HomeCare Reablement Service

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm.

At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people were safe and protected from avoidable harm.

This service scored 72 (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 had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

Staff described clear processes for escalating incidents and safeguarding concerns, and there were structured systems to record and review events. Care records showed that staff documented concerns in daily notes and used communication books to share information across visits, ensuring continuity and awareness among staff.

The reablement pathway supported shared learning through structured processes, including referral screening, multidisciplinary team (MDT) discussions and regular reviews. These systems enabled staff to discuss risks, reflect on care delivery and adjust support based on people’s changing needs.

Records showed consistent communication between professionals and reablement workers, with regular updates recorded in care notes and MDT templates. This supported ongoing monitoring and adaptation of care.

People benefited from a service where safety concerns were recognised and shared, which reduced risks and supported consistent care delivery.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

The service had clear pathways to support safe care from referral through to discharge. Referrals were screened and allocated appropriately, with initial contact made within 24–48 hours and assessments completed within 5 days, ensuring timely support.

Records reviewed showed structured care pathways in practice. For example, people had documented admission details, goals and discharge planning within their records. For one person, hospital admission and discharge details were clearly recorded, along with reablement goals and review dates.

The service coordinated care with external professionals, including therapists and healthcare services. MDT discussions and follow-up processes supported safe transitions, including discharge and referral for ongoing care where required.

As a result, people experienced timely and coordinated care, which supported safe transitions and continuity of support.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately.

The service embedded safeguarding within practice, and staff understood how to identify, report and respond to concerns. Staff described clear processes to recognise abuse and escalate safeguarding issues, and they were confident in taking appropriate action. Staff received safeguarding training, which supported their understanding of how to recognise, and report concerns and follow safeguarding procedures.

Staff incorporated safeguarding into assessments and care planning. They considered risks such as cognition, vulnerability and environmental factors, and recorded these clearly in care records. Staff documented concerns in daily notes and used communication systems to share information across visits, which supported continuity and awareness among the team.

The reablement pathway strengthened safeguarding by including checks at referral and assessment stages. Staff identified risks early and monitored them throughout the service. Multidisciplinary team discussions and regular reviews enabled staff to reflect on risks, review care delivery and adjust support where needs changed.

Records also showed consistent communication between reablement workers and professionals. Staff recorded updates in care notes and multidisciplinary documentation, which supported ongoing monitoring and timely responses when risks changed.

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

Staff involved people in identifying and managing risks while promoting independence. Staff assessed risks such as falls, mobility and environmental hazards and used this information to develop care plans that balanced safety with independence.

Care plans included collaborative goal setting, which helped people understand risks and work towards independence safely. One person told us, “They will observe me having a shower to keep me safe, so I don’t fall”, which showed how staff enabled independence while managing risk. Another person told us, “They have helped me to improve as they walk with me and do exercises”, which demonstrated a gradual approach to building confidence and mobility.

Records showed goals focused on improving mobility, personal care and daily living skills. In one case, staff used graded support and physiotherapy input to enable safe progression and reduce risks over time.

People were supported to understand and manage risks, which enabled safe progress towards independence.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

Environmental risks were assessed and managed through structured assessments and checks. Staff completed environmental risk assessments at the first visit and reviewed them as needed to ensure risks remained appropriately managed.

In most cases, risks were low or not present. Assessments showed people lived in safe home environments with minimal hazards. One person told us, “The manager did full risk assessments to ensure I had a safe environment and also installed a key safe”, which supported safe access to their home.

Where risks were identified, such as clutter or mobility challenges, staff took action. They provided equipment, gave advice and made adjustments to reduce risks and improve safety. Fire safety assessments were also completed before discharge to ensure appropriate measures were in place.

The provider did not ensure staff were consistently competent or safely trained. Training governance was not always effective, and records showed gaps in mandatory training, including safeguarding, moving and handling and infection prevention.

Systems to monitor training did not consistently identify or address these gaps, which reduced oversight of staff competence and safe practice.

Managers recognised these issues, but processes to monitor and improve training compliance were not well developed or consistently used. This meant the provider could not demonstrate that all staff had up-to-date training and competency.

The provider had started to take action. At the time of the assessment, they had identified overdue training and booked staff onto required courses, with further training scheduled to improve compliance.

Overall staff delivered care appropriately and supported people with personal care and safety monitoring. People told us they felt safe with staff. One relative told us, “[person] is safe beyond a doubt with their reablement workers”, and a person told us, “I feel very safe with them.” Another person also told us, “I found the manager very competent and the reablement workers are well trained.”

Staff reported feeling confident and supported in their roles and said supervision and team meetings helped them in their work. Records showed staff supported people with personal care, mobility and reablement activities in line with their needs.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

Staff followed infection prevention and control procedures. They demonstrated safe infection prevention and control practice in their work. Care records showed they considered hygiene, personal care and environmental risks when delivering support. Staff used personal protective equipment and maintained hygiene standards during visits.

Quality assurance processes supported monitoring of infection control. Managers completed spot checks, on‑site observations and quality monitoring visits to review staff practice. These checks provided oversight of how staff applied infection prevention measures in people’s homes.

The service also provided infection prevention and control training. This supported staff to understand good practice and apply it consistently.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened.

Medicines were managed safely and supported people to maintain independence. Staff assessed whether people could manage their own medicines or required support and used this to inform care planning.

In many cases, people managed medicines independently, with capacity clearly recorded and no staff input required. Where people required support, staff followed clear processes to ensure safe administration and monitoring. Staff supported people with topical medicines where required, and records showed topical medication administration record (MAR) charts were completed to guide safe application of creams and ensure these were used as prescribed.

Staff did not administer oral medicines. Staff provided prompts and reminders where required, which supported people to take medicines safely while maintaining independence and control.