Blackburn with Darwen Reablement Service and Home First Service

Blackburn with Darwen Reablement and Home First is a domiciliary type service providing care and support to people in their own homes with reablement, and also when they have been discharged from hospital. At the time of the inspection, 44 people were using the service.

Not 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.

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

Recruitment systems and processes were not always robust. For example, gaps in employment were not always explained and references were not always sought from previous employers where a person had a history of working with vulnerable adults.

None of the people we spoke with knew who the registered managers were. However, people knew they could contact team co-ordinators and reviewing assessment officers if they had any concerns. The provider had quality assurance processes in place. However, it was not always evident how findings from audits and feedback from people had been used to ensure regulatory requirements were met. Our findings in relation to recruitment showed a lack of scrutiny by the provider to ensure safe recruitment practices had always been followed.

We received mixed responses from staff in regard to staffing levels. Some staff felt there was enough and others stated staffing levels were low. We recognised the impact the pandemic was having on the service which had also been supporting care homes at times of crisis. Some people we spoke with told us staff did not always turn up when expected.

We have made a recommendation about staffing and call times.

We saw training courses the service had deemed mandatory and were to be completed on an annual basis. However, we found not all staff had completed these within the annual timeline as set by the provider. People felt staff were knowledgeable and had the appropriate skills to meet their needs. Records we looked at showed supervisions were not always being completed in full.

We have made a recommendation about training and supervisions.

People were protected from the risk of harm, abuse or discrimination. Although not all staff were up to date with safeguarding training, all staff spoken with were aware of their responsibilities to report any concerns and who to report to. The provider had a robust safeguarding policy and procedure in place to guide staff in their roles.

The provider maintained effective systems to ensure potential risks to people's safety and wellbeing had been assessed. Care records we reviewed showed personalised risk assessments relating to people’s health and welfare. Medicines were safely managed. The provider had policies in place to support staff to administer medicines safely. Due to the nature of the service, the emphasis was on supporting people to self-administer their medicines whenever possible. The provider had systems in place to prevent and control infections, including COVID-19.

The registered managers and staff all worked closely with other agencies to ensure people were in receipt of consistent care which achieved good outcomes. People’s healthcare needs were monitored and managed. Details of any medical conditions were included in people’s care records. 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.

Everyone we spoke with told us they were well treated by kind and caring staff. Care records documented people's preferences and information about their backgrounds. Staff told us they used this information to develop caring relationships with the people they supported. Staff had completed training in equality and diversity and best practice in supporting people who are LGBTQ+. The focus of the service was on promoting people’s independence as far as possible and helping them to regain skills and confidence in their own homes. The service supported people to express their views and to be involved in the development of care plans.

People received care and support that was personalised to their needs, preferences and choices. People’s communication needs were assessed and recorded as part of the care planning process. The provider had a policy for the management of complaints; this included timescales for a response and the contact details for relevant external organisations.

Records and statistics reviewed were extremely positive and showed 55% of people using the reablement part of the service fully regained their independence. The provider promoted and encouraged candour through openness and honesty. The provider had several methods of engaging with people who used the service and staff to gather their feedback. The service worked with a range of professionals to ensure people received safe and coordinated care.

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

Rating at last inspection

Blackburn with Darwen Reablement Service and Home First Service re-located to the same location to make one newly registered service. This service was registered on 18 April 2019. This was the first inspection for the newly formed service.

The last rating for Home First was good (published 21 May 2019). The last rating for Reablement Service was good (published 23 April 2018).

Why we inspected

This was a planned inspection based on the registration of the service.

Enforcement

We have identified breaches in relation to recruitment and governance at this inspection. Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.