Care at Home Reablement Service

Updated 20 December 2023

The inspection

We carried out this performance review and assessment under Section 46 of the Health and Social Care Act 2008 (the Act). We checked whether the provider was meeting the legal requirements of the regulations associated with the Act and looked at the quality of the service to provide a rating.

Unlike our standard approach to assessing performance, we did not physically visit the office of the location. This is a new approach we have introduced to reviewing and assessing performance of some care at home providers. Instead of visiting the office location we use technology such as electronic file sharing and video or phone calls to engage with people using the service and staff.

Inspection team

The inspection was carried out by an operations manager and 2 Experts by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

Inspection activity started on 7 November 2023 and ended on 6 December 2023. We contacted people and their relatives on 13, 14 and 15 November 2023.

What we did before the inspection

We reviewed the information we held about the service including information submitted to CQC by the provider about serious injuries or events. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections.

We sought feedback from the local authority contracts monitoring and safeguarding adults teams and reviewed the information they provided. We contacted the local Healthwatch for their feedback. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used all of this information to plan our inspection.

During the inspection

This performance review and assessment was carried out without a visit to the location’s office. We used technology such as telephone calls to enable us to engage with people using the service and staff, and electronic file sharing to enable us to review documentation. The inspection activity started on 7 November 2023 and ended on 6 December 2023. We contacted people and their relatives on 13, 14 and 15 November. We requested feedback from staff via email.

We spoke with 11 people who used the service and 18 relatives about their experience of the care provided. We received feedback from 34 members of care staff. We spoke with the registered manager to discuss the inspection findings and deliver feedback.

We reviewed a range of records. This included 6 people's complete care records and medication records for 5 people. We looked at 3 staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were also reviewed.

Updated 20 December 2023

About the service

Care at Home Reablement Service is a domiciliary care agency providing short-term personal care and support to people living in their own homes. Everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided. At the time of inspection 143 people were receiving personal care.

People’s experience of using this service and what we found

People and relatives we spoke with, gave positive feedback about the service and the staff team. A relative discussed their experience of the service provided. They said, "I have felt there is nothing [staff] haven’t done. They are always willing and very accommodating. We feel they are invested in his well-being. We trust them completely.”

People were supported by a consistent staff team who had the relevant training and qualifications to safely support them. Staffing levels were safe and were reviewed regularly by the registered manager. People told us their calls were regular and there was flexibility if they needed to change their visit times to attend health appointments. A relative commented, “[Person] loves talking to [staff], she looks forward to them coming in. She knows them all from a small group that rotates. They are kind and caring, they are friendly she is very comfortable. They always ask, ‘anything else you need’. They are considerate and respectful.”

Risks people may face were fully identified and mitigated. Medicines were safely managed, and the service worked in partnership with other health care professionals to make sure people received a continuous level of support.

People had person-centred care plans which were created from holistic assessments of people's needs. People told us they felt safe with the support provided by staff. Relatives commented that they did not have to worry about people’s safety or well-being, as the staff were very kind and caring.

Staff had a positive relationship with the registered manager and felt able to provide feedback regularly about the service. A staff member told us, “I feel that the registered manager is a proactive manager who is also involved in the day-to-day work as required. She is approachable and cares about the service we provide to adults and the welfare of the staff.” The quality and assurance systems in place allowed for effective monitoring of the service by the registered manager and provider.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Staff had access to PPE and followed best practice guidance and the provider's policy in relation to infection prevention and control. Staff received appropriate training and were positive about the range of training modules available.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 31 August 2018).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

As a result, we undertook a focused inspection to review the key questions of safe and well-led only. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has remained good based on the findings of this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Care at Home Reablement Service on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

This was an ‘inspection using remote technology’. This means we did not visit the office location and instead used technology such as electronic file sharing to gather information, and video and phone calls to engage with people using the service as part of this performance review and assessment.