Archived: Short Term Assessment Reablement and Telecare (START)

Updated 21 July 2018

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 took place on 30, 31 May and 1 June 2018 and was announced. One inspector and an assistant inspector visited the service on the first day of inspection. On the second day, one inspector visited people in their own homes and on the third date an expert by experience telephoned people and relatives who used the service.

We met with three people and spoke with six people using the reablement service to learn about their experiences. We also spoke with two relatives, six staff including the acting manager and received written feedback from 15 health and social care professionals.

We reviewed three people’s support plans and records in full. We also looked at four staff’s supervision and training files, case studies and other records relating to how the service was managed.

Before the inspection, we reviewed the information we held about the organisation including the Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We reviewed the CQC survey responses from people, staff and community professionals.

Updated 21 July 2018

Short Term Assessment, Reablement and Telecare (START) provides reablement support to a wide range of people in their home following either a hospital admission, or a change to the person’s ability or independence. The service supported people to regain lost skills, learn new ones, and generally increase their ability and independence. The service is not time specific and provides support in set time slots over a 24 hour period. This is so staff can support people at the pace that promotes the person’s independence. At the time of the inspection the service was supporting 17 people.

This inspection took place on 30, 31 May and 1 June 2018 and was announced. The service had previously been inspected in January 2017 at their previous address.

At our last inspection we rated the service outstanding. At this inspection we found the evidence continued to support the rating of outstanding and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

There was not a registered manager in post they left the service one week before the inspection. The deputy manager was acting as manager. They had worked at the service since it was first established in 2014. A registered manager is a person who has registered with the Care Quality Commission to manage the service. The provider is currently recruiting to the registered manager’s post. 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.

We received some outstanding feedback about START. Without exception, people, their relatives and health and social care professionals told us they were extremely happy with the care and support provided by START.

People were placed at the heart of the service. Each person had a small team who they knew well. People wrote and directed their support plans with staff. Support plans contained highly personalised information about what was important to the person, what mattered to them, what they would like their team to know and do, and the help and support they needed.

People consistently told us they felt safe and there was an extremely proactive approach to safeguarding. Staff involved people in looking at innovative approaches to safeguarding. This supported positive risk-taking so people could have full control over their lives.

The service was committed to providing a learning and development programme that nurtured staff's knowledge, skill and professional development. Staff undertook champion roles to promote good practice across the service.

The acting manager of the service was very dedicated in creating and championing a culture within the service that was compassionate and innovative. The service had a proven track record of finding extremely creative solutions to meet people's needs. They had worked in partnership with health and social care professionals to provide a reablement programme that helped reduce avoidable hospital and care home admissions. This was characteristic of a highly responsive service that was quickly able to adapt to meet people's needs.

Staff were caring, compassionate and creative in overcoming obstacles and findings opportunities to go' the extra mile' in order to promote people's independence and wellbeing. People told us they valued their relationships with staff and they were treated with dignity and respect.

START provided outstanding end of life care even though this was not a service they usually provided to people. Staff were dedicated, skilled and extremely empathic in their role.

The service had a strong sense of social responsibility; they played an active role in the community and out of office hours they were able to respond to and support people in crisis. They also worked with the local authority to sign post people to services that reduced social isolation.

There was a clear management structure in place and oversight from the provider. The acting manager and staff team placed a strong emphasis on providing a high quality service and looked for ways to continually improve. The service used feedback and any accidents or incidents as an opportunity to learn and improve. People were consulted about how their care and support was delivered and given opportunities to feed back about how they felt the service was doing.

Further information is in the detailed findings below.