Archived: HaRT Havering Reablement Service

Updated 24 January 2017

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 was 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 8 December 2016. This was an announced inspection, which meant the provider knew we would be visiting. This was because it was a domiciliary care agency and we wanted to make sure that the registered manager or someone who could act on their behalf would be available.

The inspection team consisted of two adult social care inspectors and an expert 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.

Before the inspection, we reviewed the information we held about the service. We looked at any complaints we received and statutory notifications sent to us by the provider. A notification is information about important events which the provider is required to tell us about by law.

During the inspection, we spoke with the registered manager, a deputy manager, a care coordinator, a recruitment officer and an office administrator. We also spoke with ten people who used the service by telephone. After the inspection, we spoke with three reablement support staff by telephone.

We looked at documentation, which included ten people’s care plans, including risk assessments; six support staff recruitment files, training files and other records relating to the management of the service.

Updated 24 January 2017

This inspection took place on 8 December 2016. The provider was given 48 hours’ notice because the service provides a domiciliary care service in people’s own homes and we needed to be sure that someone would be available to assist with the inspection. We last inspected the service in September 2013 and found that the service was meeting the required standards.

The Havering Reablement Service is provided by Family Mosaic Housing and delivers personal care and support to people in their own homes, within the London Borough of Havering. At the time of our inspection, approximately 79 people were using the service. The service was employing 70 reablement support workers who provided support to people living in the community.

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 care homes, 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.

A reablement service aims to provide short term support to people in order for them to stay independent in their own home by regaining daily living skills and improving their quality of life, often following a stay in hospital.

We found that systems were in place to ensure people were protected from the risk of abuse. Staff were aware of the different types of abuse and how to respond to any concerns.

People received reablement care at home from staff who understood their needs. Not all risks to people were effectively managed because risk assessments were incomplete for staff to minimise identified risks. This meant people were not being effectively protected.

When required, staff administered people’s medicines and had received the appropriate training to do this.

The provider had sufficient numbers of staff available to provide support to people, although initial assessments had not taken place recently within the stipulated 48 hours of referral, due to staff shortages. Staff had been recruited following appropriate checks with the Disclosure and Barring Service.

The service did not always monitor staff to check that they had arrived to carry out personal care to people in the community. We have made a recommendation about logging calls and ensuring staff are able to manage their rotas..

Staff received training in a number of areas that were important for them to be able to carry out their roles. They told us that they were provided opportunities to develop. However, some staff did not always feel able to raise any concerns and were not always confident that these would be addressed satisfactorily by the management team.

People were treated with privacy and dignity. They were listened to by staff and were involved in making decisions about their care and support. People were supported to meet their nutritional needs. They were registered with health care professionals and staff contacted them in emergencies. People told us they received support from staff who encouraged them to remain as independent as possible.

We found that care plans were task led and not person centred. They did not contain details of people’s preferences and choices. This meant people were not receiving appropriate personalised care.

A complaints procedure was in place. People and their relatives were able to make complaints, express their views and give feedback about their care and support. They told us they could raise any issues and that action would be taken by the management team.

The provider undertook audits and checks to look at where improvements could be made. We noted that some areas of the service required further progress. Two week reviews were not always carried out or recorded. We also found that exit interviews did not always take place with people after they had ceased using the service, as required by the provider’s procedures.

We found three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.