London Borough of Hillingdon

Updated 17 March 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 13 February 2018 and was announced. We gave the provider two working days' notice of the inspection as the service provided care and support to people living in their own homes and we needed to make sure the registered manager would be available to assist with the inspection.

The inspection was carried out by two inspectors and an expert-by-experience. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service.

We reviewed the information we held about the service. This included the last inspection report, statutory notifications about incidents and events affecting people using the service and a Provider Information Return (PIR) the registered manager completed and sent to us in December 2017. The PIR is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.

Before the inspection we contacted people who used the service and their relatives for feedback. These telephone calls were made by our expert-by-experience. They spoke with 14 people who used the service and two relatives.

We emailed 15 care workers prior to the inspection for their feedback on the service and eight responded to us. We also contacted nine professionals for their views on the service and four replied to us.

At this inspection we spoke with the registered manager, two operational managers, one physiotherapist, a senior care worker, a staff member who planned the rotas and an occupational therapist. We reviewed the care records for nine people using the service. We also looked at four staff recruitment files and records related to the running of the service. These included, audits carried out on care records, checks on care workers and satisfaction surveys to monitor quality in the service and make improvements.

After the inspection the registered manager sent us further information, for example, action taken to address the medicines recording issue, the staff team training plan, a sample of minutes from various staff meetings, details of complaints and a sample of policies and procedures.

Updated 17 March 2018

This comprehensive inspection took place on 13 February 2018. We gave the provider two working days' notice of the inspection as the service provided care and support to people living in their own homes and we needed to make sure the registered manager would be available to assist with the inspection.

The Reablement service is run by the London Borough of Hillingdon. The service offers support, including personal care, to adults of all ages and was usually provided for a period of up to six weeks. The service helped maximise people's independence and confidence often after a hospital admission. People using the service had a range of needs such as recovering from a stroke or an operation. Some people might also be living with dementia. Support was provided by care workers with occupational therapists and a physiotherapist working in the service to provide specialist support if this was required.

In addition, the service provided evening and night support to people living in sheltered accommodation in the London Borough of Hillingdon and also assistance for people in the evening and throughout the night if they had the telecare line in their homes.

There were 66 people using the service at the time of the inspection. At the end of the support from the reablement service people either had achieved their goals of gaining independence or were transferred to another community domiciliary care agency for longer term care.

There was a registered manager in post. 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.

At the last inspection, the service was rated Good. At this inspection we found the service remained Good overall. However, we rated ‘Is the service Safe?’ as Requires Improvement.

People rarely needed help with their medicines. Where this was a task to be completed systems were in place to record when people had received their medicines from the care workers. Records had not been correctly completed for two people using the service and steps were immediately taken to rectify the situation.

People told us they were happy with the service they received. They confirmed having this short term assistance gave them the confidence to regain skills in order to be as independent as possible.

People needs were assessed and a plan put in place to meet their needs and promote and regain their independence. The risks to people's wellbeing had been considered so that people were supported in an appropriate way.

The provider had procedures for safeguarding adults and for responding to accidents and incidents. There was evidence the provider had learnt from incidents and had changed practices to help protect people in the future.

People and relatives were happy with the care and support people received. People said staff were respectful and maintained people's privacy and dignity. Staff understood people's individual care and support needs and worked with them to meet these.

People were given copies of the complaints procedure and said they would feel able to raise a concern if they had one. Informal complaints had been documented so that the registered manager had information on what, if any, were the common themes

Care workers told us they felt supported and had the training they needed. They confirmed that they could speak with their line manager or the registered manager whenever they needed and they enjoyed their work. There were enough staff to meet people's needs and they had been recruited in a suitable way.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice. People had consented to their care and the provider was working within the principles of the Mental Capacity Act 2005.

The registered manager and staff team worked closely with other professionals to make sure they were up to date with best practices. There was a clear management structure and the senior staff knew their roles and responsibilities. There were systems for monitoring the quality of the service and making improvements. People’s views were sought on the service so that changes could be made to meet people’s needs.