Archived: South Tyneside Home Assessment Reablement

South Tyneside Home Assessment Reablement Team is a domiciliary care agency providing personal care to adults who require short term, focussed support to increase their independence and confidence to live at home. They usually provide care for up to six weeks.

The service did not have a registered manager. 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 registered provider had breached regulations 9, 12, 17 and 18 of the Health and Social Care Act 2008. This was because medicines administration records (MARs) were not always accurate or complete. Staff regularly left medicines out for people to take later in the day, but there was no care plan or risk assessment to support this arrangement. Medicines audits were ineffective in identifying areas of concern and ensuring action was taken to improve the quality of medicines records. Staff had not completed all of the training they needed, particularly safe handling of medicines and infection control. One to one supervision and employee performance management or EPM meetings were overdue for all staff [EPM is the name for the registered provider’s appraisal process]. People were not involved in developing their support plans. Support plans lacked detail and were not personalised. The registered provider had consistently not acted on the findings from previous audits to improve the quality of the service people received.

You can see what action we have asked the provider to take at the back of the full version of this report.

People gave only positive feedback about the support they had received from the service. They said they were supported by friendly, kind and caring staff who treated them with respect. One person commented, “Very good, no faults whatsoever. They were brilliant. Very helpful, they help me as much as they can.” Another person said, “They are really nice, friendly. Oh yes I like all of them. They stay and chat for a little while.” People told us they had been supported to regain some of their independence. One person said, “I am getting on smashing because of the help I have had.”

People said staff were reliable and consistently on time. Staff told us they usually had enough time to give people the time they needed. One person said, “Everyday they turn up on time.” Another person told us, “They are always on time and they always stay.” Staff followed the registered provider’s recruitment procedure when recruiting new staff.

Risk assessments to help keep people safe were brief and lacked personalised information.

Staff displayed a good knowledge of safeguarding and the registered provider’s whistle blowing procedure, including how to report concerns. One staff member said, “I think they would take it straight to the top.”

Staff had received training on the Mental Capacity Act 2005 (MCA). However, people currently using the service had capacity to make their own decisions and choices. People said staff always asked for consent before providing support. One person commented, “They ask what I want doing.”

Care records showed people had input into their reablement from a range of health and social care professionals. For instance, GPs, community nurses, occupational therapists and care managers.

People were supported to prepare their chosen meals. One person said staff ask me “if I want anything made for my dinner.”

People had specific goals aimed at developing their daily living skills and increasing their independence. From the information available to us we were unable to assess how successful the service had been in supporting people to achieve their goals.

People we spoke with did not raise or complaints or concerns about the service. One person said, “None whatsoever [complaints]. They are brilliant.”

People had the opportunity to give their views about the support they received from the service. They gave positive feedback following the most recent consultation in December 2015.

We saw there were records of assessments and care plans. People we spoke with told us they had copies of these documents in their own home. They told us staff knew their needs when they turned up and if they were unsure they consulted the care plan. Staff told us where manual handing support was required a detailed manual handling risk assessment was available.

Appropriate checks were carried out on staff prior to commencing employment.

Another person said that the care they received was 'Alright'. The other person said that the staff were 'Smashing' and 'They knew what they were doing'.

We found that people's dignity and independence were respected. We also found that people experienced the correct care and support.

We found that people were protected from the risk of abuse and also cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard. We also found that the provider had an effective system to regularly assess and monitor the quality of service that people receive.