HomeCare Reablement Service

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive

Responsive – this means we looked for evidence that the provider met people’s needs.

At our last assessment we rated this key question outstanding. At this assessment the rating has changed to good. This meant people’s needs were met through good organisation and delivery.

This service scored 75 (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 made sure people were at the centre of their care and treatment choices and they decided, in partnership with people, how to respond to any relevant changes in people’s needs.

The service delivered person‑centred care that reflected people’s individual needs, preferences and circumstances. Staff took time to understand what mattered to people and adapted care accordingly.

People told us staff listened to them and tailored support to their wishes. One person said, “Staff, took time to understand what I wanted”. People also described flexibility in care, with another person saying, “They have been very flexible if I wanted to change the time of calls and actioned my request.”

People said staff involved them in planning their care. One person said, “Staff, worked with me to achieve my goals”, and another said staff “never assumed I needed help, they always asked if there was anything they could do.” This showed a collaborative approach that respected choice and control.

Care records supported this feedback. Staff completed detailed assessments and developed personalised plans with individual goals, including washing, dressing, mobility and daily routines. Plans were regularly reviewed and updated to reflect people’s progress and preferences.

The provider understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

The service delivered joined‑up and flexible care that reflected people’s needs and supported continuity. Staff followed a structured reablement pathway from referral to discharge, including screening, timely assessment, regular review and coordinated discharge planning.

Staff adapted care as people’s needs changed. One staff member said, “Sometimes needs change and the goals have to be updated with less calls or more calls from what the hospital has suggested.” This demonstrated a flexible approach to support people. Partnership working supported continuity, with staff describing a “streamlined referral process” and joint handovers when people required ongoing care.

Professionals confirmed strong integration across services. A physiotherapist told us the team worked collaboratively with district nursing teams, GPs and community services to support people at home. They also said staff set person‑centred goals that are agreed collaboratively and reflect outcomes that are meaningful to people.

Regular multidisciplinary team meetings enabled professionals to review progress and adjust care. Information sharing across teams supported consistent delivery and reduced duplication.

People’s feedback reflected this coordinated approach. They described staff as “always on time and happy to help” and valued the continuity and reliability of support.

The provider gave people clear, accurate and up‑to‑date information in formats that met their needs.

Staff explained care plans, goals, support arrangements and how to contact the service, which supported informed decision‑making. One person said, “The information that we were provided with regarding the care plan and contact numbers for the company was very comprehensive and transparent.”

People said they received information before and during the service. They told us staff explained support in a way they could understand and provided details about how to raise concerns. The service also gave people written information, such as service leaflets and home folders, to support understanding.

The service met the Accessible Information Standard by providing information in accessible formats. There were options for people to request formats such as large print or braille, which supported people with sensory needs. The registered manager also confirmed information could be adapted, for example by changing font size to meet individual needs.

Some people said information could be clearer, particularly about how the service operated and what to expect at the end of the reablement period.

The provider made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support.

The service actively involved people in decisions about their care through a structured reablement approach. Staff worked with people to agree goals, review progress and involve them in decisions about their care and discharge. Records showed people were consistently involved in setting and reviewing their goals throughout the programme.

People confirmed they were listened to and involved in their care. They said staff took their wishes into account and worked collaboratively with them to achieve their goals. One person said they felt heard and were very happy with the service, while another said staff went “above and beyond” to ensure their needs were met.

The provider had systems to gather and respond to feedback. These included questionnaires, compliments and a clear complaints process. Where people raised concerns or shared feedback, the provider responded and explained the actions taken.

The provider made sure that people could access the care, support and treatment they needed when they needed it.

The service ensured people had equitable access to support by providing timely, structured reablement interventions regardless of their circumstances. Referrals were screened consistently, and assessments were completed within agreed timescales, which enabled prompt access following referral or hospital discharge.

Staff identified potential barriers to access early through detailed assessments. These included communication needs, social circumstances and support networks, which allowed staff to adapt care and arrange appropriate support. The service also followed reasonable adjustments processes to reduce disadvantage and ensure people with additional needs could access care.

Feedback confirmed most people were able to access the service easily and understood how to engage with it. People said they received information about the service, consented to their care and were supported from the start of the reablement programme.

This enabled people to access timely and appropriate support, which reduced barriers to care and supported early recovery and positive outcomes.

Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

Staff and leaders recognised people had different needs and ensured care was tailored to support equitable experiences and outcomes. Care was delivered using a strengths‑based, person‑centred approach that focused on improving independence, mobility and daily living skills.

Records showed people progressed through the reablement programme with measurable improvements. Staff adapted care to reflect individual needs, with people moving from requiring support with personal care and mobility to managing tasks independently or with minimal assistance.

Feedback showed people experienced consistently positive care. People said they felt supported to achieve their goals. Some described the service as “outstanding” or “essential”, indicating consistently positive experiences across different people.

The service promoted equitable outcomes through structured discharge planning. Staff ensured people either achieved independence or were referred appropriately for ongoing support, which supported continuity and reduced the risk of unequal outcomes.

People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

The service supported people to plan for the end of reablement and future care needs. The reablement pathway included final reviews, discharge planning and referral to ongoing services where required.

Records showed clear documentation of outcomes and next steps, including whether people achieved independence or required further support.

Feedback confirmed staff discussed what would happen after reablement and provided information about other services when needed.

As a result, people were supported to transition safely from the service, with appropriate planning for ongoing care or independence.