Archived: START

The START service (Short-term assessment reablement team) provides short term domiciliary care and support of up to six weeks to adults living in their own homes following ill-health or an injury. The aim of the service is to enable the person to regain confidence and skills in their daily life. At the time of the inspection there were 12 people living in North Somerset and surrounding area receiving a service.

There was a registered manager in post at the time of this inspection. 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 service provided good support to people and was proactive in ensuring people’s safety and it was responsive to people’s needs. Care workers knew how to identify abuse and knew who to go to should they suspected abuse although one care worker was unsure of who to go to outside of the service. People felt safe and knew their care worker well. People were supported by staff who had satisfactory checks prior to starting their employment.

The service identified risks to people’s safety and was proactive at reducing risks through specialist equipment and technology. Incidents and accidents were managed to prevent similar incidents from occurring again.

People and relatives felt there was a good standard of care and all were happy with the service. Staff felt the managers were approachable and accessible. There was a positive culture that was person-centred and that aimed to enable people to regain their independence. People had their feedback sought at the end of the service and all were complimentary about the care workers and service provided. The service had a complaints procedure in place. No complaints had been received in the last 12 months.

People’s care and support was planned in partnership with them. The service was able to give people encouragement to regain their confidence. Care workers had a consistent rota that provided people with continuity of care staff. People were made aware when there were changes to care workers rotas.

People were happy with how staff administered their medicines and staff had received training to enable them to undertake this task. People and relatives felt positive about the caring attitudes of the care staff. All confirmed they were happy and that staff treated them with kindness and respect.

People were supported by staff who received training in order that they could carry out their roles effectively and competently. Staff had received additional training so that they could provide specialised equipment if required. Care co-ordinators undertook staff supervisions and spot checks and all staff felt well supported and happy in their roles although staff had not received an annual appraisal for over 12 months. The registered manager monitored the quality of the service along with the care co-ordinators.

Below is a summary of what we found. This is based on our visit to the office, discussions with members of the staff and management team and speaking with people who use the service. Please read the full report if you want to see the evidence supporting our summary.

Is the service caring?

People that we spoke with as part of our inspection were positive about the care they received. We received a number of positive comments including "really excellent" and "they are brilliant". People told us that they were treated with dignity and respect.

People had support plans in place to guide staff in delivering support to people in the way that they wished. We noted that on occasion the language used to describe the goals that people were working towards was generalised and didn't always reflect the person centred nature of the care that was being provided

Is the service responsive?

Within people's care records, we saw that 'progress charts' were used to document how people were progressing over time. This supported staff to respond appropriately to people's needs over the course of the care package. Due to the nature of the service provided, people's needs changed frequently. Reviews were carried out at various points throughout the care package so that any changes to the support provided could be made.

Is the service safe?

People that we spoke with reported feeling safe with staff that supported them and trusted them in their homes. Staff confirmed that they had received training to support them in their duty to safeguard vulnerable adults. We heard about specific examples of when staff had taken action to ensure that a person was safe.

Risk assessments were in place to help ensure that people were cared for in a safe and appropriate way. These covered aspects of their care such as moving and handling and the environment.

Is the service effective?

There were systems in place to monitor the quality of the service provided and this included gathering feedback from people who used the service. The manager told us that they were looking at ways to better use the information obtained from feedback forms.

The aim of the service was to support people to achieve greater independence and we saw that this was monitored through clear recording in people's care files.

Is the service well led?

There was a managed register in place at the time of our inspection. Staff told us that they fell well supported in their roles and had good training to enable them to deliver care effectively.

There was a 'team plan' in place that described how the service was seeking to improve the service they provided.