North Lincolnshire Council Home First Residential

Updated 22 November 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 was a comprehensive inspection and took place on 27 and 28 September 2018. The inspection was unannounced on the first day and was announced on the second day. The inspection was completed by one adult social care inspector.

We looked at information we held about the provider and the service, this included statutory notifications. Statutory notifications include information about important events, which the provider is required to send us. We used this information to help us plan this inspection.

We contacted Healthwatch and used their feedback to aid the inspection. 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 information 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.

During the inspection we spoke with the registered manager, four staff, a chef, two social care professionals and one health care professional. We received feedback from six people who used the service and five relatives.

We looked at a four care plans, six medicine records, daily records and monitoring charts. During the inspection we completed observations. We also looked at information regarding the running of the service which included staff recruitment, induction and training. We looked at staff rotas, policies and procedures, audits and feedback the service received.

After the inspection we contacted the local safeguarding team and used their feedback to aid the inspection.

Updated 22 November 2018

North Lincolnshire Council Home First Residential is a rehabilitation and re-ablement service registered to provide personal care for up to 30 people. The service is located on one floor and shares the building with community services. The service aims to facilitate timely discharges from hospital and supports people to return home. In order to do this, people who use the service receive support from on-site nurses, occupational therapists, physiotherapists and the social work team. They are supported to improve their independence through regaining skills and abilities. On average, people who use the service stay for 14 days. At the time of our inspection, 29 people were using the service.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good 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.

People continued to be protected from harm and abuse and risks to people safety were managed whilst respecting their freedom. People received their medicines as prescribed and systems were in place to prevent the spread of infection. The environment was clean, comfortable and aided people’s rehabilitation. Lessons were learned from accidents and incidents. Staffing levels and recruitment processes remained safe.

Staff had the skills and knowledge to meet people’s needs and support them to achieve positive outcomes. Training needs were identified through appraisals and supervision which, was used to embed learning. People’s dietary needs were met and they were supported to access health services in a timely manner. Staff sought consent from people.

People were supported by staff who showed kindness, respect and compassion and built positive relationships with people in a short amount of time. Equality and diversity was considered and people were included in decisions, care planning and activities. Staff maintained people’s privacy, dignity and confidentiality whilst promoting their independence.

Staff were responsive to people’s changing health needs and ensured care plans were reviewed and updated accordingly. People were included in activities that reduced isolation and aided their rehabilitation. People were respected as individuals and support was available to ensure people had pain-free and dignified deaths. A policy was in place to provide information in line with the accessible information standards (AIS). Complaints were responded to in line with the providers policy.

The registered manager led by example and promoted an open, honest and inclusive culture. People and staff were included in the development of the service. The service worked closely with other organisations and was integrated within the local community.

Audits were completed but had not identified or addressed all shortfalls in quality. Policies were in place but now always followed. We have made a recommendation about this.

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.

Further information is in the detailed findings below