the overall quality of care and said the service was well led.

We found breaches of two regulations. You can see what action we asked the provider to take at the back of the full version of this report.

The service provides personal care and support to people living in their own homes. On the day of our visit there were 92 people using the service.

There was 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.

People told us that they felt safe using the Peripatetic Service and they trusted the staff who supported them.

Staffing levels were appropriate to meet people’s needs in a timely way, although some people and staff said they though additional staff would enhance the service.

Staff had a good understanding of how to ensure people’s safety when supporting them in their home. Risk assessments were documented for individual aspects of people’s care.

People were supported by experienced and knowledgeable staff who were confident in their abilities.

Staff training was up to date and managers were creative in finding ways for staff to develop their skills and knowledge and share good practice with others.

Care was person-centred and staff were dedicated to their role with a clear focus on meeting people’s needs in an individual way. Staff treated people with kindness, respect and dignity.

The provider promoted best practice and staff were supported well through supervision and effective line management.

Care records documented people’s individual preferences and how their support should be given, although some staff were less confident in completing care documentation.

Procedures were in place to manage concerns, complaints and compliments about the service. Only compliments had been received by the service, no complaints.

Clear management structure and an open and transparent culture meant staff understood their roles and responsibilities. Processes were in place for monitoring the quality of the provision and these were being developed further as the service evolved.

We did not identify any breaches in regulation.