Supporting Independence Team

Updated 24 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.

The inspection of Supporting Independence Team, which is run by Hull City Council, took place on 15 and 26 February 2018 and was announced with 42 hours’ notice given, as we had to make sure there would be someone at the agency offices to see us.

Our inspection site visit activity started on 15 February 2018 and ended on 26 February 2018, taking two days to complete. It included a visit to the location premises, issuing a questionnaire and speaking to people that used the service and staff on the telephone. We visited the office location on 15 February 2018 to see the registered manager and office staff; and to review care records and policies and procedures.

One adult social care inspector carried out the inspection. Information had been gathered before the inspection from notifications sent to the Care Quality Commission (CQC). Notifications are when providers send us information about certain changes, events or incidents that occur. We also received feedback from the local authority’s safeguarding team and reviewed information from people who had contacted CQC to make their views known about the service. We used information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make.

We spoke with five people that used the service and four relatives. We spoke with the registered manager, four service support organisers and three support assistants that worked at Supporting Independence Team. We looked at care files for six people that used the service and viewed records and documentation relating to the running of the service, including the quality assurance and monitoring system, accidents, incidents, staffing, complaints and compliments.

Updated 24 March 2018

This comprehensive inspection of Supporting Independence Team took place on 15 and 26 February 2018 and was announced. The service had changed late in 2016 under a Hull City Council re-organisation, changed its name and its location and received a new registration in February 2017. Therefore this is the service’s first rated inspection. We found the overall rating for this service to be ‘Good’. The rating is based on an aggregation of the ratings awarded for all 5 key questions.

The Supporting Independence Team is a Hull City Council care at home service providing active recovery support to people in their own homes. It aims to be helpful, supportive, relevant and accessible to enable people to live as part of their community, by meeting their needs and supporting their rights and entitlements. It achieves this by working with people, with the view of setting and meeting of person-specific goals and to support individuals to re-gain their independence where possible. Where people are assessed as requiring long-term care, packages of support are sourced for them with private care at home providers. The service is provided to adults aged 18 and above, older people, people who have had a mild to moderate stroke, people who needed end of life care, people with mental health problems (in partnership with the NHS), people with physical disabilities, those with a mild learning disability and those who care for any of these groups of people. The service also provides emergency support and out of hours night time support.

Following on from the intervention by the active recovery assessment team, who work with the people to devise the initial support plan during the assessment process, The Supporting Independence Team deliver the active recovery support and monitor and review people’s progress throughout this process. Thornton Court, where the care at home office is located, is a housing community facility where the people sign a temporary stay agreement during their Active Recovery rehabilitation before returning home, if they require adaptive premises to aid their recovery.

Not everyone using Supporting Independence Team receives regulated activity; Care Quality Commission (CQC) only inspects the service being received by people provided with 'personal care'; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

The provider was required to have a registered manager 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 had been in post for the last year with the service and for another two and a half years prior the re-organisation.

People were protected from the risk of harm and staff were trained in and knowledgeable about safeguarding people from abuse. Risk was safely managed. Recruitment of staff followed safe practices to ensure staff were ‘suitable’ to care for and support vulnerable people. Staffing numbers were sufficient to meet people’s needs. The management of medicines was safe and systems in place demonstrated there was a safe audit trail for handling all medicines. Staff followed good hygiene for safe control of infection.

Systems in place acknowledged and recorded when things went wrong and lessons were learnt to ensure problems or mistakes were not repeated. Staff enabled people to make choices and decisions wherever possible in order to regain control over their lives. People were cared for and supported by qualified and competent staff who were themselves regularly supervised and received annual appraisals of their personal performance. Staff respected the diversity of people and met their individual needs. Nutrition and hydration needs were supported to ensure people’s health and wellbeing.

People’s mental capacity was appropriately assessed and their rights were protected. Staff had knowledge and understanding of their roles and responsibilities in respect of the Mental Capacity Act (MCA) 2005 and they empowered people to make decisions for themselves. The registered manager followed the ‘best interests’ route and multi-disciplinary consensus where people lacked capacity to make their own decisions. Consent for support to take place was respected so that staff always sought people’s cooperation and agreement before engaging in rehabilitation.

People were cared for with compassion. Staff got to know people’s needs and preferences and were kind in their approach to encouraging independence. People directed and were fully involved in and their care. Their right to express their views was respected. The management team followed good principles of care, equality, dignity and respect, all of which was embedded in the ethos of service delivery. Wellbeing, privacy, dignity and independence were respected and encouraged.

Person-centred support plans laid the foundations for good care. They reflected people’s needs well and were regularly at two and five weeks. They gave follow-on private providers the basis for continued support where this was necessary. An effective complaint procedure in place ensured people’s complaints were investigated without bias. The service sensitively managed people’s needs with regard to end of life preferences, wishes and care, when this was necessary.

The provider met the regulation on quality assurance and systems used were effective. Audits, satisfaction surveys, meetings, and ‘spot checks’ on staff ensured there was effective monitoring of service delivery. Culture was person-centred, progressive, open, inclusive, empowering and ensured good outcomes for people. The registered manager understood their responsibilities and practiced a management style that was professional, open and approachable. The registered manager strove for continuous learning and good practice at every opportunity. The service fostered good partnerships with other agencies and organisations.