START stands for the Short-Term Assessment and Reablement Team. START is a community reablement service, providing assessment and goal-based support to people living in their own homes. Assessment and support are usually provided for up to six weeks, often after a person is discharged from an acute hospital setting. The service supported 11 people at the time of inspection. The service sets their own limits about how many people they are able to support at any one time.
Optalis Limited (the provider) provides adult social care in partnership with the Royal Borough of Windsor and Maidenhead and Wokingham Borough Council. People’s reablement packages delivered by START are entirely funded by the local authority. START only provides assessment and reablement services to people who live within the boundaries of Wokingham Borough Council.
Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks such as those related to personal hygiene and eating. Where they do, we also consider any wider social care provided.
People’s experience of using this service and what we found
Improvements to safety were made since the last inspection. People were protected against abuse and neglect. People's risks were satisfactorily assessed. Medicines were safely managed. Personnel files contained all the required documents and checks to ensure safe staffing recruitment. People are protected against the risk of infections, especially during the pandemic.
People's preferences were assessed and documented. Staff were well supported and the training, supervisions and performance appraisals were up to date. People's nutrition and hydration were monitored to ensure they received enough to eat and drink. People’s healthcare or social care issues needing support were referred to external healthcare professionals, to ensure joined up care.
Staff identified themselves as kind and caring, and this was confirmed by people, relatives and community social workers. There was good engagement between staff and people who use the service. There was evidence of people's and relatives' involvement in the care planning. Reviews were undertaken in an ongoing manner. People's dignity and privacy was respected.
There were very detailed reablement plans, and these were person-centred and people's preferences were well-documented. There was a complaints system in place. Information is presented in line with the principles of the Accessible Information Standard. Some continued AIS work is required for people with learning disabilities, autism and dementia. We made a recommendation about this.
Improvements to governance were made since the last inspection. There was a positive workplace culture. The provider and the registered manager had robust quality assurance systems in place. Actions were taken when improvements were required. There was good engagement with people, relatives and staff. The service has adapted their aims and objectives to ensure the focus is increasing people’s independence. The staff and management team have embedded continuous learning and improving care into everyday practice.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection (and update)
The last rating for this service was requires improvement (published 22 October 2019). The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
This was a planned inspection based on the previous rating.
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.