East Surrey Area Reablement Service

Updated 1 January 2019

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.

This comprehensive inspection took place on 14 and 15 November 2018 and was carried out by one inspector. The provider was given 48 hours’ notice of the inspection visit because it is a short term domiciliary care and reablement service. We needed to be make sure someone would in the office. We also needed to get people’s consent for us to visit them at home or telephone them as part of the inspection.

Before the inspection, we reviewed the information we held about the service. This included the previous inspection report and notifications since the last inspection. Notifications are changes, events and incidents that the service must inform us about. We used information the provider sent us in their Provider Information Return (PIR). 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.

During the inspection, we visited three people and their relatives in their own homes, asked about the reablement support they received and looked at their care records. We asked for medicines records for two other people and spoke with four people by phone. We also spoke with two reablement assistants, one team leader, the registered manager, a senior manager and the registered nominated individual for these services in Surrey.

We looked at five support and care plans, risk assessments or medicines records. We also saw policies, notes of meetings held and evidence of quality monitoring that demonstrated how the service was managed.

We later received feedback from two health and social care professionals about the service.

Updated 1 January 2019

East Surrey Reablement Service provides short-term support and personal care to people with the aim of enabling them to live independently in their own homes. The service also supports a hospital discharge assessment programme. The service provides reablement and personal care to older and disabled people living in their own houses and flats in the community. At the time of the inspection there were 41 people receiving the service.

At our last inspection in March 2016 we rated the service as good. Since the last inspection the service has matched the area they cover to that of the community health service (Reigate, Redhill, Horley and Tandridge) to facilitate effective joint working with health professionals.

At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission 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.

There were sufficient staff to deliver all the care hours that were commissioned and needed by people. There were safe staff recruitment practices in place. The team was being guided through a time of change in the service, following the strategic decision to integrate reablement with the community healthcare service.

People were kept safe from abuse because there were robust safeguarding procedures in place and staff were aware of potential harm and knew how to report it. The risks to people (and for staff) in the person’s home were identified and recorded at the outset of any care provision. There were plans in place to reduce the risks and staff knew what actions to take. Incidents and accidents in the person’s home were recorded and reviewed, and learning was discussed with staff. Staff also followed safe practice to reduce the spread of infections and kept people’s homes clean.

Where people were assisted to take their medicines, this was being done safely and was closely monitored by managers. Following a medicines error, there had been staff meetings and action to ensure learning on the correct recording and administration procedure had taken place.

Staff received training to administer medicines.

People received an assessment in line with good practice before any service was provided. This was discussed with the person and their family and their support plan included specific goals for recovery or independence that had been agreed with the person themselves. These were kept under review as people improved or if further needs were observed.

Staff had received a good induction and had access to mandatory refresher training as well as a wide range of other more specific and relevant training to be able to carry out their reablement role. Staff were supervised on a regular basis. They felt able to ask for support and advice at any time to meet the needs of people.

The service worked closely with healthcare services which meant that people’s health and rehabilitation needs could be addressed sooner and so that the outcomes for people’s health and well-being were improved. Staff worked together and fed back to their team leader any new concerns about a person that needed to be addressed.

People’s consent was sought, prior to staff providing any support and care. Staff were aware of the responsibilities and worked in line with the principles of the Mental Capacity Act 2005. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.

People were treated with kindness and respect. Staff worked in partnership with people to agree their goals and to encourage their independence. Positive relationships were formed quickly and, where people required long term care, a personal handover was given to the new agency.

People’s personal goals were included in their care and support plans. The service responded to individual requirements wherever possible. People’s concerns were responded to personally. People knew how to complain but there had been no formal complaints in the last year.

The service had a clear and well-defined purpose, which the managers and all staff supported and able to promote. The service worked with, and alongside, other council managed care services and provided a flexible approach to meeting priority needs, for example during winter pressures. There was a positive staff culture in the face of adapting to change and meeting any challenges due to planned integration with healthcare.

There was a system in place to ensure regular quality assurance checks. Medicines audits and observed visits of staff in the home were also undertaken. Information on service performance and risks was reported to the council’s service delivery team at least once a quarter. Statutory notifications to the CQC were sent correctly and oversight was maintained by senior managers.

The service was working collaboratively with health and social care services and relied on strong links with other care agencies, having a short-term and focused offer. These partnerships and relationships meant that people received joined up care provision at a time when they needed it.