Reablement Provider Service

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm.

At our last assessment we rated this key question good. At this assessment the rating has changed to outstanding. This meant people were protected by a strong and distinctive approach to safeguarding, including positive risk-taking to maximise their control over their lives. People were fully involved, and the provider was open and transparent when things went wrong.

This service scored 88 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a strong proactive and positive culture of safety, based on openness and complete honesty. Staff actively listened to concerns about safety and thoroughly investigated and reported safety events. Lessons were always learnt to continually identify and embed good practice.

People and family members we spoke with said they had not raised any concerns relating to safety and expressed confidence in the service to keep them safe. People were aware of how to raise a concern.

A collaborative approach of working with and alongside strategic health and social care partners facilitated a positive culture of safety, where potential risks both strategically and within the service were shared and understood. This enabled the registered manager to maintain the service based on staffing and the resources available, and the known needs and resources of external partners. A key stakeholder told us, “The service works constructively with system partners and commissioners to support wider system plans, including ‘home first’, neighbourhood working, frailty and prevention agendas. It is responsive to system pressures and demonstrates the ability to adapt quickly to changing needs, adjusting delivery models, capacity and focus where required.”

Systems and processes for reporting and monitoring safety incidents and accidents were fully understood by staff. A member of staff told us, “If a person falls, we write a falls report.” The provider’s falls protocol and assessment tool provided clear guidance, enabling staff to assess the risk based on the person’s presentation, including identifying any injuries, the initial actions they should take, and the escalation process. For example, seeking the support of a health care professional.

Records provided a clear audit trail of any incidents, including the action taken and the involvement of any other health or social care partner. For example, staff had liaised with a range of services including the manager of a housing complex and a GP in response to their identifying a decline in a person’s mental health, and indicators of potential self-harm.

The registered manager evidenced their commitment to a proactive and positive culture of safety, facilitated by a robust and comprehensive analysis of concerns and incidents relating to safety. Senior managers and the provider’s health and safety team investigated all incidents with all events being triaged. For example, the 3 incidents reported in the last 12 months found all to be low-harm events which had not required escalation to RIDDOR (Reporting of Injuries, Diseases and Dangerous Occurrences Regulations) and no repeated themes having been identified. The analysis of the individual incidents identified a combination of contributory factors, and in response an action plan was developed. All staff were reminded of the importance of footwear safety and emphasised the significance of their communicating effectively with people as to why a task could not be completed by them, when asked to do so. In addition, the action plan emphasised the importance of managerial staff supporting staff through reflective conversation, to ensure safe practices were prioritised.

Learning from concerns was an intrinsic element of the learning culture. For example, an analysis of concerns identified a theme of medication errors, which had not resulted in harm, but were identified as a potential high risk. The analysis had identified an increase in medicine anomalies when the service changed its electronic call monitoring system. The registered manager was proactive and implemented medication workshops for staff.

The provider always worked with people and healthcare partners to design, establish and maintain safe systems of care, in which safety was always well managed and monitored. They made sure there was always continuity of care, including when people moved between different services.

People spoke positively of the referral process which showed how the collaborative approach between hospital-based staff and the service worked in practice. A person told us, “They [hospital staff] asked me questions about our home at hospital, and one of the nurses referred me to the reablement service. They explained the service.” The provider’s analysis of data for 2025 identified 98% of referrals to the Reablement Provider Service were accepted.

The collaborative approach, supported by effective systems and processes of communication between health and social care partners facilitated the safe transfer of people between services. Social care partners had access to records via an electronic data platform, this facilitated timely and effective sharing of information. Referrals to the Reablement Provider Service were triaged by office-based staff and if accepted, several staff with identified skills and responsibilities shared information to facilitate, for example, a safe discharge from hospital. A key partner told us, “Transition planning begins at the point of referral, with clear identification of goals, risk and anticipated onward needs. This reduces delays and prevents gaps in support when people move from hospital, intermediate care or community services into reablement.”

Collaborative working between agencies, ensured the appropriate equipment was sent with the person to their home, for example, a walking aid. A schedule of calls was planned, based on the person’s needs as identified within their referral assessment. Assurance was sought that the person could access their home, and arrangements included the involvement of family members if appropriate, to be at the person’s home for their return from hospital if required. Other factors considered were also planned for, for example, the installation of a key safe to enable staff to access the person’s home, in the event the person was unable to open their door and invite staff inside. This required liaising with other departments to both request the equipment and organise its installation.

Staff from the Reablement Provider Service, along with key partner agencies, which included occupational therapists, assistive technology, social workers and the minor adaptations department, meet each working day to identify any interventions required to support people’s recovery and reablement. For example, an update as to a person’s progress may indicate an additional item of equipment was required, such as perching stool. This would be agreed at the meeting, ensuring timely action was taken, avoiding any unnecessary delays, and have a measurable and positive impact on the person’s recovery in maximising their independence.

In circumstances where a person had reached their recovery goals, it may be necessary for the person to continue ongoing support at home. In this instance, a Care Act Assessment (an assessment undertaken by local authorities to identify a person’s support needs) was completed by suitable experienced and skilled staff of the reablement service. This was then shared with partner agencies. A key partner told us, “If someone has ongoing needs following a Care Act Assessment, they [Reablement Provider Service] will make an eligibility decision and transfer the person to the long-term team to undertake a review of their needs.” This example, further confirmed how staff supported smooth and timely referrals to support a safe transition to other services.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately.

People and their family members expressed no concerns regarding their safety and spoke positively of the service and the kindness of staff which made them feel safe. A person told us, “Staff are lovely to have in the house, we felt secure with them. No one was abusive. They know exactly what to do and what I can do safely.”

Staff demonstrated a good understanding of what would constitute a safeguarding concern, had an in-depth knowledge as to the forms of abuse, and were aware of the agencies to escalate information of concern to if required, including police and social services. Staff had undertaken training in safeguarding children and adults and was regularly updated.

Staff attended safeguarding meetings where referrals to the service for recovery and rehabilitation had been received, as part of a multi-disciplinary approach to supporting people identified as being at risk.

The provider had systems and processes for the management and escalation of safeguarding concerns. The reablement social work team recorded and progressed safeguarding alerts and incidents, their remit was not exclusive to the Reablement Provider Service.

The provider always worked well with people to fully understand and manage risks by thinking holistically. Staff provided care that fully met people’s needs and was safe, supportive and enabled people to do the things that mattered to them.

People and their family members felt fully involved in the assessment of risk. A person told us, “The carer came and did a risk assessment.” Potential risk was assessed, and where required equipment was provided to reduce risk and support the person in their recovery journey. A person told us, “I was provided with 2 walkers and handrails, the walker is near to my bed to help me when I get up.”

Care records evidenced a dynamic risk assessment was undertaken upon commencement of the recovery package of care, this identified potential risks and barriers to a person’s recovery journey. Positive risk taking was a key in enabling people to gain independence. Records showed the person was at the heart of the assessment, identifying what was important to them and the outcome they were looking to achieve. Agreed specific, measurable, achievable, relevant and time managed (S.M.A.R.T.) goals were identified to facilitate independence of daily living activities, for example preparing food and cooking, mobility, or personal care such as washing and dressing. Any associated risks were identified, and decisions made how to reduce them. For example, the provision of equipment to enable people to facilitate independence, whilst keeping them safe.

A key stakeholder told us, “The reablement service frequently contacts the care technology service for equipment and services which support people to live as independently as possible in their own homes. Referrals from the reablement service are prioritised to support hospital discharges and others who the service is supporting in the community.”

Independence was not exclusively related to tasks of daily living linked to people’s physical ability. Support was also provided for people whose mental health, substance or alcohol misuse impacted on their ability to care for themselves, which placed them at risk. In these circumstances staff worked alongside other health and social care professionals, with a coordinated strategy to improve people’s mental health and well-being by supporting and working with them to improve their ability to self-care.

The provider was fully aware of all potential risks in the care environment and controlled them well. They made sure equipment, facilities and technology supported the delivery of safe care.

People and family members were unequivocal in their praise of the service, and the impact of collaboration between services, which resulted in timely minor adaptations to their property to support their recovery and reablement journey. A person told us, “I had a care navigator, therapy team and reablement visit to look and do an assessment of the environment. It included my mental and physical health as well as my abilities. I got 2 bath rails, 2 stair rails, a wheelie trolley, walking sticks, perching stools and toilet seats. They assessed the space in the main room with me”

A key stakeholder shared how staff went above and beyond to achieve good outcomes for people, by prioritising people’s safety and well-being by acting in a way so as not to delay people’s commencement of the reablement service. They told us, “The reablement service has, when needed, supported people via the collection of care technology and equipment from the care technology team and installed and demonstrated its use. This has allowed people to be supported without delay.”

Measures were taken to reduce risk to remove potential barriers to people’s recovery and independence This included making changes to people’s home through the installation of equipment, such as grab rails or by making changes to how the person lived. A person told us, “Staff took photographs, as they were concerned about one step into the house. They advised me to clear the bedroom so that it was easy to get in and out.”

Records evidenced household risks were identified as part of the dynamic risk assessment process, which included considerations as to people and staff safety. For example, parking arrangements, pets, and whether the home was fitted with a smoke or carbon monoxide alarm. The reablement service referred potential fire risk concerns to the fire and rescue service. A person told us, “We had a smoke alarm fitted.”

Collaborative working with key stakeholders enabled staff to make timely referrals for equipment to promote people’s safety. In addition to equipment to assist people with mobility, emergency alarms were also requested, which provide a direct link to a control centre when activated. A family member told us, “My [person] has been given a lifeline alarm around their neck and on their wrist.”

The provider made sure there were always enough qualified, skilled and experienced staff, who received thorough support, supervision and strong development opportunities. They worked together well to provide safe care that met people’s individual needs.

People and family members were consistent in praising the reliability of the service. A person told us, “Staff turn up at the allotted time.” A family member said, “We knew which staff were coming, and at what time.”

People’s needs, including protected characteristics as defined by the Equality Act were considered when scheduling care calls, which included ensuring staff understood and were able to meet people’s communication, religious and cultural needs. A family member told us, “The carers can speak Gujarati and Hindi, so my [person] can understand them, as [person] can’t speak English.”

People and family members expressed confidence in the ability of staff, they spoke of staff’s knowledge and understanding of their specific needs and the impact this had on their recovery journey. For example, a person recovering from a stroke spoke of staff sharing their skills and knowledge by teaching them how to roll over in bed, using their good leg to turn themselves gently and carefully, so as they could transfer from the bed into a wheelchair or sit on the commode.

A collaborative and co-ordinated team approach facilitated the planning of care calls. The number of people requiring support continually changed, as new packages of care were accepted, people’s progress resulted in a reduced number of care calls, and people’s discharge from the service upon completion of their recovery journey. This meant staff had to keep a continuous oversight, adapting care call schedules as required. The service had not identified any care visits had been missed, which was confirmed by people we spoke with.

An electronic system was used to support staff in scheduling care calls and recording their arrival and departure time, which was monitored to ensure people received a timely service Staff had access to the electronic management system known as ‘OneTouch’ via an app on their phones. A member of staff told us, “Rota management is completed on ‘OneTouch’. We use it for electronic call monitoring, and is effective, with staff having access to it on their phones.”

Records showed staff had undertaken training in a range of topics related to health, safety and welfare. In addition, staff received training in key areas specific to the role of reablement and recovery, which focused on assessing and mitigating risk, and the setting of goals through positive risk taking to facilitate people’s recovery and rehabilitation journey. Training in key areas of need were undertaken by staff, which included dementia awareness and the Oliver McGowan national learning disability and autism training. Training workshops delivered comprehensive training for staff in a range of topics, including roles and responsibilities.

Staff were recruited in a safe way. Appropriate checks were carried out prior to people commencing work to enable the provider to be confident suitable staff with the right skills and experienced were employed. Staff received the support they needed to deliver safe care; this included supervisions, appraisals and support to develop and learn. Staff confirmed they had regular supervision and had their care practices checked. Staff completed the Care Certificate as part of a structured induction and were encouraged to study for vocational qualifications in care.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

People and family members confirmed staff followed infection control procedures by wearing personal protective equipment (PPE), which included gloves and aprons. A person told us, “The carers wear gloves, aprons, and masks if needed.” People spoke of how staff respected people’s homes in keeping them clean. A person said, “Staff wear protective covers on their shoes, and put all the dirty things in a bag, and take them out when leaving.”

Staff completed training in infection prevention and control, and observations of staff competency included assurance staff adhered to the provider’s infection prevention and control policy.

The registered manager informed us that infection prevention and control remained a core part of the service’s working practice. There were clear expectations for all staff and regular refreshers to maintain compliance, with the principles of minimising risk, promoting hygiene, and responding emerging illness remained fully embedded in everyday practices.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened.

People were supported with taking their medicine if the assessment had identified this was an area of need. A person told us, Staff give my medicines to me, and I take them whilst they are here.” Supporting people to manage and take their medicines safely, for some, was an identified goal as part of their reablement and rehabilitation journey.

People’s care records contained information as to people’s prescribed medicines, and detailed staff’s role and responsibility in supporting with medicine, where required. Where a person was returning to home from hospital, staff liaised and sought assurance medicine, where prescribed, would be dispensed by the hospital pharmacy and sent home with the person. Family members involvement in medicines was also detailed, which included where they were liaising with pharmacies and health care professionals regarding prescriptions and the packaging and delivery of medicines to their relatives’ home. The reablement service made referrals for care technology, which included equipment that could be programmed to remind people it was time to take their medicine.

Staff received training and had their competency in medicine management assessed. A medicine workshop had been attended by all staff to emphasise the importance of medicine management, including recording, management of, and liaising with other health care professionals.

The registered manager maintained a medication incident matrix. Any incidents involving medicine were assessed for severity with consideration to the risk of actual or potential harm. Medicine administration records were monitored as part of the provider’s quality monitoring process. The severity of the risk informed the action to be taken.