The Reablement Team

The Reablement and Crisis Team and Helpline/Response Service provides personal care and crisis support to adults living across Oldham. The Reablement Team offers a seven-day service, providing planned short-term intensive reablement support to promote independence, and avoid admission to hospital or residential care. The Helpline and Response team provides a seven-day, 24-hour emergency response service. These services are part of Oldham Care and Support Ltd; the parent company being MioCare Group, a care and support provider owned by Oldham Council. Since February 2019 the service was joined by Pennine Care Oldham Rapid Community Assessment Team (ORCAT).

Not everyone who accesses the Helpline/Response service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

People’s experience of using this service and what we found

Robust quality monitoring systems had been embedded helping to identify any areas of improvement. Through our discussions it was evident the registered manager and senior management team had a strong commitment and were passionate at driving improvements so people received the highest standard of care and support.

The integration of the Reablement Team with ORCAT had made a positive impact on the service delivery. The service also worked collaboratively with other agencies so people’s social, emotional and physical health care needs could be safely and effectively met.

People, their relatives and staff said the service was well-led, with one person commenting, “Yes they are well led, they’re excellent at every turn”. The registered manager was described as, “Brilliant” and “Driven” in leading and supporting the team to achieve the best outcomes for people.

Safe systems had been maintained to help ensure the safety and protection of people who used the service. These included the safe management and administration of people’s medication, thorough recruitment and training processes, assessment and management of areas of risk and infection control procedures.

People spoke positively about their experiences and felt the service responded effectively in meeting their individual needs. People felt confident staff had the knowledge and skills needed and knew how to support them in a personalised way. Staff spoken with clearly understood the importance of respecting people's privacy, dignity and independence.

Information about people’s needs and wishes were detailed in a care plan, which was kept under review. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Staff received the training and support needed to carry out their roles effectively. Staff had been safely recruited and there were enough staff to provide people with the personalised support they needed.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection –The last rating for the service was Good (published December 2016)

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

We last inspected this service in June 2014 where we found it was meeting all the regulations we inspected.

The Reablement Team and Helpline/Response Service provide personal care and crisis support through domiciliary care services to adults. The Reablement Team offers a seven-day service, operating between 07.00 and 23.00, and provides planned short-term intensive reablement support in order to promote independence, and avoid admission to hospital or residential care. The Helpline and Response team provides a seven day, 24 hour emergency response service. These services are part of Oldham Care and Support Ltd; the parent company being MioCare Group, a care and support provider owned by Oldham Council.

When we visited the service a registered manager was in place. 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.

Staff had a good understanding of the procedures needed to keep people safe and what action to take to protect vulnerable people in their care. Risk assessments, both environmental and personal had been completed and were reviewed regularly. The safety of staff was taken seriously and staff whereabouts was monitored through an electronic call monitoring system. The primary purpose of this monitoring system is to ensure people are visited on time. However it also enables office staff to have oversight of where carers working in the community are at any one time. People working at night for the Helpline and Response service worked in pairs to maintain their personal safety.

People we spoke with felt there were sufficient, appropriately trained staff to support them and care visits were on time and of a suitable length to provide high quality care. No one had had any missed calls. People who had called the Helpline and Response service told us they received assistance promptly.

Appropriate recruitment checks had been carried out on all staff to ensure they were suitable to work with vulnerable people.

Staff had undertaken a variety of training which supported them to carry out their roles effectively. Staff received regular supervision which provided them with opportunity to voice any concerns and plan their professional development.

People we spoke with were very complimentary about the standard of care they received and about the caring nature of the staff. People were spoken with politely, treated with dignity and respect and their independence encouraged and promoted.

Assessments and care plans were thorough and were reviewed frequently to ensure that the number of visits people required were appropriate to their current level of need.

The registered manager showed good leadership skills and staff told us they worked well together as a team. Quality assurance processes, such as regular audits were carried out to ensure that the service delivered high quality care.

Feedback was sought from people who used the service through questionnaires. All the feedback comments we saw were positive.

The inspection was undertaken by one inspector. This summary addresses five key questions: is the service safe; is the service effective; is the service caring; is the service responsive and is the service well led?

The summary is based on a visit to the service offices where we looked at records and talked to the manager. Following the visit we contacted, by telephone, a sample of people who used the service and relatives of people using the service. We also talked to some care staff on the telephone.

The full report contains the evidence to support this summary.

Is the service safe?

The service had a written policy and procedure in connection with safeguarding vulnerable adults. Staff had received training in safeguarding which meant they understood what to look out for and what they should do if they had any concerns. Staff told us they were confident the people they visited were safe. They also told us they understood their responsibility to 'whistle blow' if necessary.

Health and safety assessments were undertaken as part of the care planning process. This helped to ensure the physical safety of people using the service and staff.

People who used the service told us they felt safe and had good relationships with the carers who supported them. People knew how to contact the office if they needed to.

Is the service effective?

The service was provided on the basis of an assessment of the individual's needs and a written plan of care. People using the service, and when appropriate their representatives, were involved in discussing the best way for identified needs to be met. The Reablement Team did not take on support responsibilities for people if the service did not have the capacity to support them effectively.

Although the service was short term, in exceptional circumstances the support was provided beyond the six weeks while longer term support was organised with other service providers.

Staff were appropriately trained. Staff were not asked to undertake any tasks which they were not trained to do effectively. One member of staff told us 'Reablement is fantastic ' the amount of people we get back on their feet.' Another told us they thought one of the best things about the service was 'seeing people improving ' '.

Audit processes were in place to assist in maintaining the effectiveness of the service. Checks included sampling visit records to help ensure the care plan was being followed and an 'exit questionnaire'. The exit questionnaire provided information which could assist the effective provision of the service to people being supported in the future.

People using the service spoke positively about the support they received. They also said staff usually turned up on time. On the odd occasion when staff were delayed they were contacted to be advised of that.

Is the service caring?

All the people using the service and their relatives who we spoke with were positive about the attitude of the staff. Comments included: 'they [staff] are all very nice people, very careful and caring', 'I thought I would feel embarrassed, but they don't make you feel embarrassed', 'very good [service]', 'very helpful ' very nice and I feel comfortable [with the staff]' and 'I can't fault the service'.

Staff spoke positively about the work they did and the people they supported.

Is the service responsive?

We did not look specifically at the service's complaints procedure. However people using the service and their relatives told us they knew how to contact the office if they needed to. They also told us that they believed they would be listened to and their opinions were valued. One person told us they appreciated that the service was 'very flexible and very understanding'.

One member of the management team told us they believed the service was person centred. They also said the question 'how would you [the person using the service] like us to deliver your support' was fundamental to the philosophy of the service.

Staff told us they could seek support from colleagues, including any of the AROs or managers and that it would be forthcoming.

Quality monitoring systems were in place. These would enable the service to identify if any modifications to the service would be beneficial.

Is the service well led?

There were clear lines of accountability within the service.

Staff who we spoke with were positive about the leadership within the service. They told us that the office based staff were approachable, supportive and responsive whenever they felt the need to contact them. They told us they were not asked to undertake any tasks they had not been trained for.

There was a formal, structured process for staff supervision and appraisal, together with staff being able to access support whenever they needed to.

People using the service and their relatives told us they were listened to and that their opinions were valued.

Communication within the service was good. Staff told us they felt well supported by managers who made themselves available for them.

People told us the service was reliable.

Quality monitoring and assurance was in place.