Background to this inspection
Updated
30 August 2019
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
Inspection team
The inspection was undertaken by one inspector 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.
Service and service type
Wiltshire Council Reablement Service (Trowbridge Hub) is a domiciliary care agency that provides a therapy led, reablement service to people in their own homes.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
This inspection was announced. We gave the service 48 hours’ notice of the inspection visit to ensure the registered manager would be available to assist with the inspection.
We visited the office location on 1 August 2019, to see the registered manager.
What we did before the inspection
Before the inspection, we reviewed information we had received and held about the service. This included statutory notifications sent to us about events and incidents that had occurred at the service. A notification is information about important events which the service is required to send us by law.
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.
During the inspection
We reviewed people’s support plans and associated care records and information relating to the management of the agency. This included areas such as quality auditing and staff recruitment, training and supervision. To gain feedback about the service, we spoke with five people and four relatives on the telephone. We spoke to four members of staff in the office, the registered manager, the head of service and nominated individual.
After the inspection
We contacted 12 health and social care professionals for their feedback about the service. Seven health and social care professionals responded.
Updated
30 August 2019
Wiltshire Council Reablement Service (Trowbridge Hub) is a domiciliary care agency that provides a therapy led, reablement service to people in their own homes.
Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is to 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
People received support over a period of six to eight weeks or less depending on their progress. During this time, staff worked with people to regain their independence and confidence. This was particularly after an illness or injury.
People were fully assessed to ensure the service was suitable to meet their needs. Within the assessment process, people were able to discuss their expectations of the service and their perceived goals. They were also assessed for any equipment that might help them with their independence.
People were complimentary about the service they received. Their support had enabled them to regain skills such as getting ready for their day and meal preparation. People generally found after their period of support, they no longer needed any registered service.
Each person had a support plan, which detailed their needs. However, the information did not show the stages of people’s reablement journey and some areas lacked detail. The registered manager told us there were plans to improve the information to ensure it was more person centred.
Each person’s progress and goals were discussed at a weekly meeting. This enabled any support to be amended in a timely manner.
Staff had not always signed the medicine administration record to show they had supported a person to take their medicines. The registered manager had identified this shortfall and had asked staff what improvements were needed. The records were amended, and errors reduced. All other aspects of people’s medicines were safely managed.
People were consulted about their support and encouraged to give their views about the service. This was within surveys or via telephone discussions. All written information was available within different formats such as large font, braille or other languages.
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.
People were complimentary about the staff and their rights to privacy and dignity were promoted. There was a very strong ethos of promoting independence and enabling people to reach their potential. This ethos was adopted throughout the staff team.
Staff were safely recruited and there were enough staff to support people. Staff received a range of training to ensure they had the knowledge and skills to do their job. There were opportunities for career progression and to complete professional qualifications. However, the registered manager recognised some training had not been delivered in a timely manner due to the changing needs of the service. Further training had been arranged to address this.
There was a clear management structure and staff were aware of their role and responsibilities. Regular audits took place to assess the quality and safety of the service and there were overviews to identify potential trends.
Reflective practice took place to improve service delivery. This was particularly apparent whilst the service was developing and becoming established.
Rating at last inspection
This service was registered with us on 30/08/2018 and this is the first inspection.
Why we inspected
This was a planned comprehensive inspection.
Follow up: We will monitor all intelligence about the service and complete another inspection in line with this and our frequency of inspection guidance.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk