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HomeCare Reablement Service Outstanding

Inspection Summary

Overall summary & rating


Updated 9 May 2019

This comprehensive inspection was undertaken on 29 November, 4 and 12 December 2018. Inspection activity was concluded on 18 January 2019. We gave the provider two days’ notice as this is a domiciliary care service and we wished to ensure that key staff would be available. The previous inspection was completed in January 2017 and the service was rated as Good. Effective, caring, responsive and well-led were rated as Good and safe was rated as Requires Improvement.

We had found one breach of regulation of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in relation to the safety of the medicines management. The care plans for people who required prompting or assistance to adhere to their medicine needs had not contained a complete written record of all prescribed medicines. Therefore, staff could not be fully assured that they had accurately supported people with their medicines. Following the previous inspection, we asked the provider to complete an action plan to show what they would do and by when to meet the regulation. At this inspection we found that the breach of regulation was met and thorough systems for the safe management of medicines had been established.

HomeCare Reablement Service is a domiciliary care agency which is registered with the Care Quality Commission (CQC) to provide the regulated activity of ‘personal care’ to people living in their own houses and flats in the community. The personal care formed part of a wider package of support offered during the reablement period. The service is operated by the London Borough of Hammersmith and Fulham and offers a free service for up to six weeks comprising personal care, reablement and other support. The aim of the service is to support people to regain their confidence and independent living skills, so they can continue to remain in their own homes. However, the intervention period is flexible and occupational therapy and/or physiotherapy could be provided for longer than six weeks depending on a person’s individual needs and circumstances. The service is available for people aged 18 and above, and there were 47 people using the service at the time of the inspection. The service works in close partnership with the Community Independence Service (CIS), which is part of a local NHS trust.

A registered manager was in post. A registered manager is a person who has registered with the CQC 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 manager was a team leader at the service and she had been registered since January 2017. During the inspection the service manager informed us that he had applied to CQC to also attain registered manager status and this registration was confirmed in February 2019. To provide clarity, this report refers to the registered manager and the service manager by the job titles they held at the time of our visit to the service.

People reported that they felt safe using the service, and felt the staff were trustworthy. There were appropriate systems in place to promote people’s safety and mitigate identified risks. Staff received training in safeguarding and infection control, and their responsibilities to protect people from abuse and harm were discussed at their supervision and team meetings. Risk assessments had been developed to identify and address risks, for example if people were at risk of falls or malnutrition. The provider worked closely with the assistive technology co-ordinator to support people’s safety and wellbeing through the sensitive and individual use of beneficial equipment. Accidents and incidents were recorded and analysed so that the provider could detect any trends and take appropriate action.

People were supported by exceptionally well-trained staff, who benefitted from a dyn

Inspection areas



Updated 9 May 2019

The service was safe.

Where required, people received safe support from staff to receive their prescribed medicines, and detailed records were kept in relation to how people were supported with this task.

Robust systems were in place to protect people from the risks of abuse and neglect. Staff had received training and knew how to report any concerns without delay.

Risk assessments had been developed to identify and addressed risks to people’s safety and wellbeing.

Robust staff recruitment practices were used and sufficient staff deployed to suitably meet people’s needs and reablement objectives.

Staff protected people from the risk of cross infection through using correct infection control practices.



Updated 9 May 2019

The service was outstandingly effective.

People were supported by a staff team with effective skills and knowledge, who received an exceptional standard of training and support.

The provider had developed excellent links with local health care professionals. They reported that the service was a valuable resource that met people’s health and social care needs in an extremely effective and highly capable manner.

Where necessary, staff supported people to meet their nutritional needs.

Staff understood the Mental Capacity Act 2005 (MCA) and supported people to make choices about their care and support.



Updated 9 May 2019

The service was Good.

People and relatives told us that staff were very kind and caring.

Care plans contained demonstrated that people and their relatives where applicable were consulted about their needs, wishes and interests.

The community independence assistants and other staff supported people to develop their independence as much as possible, and access community resources and amenities.

People were provided with written information about the service and their rights.



Updated 9 May 2019

The service was outstandingly responsive.

People and their relatives where applicable, were consulted about their reablement needs and involved in the ongoing reviewing of their goals. Care plans included people’s wishes and aims, which were reviewed and adjusted to respond to their varying needs.

The service was delivered in a flexible way. Staff were trained to provide person-centred care and could extend visits to meet people’s individual needs.

The provider worked in a seamless manner with health and social care professionals to promptly meet people’s changing needs.

People were supported to state their opinions about their care and support, and were given clear information about how to make a complaint.



Updated 9 May 2019

The service was well-led.

People and relatives spoke highly about the quality of the service and thought the service was competently managed.

Staff were positive about the leadership, training and support they received to meet people’s needs. There was a shared vision to provide a valuable service for local people.

The provider enabled staff to regularly meet to discuss how to support people who used the service and look at ways of improving the quality of care.

Staff demonstrated a motivated and committed approach, and reported that they were competently supported by the management team.