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We are carrying out checks at HomeCare Reablement Service. We will publish a report when our check is complete.

Inspection Summary


Overall summary & rating

Good

Updated 7 April 2017

The inspection was conducted on 30 December 2016, 16 January and 31 January 2017. We gave the registered manager two days’ notice as this is a domiciliary care service and we wished to make sure that key staff would be available. The previous inspection was held on 19 September 2013 and the provider met the regulations we checked.

The Homecare Reablement Service is managed by the London Borough of Hammersmith and Fulham, and is registered with the Care Quality Commission (CQC) to provide the regulated activity of personal care. It offers a free service for up to six weeks to people living in their own homes within the borough and provides personal care, reablement and other support following a stay in hospital or an illness at home. However, the intervention period is flexible and could be 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.

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 present throughout the inspection.

People were encouraged wherever possible to independently administer their own medicines and staff had received training in regards to the safe administration of medicines. Care staff and the management team regularly liaised with a group of local health professionals from different disciplines, who contributed to the reablement process. Staff told us they benefitted from these close working relationships, which enabled them to promptly seek any guidance about different aspects of people’s medicine needs and healthcare needs. Although there was a system in place for staff to record at each visit if they supported people with their medicines, people were placed at risk of receiving unsafe care as the provider did not ensure that there was an up to date record of prescribed medicines in people’s care and support plans.

People informed us they always felt safe using the service and were at ease permitting staff into their own homes. Staff knew how to protect people from the risk of abuse as they understood the provider’s safeguarding policy and had received appropriate training, including how to immediately report any concerns about people’s safety to their line manager. There were systems in place to identify actual and potential risks to people’s safety, for example risk management plans were developed to advise staff how to promote people’s independence while taking into account the need to mitigate risks.

The provider operated rigorous recruitment practices to ensure that suitable staff were appointed. People stated that they received a reliable and efficient service. There were sufficient staff deployed to ensure that people received the care and support they needed, which included ‘double-up’ calls from two members of staff, if required.

Staff received a comprehensive training programme, which included training to specifically address the needs of people receiving a reablement service. There were formal arrangements in place to provide staff with support and supervision during one to one and group meetings and the management team were described by staff as being “always very approachable” if ad hoc advice and support was needed.

CQC monitors the application of the Mental Capacity Act 2005 (MCA). Discussions with members of the management and staff team demonstrated that the provider understood their legal responsibilities under the MCA and they assessed people’s capacity when they began using the service, and reassessed people during the period of their care and support if needed.

People, and their relatives where

Inspection areas

Safe

Requires improvement

Updated 7 April 2017

The service was not consistently safe.

Although staff had received medicines training, a more detailed process for recording how they supported people with their prescribed medicines was required.

Staff understood how to protect people from the risk of different types of abuse and knew how to immediately report any concerns.

Risk assessments identified and addressed risks and guidelines were in place to reduce these risks.

Robust staff recruitment practices were used and there were sufficient staff deployed to comfortably meet people’s needs.

Effective

Good

Updated 7 April 2017

The service was effective.

People were supported by a staff team with appropriate skills, knowledge and training to effectively meet their needs. Staff expressed that they received regular support, guidance and supervision to carry out their roles and responsibilities.

People were enabled to make choices about their care and support by a staff team that understood current legislation in relation to the Mental Capacity Act 2005 (MCA).

Suitable systems were in place to support people to maintain a balanced and healthy diet.

The provider utilised its positive close working relationships with health and social care professionals and assisted people to access assistance from various professionals.

Caring

Good

Updated 7 April 2017

The service was caring.

People received individual care and support, delivered in a flexible way that took into account how people achieved different levels of progress with their reablement plan.

Staff provided kind and thoughtful care and support, which encouraged people to regain their independence.

Staff had the time they needed to give people the personal care and social support they required and people did not feel rushed.

Responsive

Good

Updated 7 April 2017

The service was responsive.

People and their relatives where applicable, were consulted about their reablement needs. Care and support plans indicated people’s wishes and aims, which were reviewed and adjusted to respond to their varying 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.

Well-led

Good

Updated 7 April 2017

The service was well-led.

People were pleased with the quality of the service and felt it was a valuable local resource.

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

The provider had implemented effective quality assurance systems to maintain and improve standards of care and support.