Reablement Service

People’s experience of using this service: People and their relatives told us they were happy with the care and support they received from the Home Care Service. One person said, “They are brilliant and do a remarkable job, I really can’t fault them, they are very organised.”

People received their care from a consistent staff team who they could build trusting relationships with. Everyone told us staff were caring and patient.

The provider ensured people received a safe service with systems and processes in place which helped to minimise risks. Staff effectively reported any safeguarding matters. The registered managers thoroughly investigated any concerns and resolved these matters. All incidents were critically analysed, lessons were learnt and embedded into practice.

People were supported by staff who had the skills and experience to help them to maintain and develop their independence. Staff treated people as individuals and respected their privacy and lifestyle choices.

Medicines systems were organised and people were receiving their medicines when they should. The provider was following national guidance for the receipt, storage, administration and disposal of medicines.

People were involved in decisions about the care they received and staff knew how to communicate with each person to help them to make choices.

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.

The provider was open and approachable which enabled people to share their views and raise concerns. People told us if they were worried about anything they would be comfortable to talk with a member of staff or the provider.

The management structure in the service ensured people and staff had access to, and support from, a competent management team. The provider monitored quality, sought people's views and planned ongoing improvements.

Rating at last inspection: Good (Last report published 10 August 2016).

Why we inspected: We inspected the service as part of our inspection schedule for ‘Good’ rated services.

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

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

Home care service is registered to provide personal care to people living in their own homes. A range of personal care services were offered by the provider. These included short term support to maximise independence and longer term support, usually for people living with dementia. At the time of our inspection 173 people received care and support services.

There were four registered managers in place, a lead registered manager and three registered managers who each covered services within a separate geographical area. 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 were safe and cared for by staff who had a clear understanding of the risk associated with people’s needs. Staff demonstrated knowledge of the different types of potential abuse to people and how to respond. People had their individual risks assessed and had plans in place to manage them. Medicines were administered by staff that had received training to do this. The provider had procedures in place to check that people received their medicines as prescribed to effectively and safely meet their health needs.

Staff had been recruited following appropriate checks and the provider had arrangements in place to make sure that there were enough staff to ensure that people had their calls at the agreed time and by the required number of staff. People told us they received care from reliable staff who understood their personal preferences. People felt staff were trained to meet their needs and staff told us the provider gave excellent access to training, which gave them the right skills for their role.

People were involved in making decisions about their care. Staff understood they could only care for and support people who gave their consent. People told us that they were happy with the way in which staff supported them with preparing their meals and that staff gave them a choice. Staff worked with external health professionals and people told us they were supported to access healthcare appointments.

People said staff were caring and provided support that ensured they were treated with privacy and dignity. People were supported by staff to maintain and improve their independence. Some people had received services to regain their independence and no longer needed support at home.

People were encouraged to express their views and give feedback about their care. People said staff listened to them and they felt confident they could raise any issues should the need arise and that action would be taken.

People were positive about the care and support they received and the service as a whole.

The provider ensured regular checks were completed to monitor the quality of care that people received and look at where improvements could be made.

Staff felt supported by the registered managers and that the provider gave them opportunity to progress. The management team was committed to developing new initiatives to support the care provided to people.

We asked the following questions about the service as detailed below:

Is the service safe?

Staff told us that they had received training about safeguarding vulnerable people. They told us that they would report concerns immediately to senior staff. Staff told us they knew about the local arrangements in place for reporting to the safeguarding team within the county council.

One staff member told us, "I would recognise different types of abuse, and I know what to do if I suspect someone has been abused. We are well trained and our training is up to date."

We saw that policies and procedures were in place and that these were reviewed on an annual basis. We spoke with people who used the service who told us they felt, "Comfortable" with the staff who supported them. One person told us, "They really care about the people and are respectful. One of the best things I've ever done is agreed to use this service."

We saw that there were suitable staff recruitment and selection processes in place and appropriate checks had been completed before staff commenced in post.

Is the service effective?

We spoke with people who used the service and their families. We received positive feedback, and people told us that they had been involved in the planning of their care. One person told us, "Everything was discussed with the team leader and they explained everything." People told us that their care was reviewed regularly and that they could call and speak with senior staff at any time if they needed to.

We spoke with staff who told us that their induction had been thorough and that they worked with other staff until they felt confident to work unsupervised. Staff were assessed and attended regular meetings with senior staff during their probationary period. 'Spot' checks were completed on them by senior staff to ensure that they were working well, to the required standards, and that the people they were caring for were satisfied.

Staff attended supervisions every three months and had annual appraisals completed with their line manager's. This meant that people could expect to receive care from competent and trained staff.

Is the service caring?

We spoke with staff who all told us how much they enjoyed their roles. Staff told us, "If my parents needed care I would trust our company completely." And, "We always look to improve, but we do deliver a great service."

People receiving care and their families spoke very positively about the quality of the service and told us, "We couldn't hope for better," and, "We have been so happy, they have been a model of good practice".

Is the service responsive?

We looked at care records that showed that there were detailed care plans for each person using the service. These plans were checked at regular intervals by senior staff. Daily recording books were completed by care staff after each visit, and these were checked on a monthly basis by senior staff, when they were returned to the office. Care reviews were usually completed on an annual basis, or if there was a change in the person's condition. Staff were also expected to report promptly by telephone if they had any concerns about the person they were supporting. This meant that people could be confident that appropriate actions would be taken if their care needs changed.

Is the service well led?

We saw that staff were well trained and that they were effectively supported. The staff we spoke with confirmed that there was always a senior member of staff that they could speak to if they needed to report an issue or if they had any concerns.

A range of quality monitoring systems were in place. The four managers we spoke with enthusiastically discussed how they used people's experiences, feedback and complaints to review, and make improvements to the service.

During this inspection we spoke on the telephone with 12 people who used the agency and four relatives. We spoke with the provider, the registered managers and four care staff at the agency office. We sent out 61 surveys to people who used the agency with an additional questionnaire for their relatives to complete. 12 surveys were returned from people who used the agency and seven from people's relatives.

People were complimentary about the care and support that they received. People said: 'Everything has been marvellous'. 'The carers help me a lot, they are very polite'.

People told us that they felt involved in any decisions that needed to be made about their care and these were made in their best interests.

We found that proper steps had been taken to ensure that individualised care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare.

Staff received the training and support needed to ensure people received appropriate care.

The provider had systems of audit in place to enable them to monitor the quality of the service provided and ensure that people received appropriate care and treatment.

We found that any comments and complaints people made were responded to appropriately.