A single inspector carried out this inspection. The focus of the inspection was to answer five key questions; is the service safe, effective, caring, responsive and 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 and the records we looked at.
If you want to see the evidence that supports our summary please read the full report.
This is a summary of what we found:
Is the service safe?
Before people were supported by the service, an assessment was completed covering each person's support needs and what areas the service would be able to assist them with. This ensured that the service was appropriate and able to support people safely.
People were cared for in their own homes and the initial assessment the provider undertook included a risk assessment of the environment to ensure that it was appropriate for the person.
There was an on-call system available which was staffed by internal team leaders between 7am and 7pm and by a regional on-call arrangement outside those hours. This ensured that there was assistance available at all times. Records were detailed and included individual risk assessments where needed. Documentation was stored safely and securely.
When people who used the service had involvement from other services this was recorded in detail to ensure that information could be shared where needed. Referrals were made on a regular basis to medical professionals and specialist services to ensure people were cared for safely and appropriately.
Is the service effective?
The focus of the care and support delivered was around enabling people to regain their independence. Packages were delivered for up to six weeks. More than 80% of those that used the service did not require any further support after the six week period had finished. People told us that they were happy with the care they received and felt their needs had been met. It was clear from speaking with staff that they understood people's care and support needs and that they understood that the focus was on supporting people to regain lost skills. One relative told us. "The staff were always cheerful and encouraging. They were very friendly and supported us both'. Another told us 'I thought they were tip top'. Staff had received training to meet the needs of the people they were supporting.
There were various systems in place to monitor the quality and effectiveness of the support being provided. The manager and staff used processes and procedures effectively to ensure that the support being provided was right for each individual person.
People told us that they felt the support they were given was always right for them and was effective in meeting their needs. At the end of a period of care, or during a review, people were asked for feedback about the support they had received. This feedback was analysed to ensure that any areas for improvement were highlighted and acted on in a timely manner.
Is the service caring?
When we spoke with staff they were focussed on the assistance they could give to people to ensure that they would be able to continue to remain in their own homes. We spoke with people who used the service and comments included 'We have been so pleased with them' and 'We had consistent care which was very good'.
We looked at the care plans and daily notes that had been recorded. The language used was positive and needs were recorded accurately and included people's personal wishes about how they wished to be supported. Input from family members was also recorded to ensure that if people benefitted from a specific approach for example, that this was then followed by all staff. When we spoke with staff they explained the ethos of the service and praised the staff team as a whole, with several telling us 'We work together as a team, including the managers'.
Is the service responsive?
People's needs had been assessed before they started using the service. Records confirmed people's religious and ethnic identity, communication skills, factors affecting their support and any risks. Support was designed for each individual to enable them to regain living skills necessary to ensure that they could remain in their own homes following hospital discharge. The nature of the way support was planned meant that it was responsive to each individual. One person told us 'They came and did an assessment, we gave lots of information before the carers came'.
Where medical assistance or intervention was required, this was sought appropriately and staff followed instructions from medical and social care professionals when caring for people.
There was evidence of the provider gathering feedback from staff and people who used the service and action planning and feedback were acted upon on both a local and regional level. The systems in place for monitoring and auditing were being used effectively to ensure that the service responded to people's needs.
Is the service well-led?
Staff had a good understanding of the ethos of the support provided. People told us that they could talk to the manager or staff about any issues. Staff told us they were clear about their roles and responsibilities. They said the management were approachable and that they felt well supported by the manager and other senior staff. One person told us 'We saw the manager several times'. Another person told us 'All the team were supportive'.
There were senior roles in place to fulfil the duties of the manager when the manager was not on duty. This ensured that staff were able to take responsibility for anything that occurred.