Archived: Penzance STEPS

Penzance STEPS (Short Term Enablement and Planning Service) is registered to provide personal care to people in their own homes. The service provides care visits for periods of up to six weeks. The aim of the service is to re-enable people to maximise and re-gain their independence, within their own home, after a period of illness and/or hospital stay. The service provides support to adults of all ages. On the days of the inspection the service was providing personal care to 23 people. Referrals for packages of care were made to the service by health and social care professionals. These included; hospital discharge teams, physiotherapists and occupational therapists.

There was a registered manager in post who was responsible for the day-to-day running of the service. 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 and associated Regulations about how the service is run.

People using the service consistently told us they felt safe and staff were caring and treated them well. They told us staff were like their family and they trusted them implicitly. Safeguarding adults’ procedures were in place and staff understood their responsibilities to safeguard people from abuse.

Potential risks to people's safety and wellbeing had been assessed and managed. People received their medicines safely.

Staff understood the requirements of the Mental Capacity Act (2005) and the Deprivation of Liberty Safeguards (DoLS) to ensure people’s rights were protected.

Recruitment and selection was carried out safely with appropriate checks made before new staff could start working for the service. Staff had the skills, knowledge and experience needed to care for people. They received training to carry out their role and were knowledgeable about how to support and care for people. They had the skills, knowledge and experience to provide safe and effective support.

Staff supported people with medicines safely. People able to manage their own medicines were encouraged to do so.

Care plans were person centred and included details of the agreed support required at each visit. Staff knew people and their needs well and could describe to us the support each person required.

Staff supported people to have a nutritious dietary and fluid intake, assisting them to prepare and eat food and drinks as they needed. Where people required specialist support with their dietary needs staff had received the training required to support them.

People were involved in the development and review of their care plans and could influence the delivery of their care. Staff had up to date information about people’s needs and wishes and there were effective electronic systems in place to quickly respond when needs changed. People were supported to have maximum choice and control of their lives and their healthcare needs were monitored as appropriate.

A number of audits were undertaken to ensure the on-going quality of the service was monitored appropriately and lessons were learned from issues that occurred. Surveys were completed with people who used the service and their relatives. Where issues or concerns were identified, the manager used this as an opportunity for change to improve care for people.

The service communicated well with people, relatives and staff. We saw evidence of several ways this was done including memo’s, newsletters and spot-checks.

Penzance STEPS (Short Term Enablement and Planning Service) is registered to provide personal care to people in their own homes. The service provides care visits for periods of up to six weeks. The aim of the service is to re-enable people to maximise and re-gain their independence, within their own home, after a period of illness and/or hospital stay. The service provides support to adults of all ages. On the days of the inspection the service was providing personal care to 28 people. Referrals for packages of care were made to the service by health and social care professionals. These included; hospital discharge teams, physiotherapists and occupational therapists.

There was a registered manager in post who was responsible for the day-to-day running of the service. 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 and associated Regulations about how the service is run.

People told us they felt safe using the service. Comments included, “No complaints at all” and “Very good service.” They also told us staff were caring and compassionate in the way they supported them and were respectful of their privacy and dignity. Comments from people included, “Staff are very nice and very helpful”, “The carers are excellent” and “They [staff] are all so pleasant.”

People received care, as much as possible, from the same care worker or team of care workers. Rotas were planned in such a way as to minimise changes of staff. People told us they had regular staff and the times of their visits were agreed with them. Everyone told us the service was reliable, visits were never missed and they were kept informed of any changes to the time of their visits. We were told that staff did not rush people and provided care and support at their pace, focusing on enabling them to do as much as possible for themselves. People praised staff for how they encouraged and helped them gain the confidence they needed to meet their goals. People commented, “Staff have given me the confidence to go out and I have walked to the end of the road” “It’s been a great help to me” and “Staff have been very encouraging.”

Staff were recruited safely, which meant they were suitable to work with vulnerable people. Staff had received training in how to recognise and report abuse. All were clear about how to report any concerns and were confident that any allegations made would be fully investigated to help ensure people were protected. Staff received appropriate training and supervision. New staff received an induction, which incorporated the care certificate. There were sufficient numbers of suitably qualified staff available to meet the needs of people who used the service.

Staff were knowledgeable about the people they cared for and knew how to recognise if people’s needs changed. Staff were aware of people’s preferences and interests, as well as their health and reablement needs, which meant they were able to provide a personalised service. Care plans provided staff with clear direction and guidance about how to meet people’s individual needs and wishes. Staff spoke passionately about the people they supported and were clearly committed to providing a responsive and caring service in line with people’s agreed goals. Comments from staff included, “I have seen people achieve really good outcomes”, “Helping people to get back on their feet is good” and “It’s nice to see people come out the other side, very satisfying.”

People told us they were involved in decisions about their care and were aware of their care plans in which their goals and aspirations were agreed. Care plans provided staff with clear direction and guidance about how to meet people’s individual reablement needs and goals. Care plans were reviewed weekly to evaluate the progress people were making against their overall goals and agree the next steps for the following week. Any risks in relation to people’s care and support were identified and appropriately managed.

The management had a clear understanding of the Mental Capacity Act 2005 and how to make sure people who did not have the mental capacity to make decisions for themselves had their legal rights protected.

Staff worked with healthcare professionals to develop individual care plans and exercise programmes to help people achieve their goals and regain their independence. Healthcare professionals told us, “Staff communication skills are excellent”, “The service has a really good success rate” and “I am confident that staff follow the programmes I set for people.”

There was a positive culture in the service, the management team provided strong leadership and led by example. The registered manager had clear visions and values about how they wished the service to be provided and these values were shared with the whole staff team. Staff told us about the management team, “I can approach [registered manager’s name] at any time”, “The support from management has been brilliant” and “If you have a problem you only have to ring up.”

There were effective quality assurance systems in place to make sure that any areas for improvement were identified and action taken to continuously improve the quality of the service provided. People and their families told us the management team was very approachable and they felt involved in their care and the running of the service. People had details of how to raise a complaint and told us they would be happy to make a complaint if they needed to. Comments from people included, “Very impressed with the service, I would recommend the STEPS team to anyone” and “I would like to congratulate STEPS on an excellent service.”