25 February 2016
During a routine inspection
At the time of the inspection, there was a registered manager. 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.
The location was last inspected under the Health and Social Care Act (Regulated Activities) Regulations 2010 on 20 February 2014, where the five outcomes we inspected were compliant. Prior to this, the location was inspected on 19 July 2012 as part of a national thematic review of domiciliary care under section 48 of the Health and Social Care Act. All five outcomes that were inspected were compliant. You can find thematic review reports on our website.
This inspection took place on 25 February 2016 and 26 February 2016 and was announced.
The service was flexible as the number of people that received personal care varied at any given point. This was due to referrals from GPs and other community healthcare professionals, and also because of pressure from local hospitals when there were not always enough beds. This meant that the nature of the service was sometimes unpredictable. The service also operated 24 hours a day, seven days a week and people, relatives, staff and healthcare professionals could telephone the office anytime to receive support. The service worked in conjunction with an NHS Trust to ensure that rehabilitation was fully implemented into people’s care packages. This joint working enabled people to regain their independence as quickly as possible.
We found the Short Term Support and Rehabilitation Team used a comprehensive assessment and care planning process which ensured that people’s care was detailed and holistic. Staff we communicated with were professional and caring and enjoyed working with people who used the service. People’s opinions of the care provided was consistently positive. There were sufficient staff to meet people’s needs at all times, and the service incorporated a robust method of determining correct staff deployment. People’s medicines were administered, stored and documented appropriately.
The service was effective in the care it provided to people. Staff received extensive induction, training, supervision and performance appraisal for their roles. The service had embraced Skills for Care’s ‘Care Certificate’ for new support workers and there was evidence that staff had successfully completed the many components. Staff received regular supervision with their managers and were able to set and achieve their own employment goals. Recruitment and selection of new staff members was robust and ensured safety for people who used the service. Consent was gained from people before care was commenced and people’s right to refuse care was respected.
We found staff were kind and generous. People’s comments mirrored our findings from the inspection. Staff told us they respected people’s privacy and dignity, and ensured that life in their homes was as close as possible to being independent. People had regular opportunities to provide feedback to the service and also have their say in how things operated.
The service was responsive to people’s needs. People had the ability to share their compliments, concerns and complaints in an open and transparent manner. Where feedback was provided by people or relatives, management would undertake necessary investigations, make changes to their care package and report back to the person who complained. The service was successful in its aims, even with the short term period of the care and the high referral rates. This was because there was a goal of people gaining their independence in six weeks. Evidence from the inspection showed in the majority of cases, people were prevented from having to move from their own home, for example, into care homes.
All of the people, relatives, staff and community teams we spoke with as part of the inspection commented that the service was well-led. They felt that the managers took time to listen and would take action to make improvements when needed. People felt that management were approachable and had a visible presence in the operation of the service. We found that the management conducted a range checks to assess the standard of care. This included satisfaction surveys where people consistently rated the service as outstanding.