South East STSS (Short Term Support Service)

South East STSS (Short Term Support Service) is provided by Northumberland County Council. It provides a range of rehabilitation for up to six weeks, including reablement, occupational therapeutic support and a 'bridging' service, when people are awaiting longer-term care packages. The service is provided to people in their own homes. At the time of our inspection there were 18 people using the service.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks 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

South East STSS was an extremely successful service which helped people achieve positive outcomes, build confidence and gain independence to better manage their lives.

People who used the service received high-quality, personalised support from an exceptionally well-led service. People said the service was “outstanding” and had successfully helped them to regain independent skills to remain at home.

Staff were fully committed to providing an extremely person-centred service. Staff were very proud to work for the service and said they received superb support from the organisation and their colleagues.

The managers provided strong leadership and constantly considered how they could enhance the service. There was excellent team work and collaboration both within and outside the service. Other health and social care professionals commended the service for its exceptional management, joint-working and open communication.

Since the last inspection, the provider had developed significant new initiatives to support and improve the service to people and to the local community. These included a ‘home safe’ support team to get people home from hospital with the equipment and resources they needed within 24 hours.

The service was safe. Risks to people’s health and safety were assessed and mitigated. Medicines were managed in a safe way. There were enough staff who were recruited safely to make sure people received the right support.

People were supported to have maximum choice and control of their lives and staff assisted them in the least restrictive way possible and in their best interests; the policies and systems in the service upheld 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

The last rating for this service was outstanding (published 28 November 2017).

Why we inspected

We carried out this inspection due to the length of time since the last inspection.

This report only covers our findings in relation to the key questions Safe and Well-led. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service remains the same, based on the findings of this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for South East STSS on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

In November 2015 South East Sector Home Care had been visited when we completed an inspection of Northumbria Healthcare NHS Foundation Trust community healthcare services for adults. We judged the community services for adults within the Foundation Trust as being outstanding.

South East Sector Home Care is a short term support service providing an enablement, early intervention and bridging service for people in their own homes. Reablement is designed to help people recover from a period of serious illness or injury which may have resulted in hospital treatment. The service provides a range of rehabilitation, care and support services for up to six weeks and is registered to deliver personal care. Early intervention services provide additional support to people who are experiencing difficulties and aims to prevent hospital admission and the bridging service provides personal care and support for people whilst they await a long term domiciliary agency picking up their care.

The service operates a fully integrated model of support so combines social care and healthcare resources. People who use the service are rapidly assessed and can receive treatment from physiotherapists, occupational therapists and technical instructors as well as support with improving their ability to attend to everyday tasks such as bathing. The service has full access to loans equipment and staff at the service will if needed deliver items to people’s homes. Each therapist has their own case load, which they closely manage in order to ensure people are seen within 18 weeks from referral.

At the time of the inspection staff supported around 58 people in the urban area of south east Northumberland. We found this number fluctuated regularly as it depended upon when people were discharged from hospital and the speed with which people were able to return to functioning independently. We found that over the course of the previous month 125 people had been referred for support redeveloping their independent living skills and 393 people had been referred for therapy whether that be input from physiotherapists, occupational therapists or technical instructors.

The service had a registered manager who had been registered with the Care Quality Commission since October 2010. 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.

Within this vibrant, dynamic and creative service there was a strong sense of leadership, commitment and drive to deliver a service which improves the lives of the people who use the service. The culture embedded in the service was an absolute commitment to deliver a totally personalised service. We found that the management style had led to the operation of a fully integrated service, that combined the skills and expertise of health and social care staff in ways that meant people experienced a seamless service.

The involvement of other organisations and the local community was integral to how services were planned and ensured that services met people’s needs. We found that South East Sector Home Care had a model of integrated community teams across health and social care to ensure people received truly joined up working that was responsive to individual needs. There was a single point of contact for all people who needed to make referrals and access services and this practice had led to the focus being on providing services in a timely manner in ways that were convenient to them.

People were overwhelmingly positive about their experience of care and treatment, and feedback gathered by the organisation showed high levels of satisfaction. Words and phrases such as “tremendous,” “cheerful and considerate,” “extremely happy with the care,” were used extensively in their feedback.

Staff told us they had received training in relation to safeguarding adults and would report any concerns. Processes were in place to recruit staff and to carry out checks to ensure they were suitably experienced and were of good character to work with people who were potentially vulnerable. People told us staff attended their agreed care appointments within prescribed time slots and there were no missed appointments. A system was in place to monitor late visits and take action to avoid any delays.

The provider had in place systems to support staff out of office hours. Following a review of provision the provider identified that the service could be enhanced by the introduction of a new call centre. The call centre staff triaged information and sent referrals to the most appropriate teams who could offer support such as access to immediate response teams or the staff working in the four Sector Home Care services working across Northumberland. Staff reported that this system was working well.

The provider had a comprehensive policy on how people should be supported with medicines and staff had received training on the safe handling of medicines. We found staff had a good knowledge of the important aspects of prompting and administering medicines and records related to this activity were complete and up to date. Audits of medicine support were regularly undertaken.

People told us staff had the right skills to support their care needs. Staff said they received training and there was a system in place to ensure this was updated on a regular basis. Staff told us, and records showed there was regular supervision and annual appraisals. Staff were aware of the Mental Capacity Act 2005 and issues relating to personal choice and best interest decisions. No one using the service was subject to restrictions imposed by the Court of Protection.

People told us they found staff caring and supportive. They said their privacy and dignity was respected when staff supported people to improve their ability to manage their own personal care needs. Staff had a clear understanding about supporting people to develop and regain their independence. Staff were able to describe how they supported people to maintain their health and wellbeing. People said they were supported by care staff, if needed, to access adequate food and drinks, however this was not the main thrust of the service provision. We heard that the therapists and technicians were skilled and adept at providing the necessary support and equipment to enable people to regain their independence.

Professionals said the service was very responsive to people’s needs and flexible in its approach. People’s needs were assessed and care plans detailed the type of support they should receive. Care plans contained goals that people wished to achieve and these were reviewed and updated as support progressed and people’s abilities improved. There had been a very small number of informal complaints in the previous 12 months and we found that all of these had been dealt with appropriately. People we spoke with told us they were happy with the care provided and they had no complaints about the service. The service regularly received compliments about the support provided by staff.

The provider had in place systems to effectively manage the service and monitor quality. A range of meetings and monitoring systems were in place to ensure the service was meeting both internal quality standards and Health and Social Care Act regulations. Although the care delivered was already personalised the consistent drive within the service to improve meant that they were looking to improve the standards of person centred care delivered.

Regular spots checks took place to review care provision, hand hygiene, medicines management and ensure people were receiving appropriate levels of care. People were also contacted to solicit their views and there was a high level of satisfaction with the service. Staff told us there were regular meetings and information was provided to ensure they were up to date about any changes in care. An electronic contact system supported care workers and allowed them to be aware of changes to people’s care needs quickly, through the use of mobile technology. Records contained good detail, were up to date and stored appropriately.

Staff told us that the registered manager and service managers were approachable and closely listened to their views. They felt empowered to make suggestions and were delighted that their views had been taken on board. We saw the managers and staff actively sought to learn lessons from events and develop a forward thinking, flexible service.

We found that the comprehensive range of audit and quality assurance tools the provider and staff used led to them readily identifying areas in the service they could enhance. We found that staff were then supported to implement these in a timely manner and constantly evaluated the effectiveness of any changes.