Archived: Peripatetic Service

Updated 15 January 2019

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

The inspection was announced. We gave the service a few days’ notice of the inspection site visit. This was because we needed to make arrangements with the provider to speak to people who used the service prior to visiting the office location. The inspection took place between 16 November and 4 December 2018. On 23 November 2018 we visited the provider’s office to review care records and policies and procedures. Between 16 November and 4 December 2018, we made phone calls to people who used the service and staff.

The inspection team consisted of one inspector.

Before the inspection we reviewed information available to us about this service. We used information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We also reviewed safeguarding alerts, ‘share your experience’ forms and notifications that had been sent to us. A notification is information about important events which the provider is required to send us by law. We also contacted the local authority commissioning and safeguarding teams to gain their feedback about the service.

During the inspection we spoke with four people who used the service and three relatives. We spoke with three care workers, the registered manager and the registered manager of the reablement service who worked closely with the service. We reviewed three people’s care records and other records relating to the management of the service such as training records, rotas and audits.

Updated 15 January 2019

This Peripatetic service also known as the business continuity team is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to older adults.

The Peripatetic service provides support to other council services who support people following hospital discharge to help ensure these services continued to function, do not become overloaded and do not compromise the flow of patients out of hospital. It was also available to assist and manage care packages in other crisis situations such as private provider failure. At the time of the inspection, the service was working closely with the reablement team, managing some of their stable packages to allow the reablement service to pick up new care packages. The peripatetic service provided short term care for a period from a few days to a few weeks, visiting them in their homes to provide personal care and support.

The inspection took place between 16 November and 4 December 2018 and was announced. At the time of the inspection there were 7 people using the service.

The service was last inspected in March 2016 and awarded a rating of Good. However, the service had changed considerably since the last inspection with a large part of its operations being re-registered as two additional services which are now inspected separately.

At this inspection we rated the service Requires Improvement. People and relatives all provided good feedback about the service and said care and support was good. However, since the service had changed its function, it had not adapted its governance systems including policies, operational procedures and statement of purpose to reflect the new way the service was operating. People were unclear they were receiving care from the peripatetic service and there was a lack of information provided to people to inform them who they were being care for by.

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.

People said they felt safe using the service. Risk assessment documents were in place which staff followed to help keep people safe. There were enough staff deployed to ensure people received reliable and consistent care.

Staff were recruited safely. Staff received a good range of training and told us they felt well supported. People said staff were appropriately skilled.

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 service worked with other council services to ensure people’s needs were assessed and appropriate care provided. They liaised with a range of health and social care professionals to meet people’s needs.

People consistently said staff were kind and caring and treated them with dignity and respect. People said they felt listened to by staff and involved in their care.

A system was in place to log, investigate and respond to complaints, however there was no separation of complaints systems between the peripatetic service and reablement service to ensure people were clear what they were complaining about.

People’s feedback was sought on the service, but again there was no separation of feedback between the reablement and peripatetic service meaning the service was unable to measure user satisfaction specifically to the peripatetic service.

People, relatives and staff praised the overall quality of care and said the service was well led.

We found breaches of two regulations. You can see what action we asked the provider to take at the back of the full version of this report.