Craven North Reablement Service

Craven North Reablement service provides personal care to people living in their own homes in the community. One of the functions of the service is to provide assessment and short-term rehabilitative support to promote people's independence or if needed access to longer term support. We inspected the short-term assessment and reablement service. At the time of inspection 17 people were using the service.

At our last comprehensive inspection in April 2016 we rated the service good. 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.

At this inspection we found the service remained good.

People and their relatives told us the service kept them safe. They trusted the staff who supported them. Risks to people were assessed and plans put in place to reduce the chances of them occurring. Policies and procedures were in place to safeguard people from abuse. People's medicines were managed safely.

The provider and registered manager monitored staffing levels to ensure enough staff were deployed to support people safely. The provider's recruitment process minimised the risk of unsuitable staff being employed.

People had access to health care professionals to make sure they received appropriate care and treatment. There was clear evidence of collaborative working and communication within the team and other professionals in order to help people progress and become more independent. People's comments in their feedback to the service included, "I was happy with the whole service, they could not have done anymore for me and I was soon reabled this time" and "It has been wonderful having someone to come and enable me to be independent, wouldn't change anything."

People told us staff were kind and caring and they felt comfortable with all the staff who supported them. They also said their privacy, dignity and confidentiality were maintained. Staff understood the needs of people and care plans and associated documentation were clear and person-centred. Staff were aware of people's nutritional needs and made sure they were supported with eating and drinking where necessary.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible, the policies and systems in the service supported this practice. Staff had received training and had a good understanding of the Mental Capacity Act 2005(MCA) and best interests decision Making, when people were unable to make decisions themselves. There were other opportunities for staff to receive training to meet people's care needs.

People had the opportunity to give their views about the service and any improvements were made if required. There were several commendations about the service and staff support. For example, "I cannot praise the reablement workers highly enough for the care, courtesy and dedication they have shown towards me. When I first came out of hospital I was deflated and feeling very down and unloved but with their encouragement and support, I have regained my lust for life."

People said they knew how to complain. The provider undertook a range of audits to check on the quality of care provided.

Further information is in the detailed findings below.

Belle Vue Mills domiciliary care agency provides personal care in people's own homes, through a short term assessment and re-ablement team (START). This offers short term support to people to regain their independence after an accident, ill health, or disability. The service is available to people who live in Skipton and the surrounding villages in the Dales. At the time of this inspection the agency was providing support for 30 people. Belle Vue Mills Domiciliary Care Agency employs 39 support staff a homecare manager and also a registered manager.

There was a registered manager at this service. 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.

People told us they felt safe and trusted the care staff who came into their home to support them. They described care staff as "Exceedingly honest and trustworthy." Relatives we spoke with also told us they thought their relatives were being looked after safely by care staff from the service. People told us how they valued the service they had received from the START. Everyone we spoke with told us that care staff were well trained to deliver a safe and caring service. Care staff were aware of safeguarding procedures and could demonstrate how they had taken action to safeguard people when necessary.

The service recruited care staff in a safe way making sure all necessary background checks had been carried out. Care staff were aware of safeguarding procedures and could demonstrate how they had taken action to safeguard people when necessary. There were risk assessments in place to identify risks due to people’s health or mobility and to make sure these were minimised without intruding on people’s privacy and independence. There were records that showed care staff received the training they needed to keep people safe.

Systems were in place for reporting and recording accidents and incidents, including detailed reviews and actions. Care records included individual risk assessments, which had been completed to identify any risks associated with delivering the person’s care. Where people’s needs were complex relevant professionals had been involved to provide advice and training. Records also showed that risks were managed positively, so that people were supported to develop confidence, skills and independence.

Care plans were comprehensively detailed to ensure people’s care needs were met by staff from the service. Some of the people who used the service were supported with taking their prescribed medication and care staff were trained and competent to assist people with this. People we spoke with confirmed that they received good support from care staff with their medicines and that they always got them or were reminded to take them.

People and their relatives told us that care staff were caring, treated them well and respected their privacy. We saw clear examples of people being supported to develop skills and independence.

People had been provided with information booklets about the service, which included the formal complaints process. They were given opportunities to raise issues or concerns on an on-going basis. We saw complaints that had been made since the last inspection had been thoroughly investigated and responded to by the service. There were many compliments and letters of thanks.

The service was well-led. The management team were committed to providing a good quality service. Systems and processes were in place to monitor the service and make improvements where necessary and the service had an action plan to address these. People who used the service, relatives and other professionals were routinely involved in meetings, reviews and on-going work so that their feedback could be taken into account.

' Is the service caring?

' Is the service responsive?

' Is the service safe?

' Is the service effective?

' Is the service well led?

Below is a summary of what we found. The summary describes what people using the service, their relatives and the staff told us, what we observed and the records we looked at.

If you want to see the evidence supporting our summary please read our full report.

This is a summary of what we found:

Is the service safe?

We spoke with people who used the service who told us they feel safer because support workers from this service supported them well. One person said, 'I get very good support they help me to wash and dress and help with my tablets.'

People told us that they felt their rights and dignity were always respected.

We looked at the agency's risk management plans. Records we saw showed us that people and staff were not put at unnecessary risk. People also had access to choice and remained in control of decisions about their care and lives, and what support they received from the agency. The service had completed comprehensive risk assessments for the environment and people's physical and mental health.

People we spoke with confirmed they received their medication as prescribed. Some people told us that they could administer their own medication safely with minimal support from staff.

We looked at the service's recruitment practice and found this to be safe and thorough. No staff had been subject to disciplinary action. Staff only commenced working in people's homes once the necessary checks had been carried out.

Is the service effective?

People's health and care needs were assessed with them, and they were involved in developing their plans of care. One person told us 'The carers involve us with everything.' People said that their care plans were up to date and reflected their current needs. Records we saw supported this. From speaking with staff they were able to demonstrate a good understanding of people's care and support needs and knew people very well.

Staff had received training to meet the needs of people they support in the community. New members of staff had had induction training when they began working at the service. They had also completed mandatory training so that they could work safely with people.

People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines.

Is the service caring?

People we spoke with told us that they were well supported by the service. We asked them for their views about the staff that supported them. Feedback from people was very positive. One person told us 'They (carers) are all smashing. All of them are very nice and helpful. You can ask them anything and they have a laugh with us.' When speaking with staff it was clear that they genuinely cared for the people they supported.

Is the service responsive?

People's needs were assessed before the agency provided a service to them in their own home. People's preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with people's wishes.

People we spoke with told us they knew how to make a complaint if they were unhappy. Everyone we spoke with told us they would ring the agency office. People also told us that complaints would be investigated and action taken as necessary. A relative told us that when they had a minor issue this had been resolved quickly by the agency.

Is the service well-led?

We saw that there was an effective and robust quality assurance system in place which meant that the service was learning from any audits and that there was continuous improvements at the service.

Effective management systems were in place to promote and safeguard people's safety and welfare.

Relatives we spoke with told us they thought the service ran well. One relative said, 'They (carers) are all very conscientious and polite and always on time. We have no complaints what so ever.'

We saw from care files that the service worked well with other health care professionals and services to make sure people received the appropriate care they needed.

People who use the service told us they were happy and satisfied with the care and support being provided. They made comments like, "Excellent service. I would have been lost without it.' And 'I would certainly recommend this agency to others.'

People also told us staff supported them in a respectful and dignified manner. They felt that staff worked hard to ensure they were supported in line with their wishes.

We looked at people's care records. We found that records were consistent, accurate and up to date. We also saw that the service delivered the care in a person centred way which meant that they included people in decision making throughout their care.

We confirmed with staff that they had the right training in place. They also said they felt well supported by the management team to do their job.

We also confirmed that there was consistent leadership and effective systems in place to regularly monitor the care, treatment and support people received.