Archived: Community Response Team South East

There was a registered manager in post who was responsible for the day to day running of the service. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, 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.

At our previous inspection we found a breach of Regulation 16 (Registration) Regulations 2009. Notification of death of a person who uses services. The registered person failed to notify the Commission without delay of a death of a service user whilst the services were being provided in the carrying on of a regulated activity. We also found a breach of Regulation 18 (Registration) Regulations 2009 Notifications of other incidents. This regulation was not being met because the registered person did not notify the Care Quality Commission without delay of any abuse or allegation of abuse in relation to a service user. At this inspection we found improvements had been made and the provider had met the requirements of both Regulations.

The management provided good leadership and were actively working to drive improvement. Feedback from people, staff and relatives confirmed the management were respected and led by example.

Staff told us that they felt their achievements were recognised and that they felt valued. Staff had a clear understanding of their roles and responsibilities. We observed staff were confident in performing their jobs and when speaking with people, other staff and the registered manager.

People, their families and professionals told us they felt the service was safe. Staff had received safeguarding training and had their competency in this subject checked. They were aware of the types of abuse that could happen to people, what signs to look out for and their responsibilities for reporting any concerns.

The registered manager had a good understanding of their responsibilities to notify the CQC of important events that happened within the service. People and their families had been given information so that they knew what to expect from the service.

People who required assistance with their medicines were supported by appropriately skilled and qualified staff. They had received training and competency checks and had a good understanding of the risks associated with the medicine people were taking.

New care staff completed the Care Certificate. The Care Certificate is a national induction for people working in health and social care who do not already have relevant training. Staff consistently told us the training they received supported them to meet the needs of people safely.

Staff said they felt supported in their role. They told us they received regular supervision and had a yearly appraisal.

Staffing levels met the needs of the people using the service. Staff had been recruited safely.

Staff acted in accordance with the principles of the Mental Capacity Act (MCA) 2005.

People had good access to healthcare. This included GPs, district nurses, occupational therapists opticians and chiropodists.

People, their families and other professionals had been involved in an assessment before the service provided any support. The assessment had been used to create care and support plans that addressed people’s individual identified needs. Staff demonstrated a good understanding of the actions they needed to take to support people.

A complaints procedure was in place and people told us they were confident and concerns would be dealt with appropriately by management.

Staff were supported and encouraged to share ideas about how the service could be improved and had been pro-active in supporting changes. They spoke enthusiastically about the positive teamwork and support they received.

The provider had good systems in place to support staff to learn lessons and implement change.

We carried out an announced comprehensive inspection of this service on 22 July 2014. Two breaches of the legal requirements were found. The registered person did not notify the Commission of any abuse or allegation in relation to a service user and did not have an effective operation in place to regularly assess and monitor the service provided. We requested the provider send us an action plan to tell us what they would do to meet legal requirements in relation to these breaches. An action plan was received and the provider informed us they would meet the first breach by the 23 February 2015 and the second breach by 1 March 2015.

Community Response Team (CRT) south east is a free service provided by Hampshire Local Authority which provides short term, up to six weeks, support for adults. The service supports people who have been discharged from hospital and or require a period of enablement to help them to become as independent as they can whilst living in their own homes. Where people require additional support following CRT intervention they are supported to move onto another care agency that provides long term support to them in their own homes. At the time of our inspection there were 48 people using the service. The amount of people using the service could change on a weekly basis dependent upon the needs of the people. There were 50 community reablement assistants, nine senior community reablement assistants, twelve team leaders and three administrative assistants providing support.

There was a registered manager in post that was responsible for the day to day running of the service. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, 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. At the time of the inspection the registered manager was on annual leave.

At the inspection on 28 and 29 June 2016 we found the service did not follow their legal obligation to send notifications to the Commission and as a result the Commission were not aware if safeguarding referrals were being effectively monitored. There was a system to manage and report, incidents, and safeguarding concerns. However the Commission were not notified of these concerns and an expected death.

Systems were in place to continually review incidents, accidents and safeguarding concerns and this information was shared with the registered manager. Quality assurance processes took place and an emergency plan was in place for any disruption to the service.

People were safe because staff knew how to keep people safe from harm and could recognise signs and symptoms of potential abuse. Risk assessments were in place to identify risks to people. There were enough staff to keep people safe and meet their needs. Safe recruitment practices were followed. There were clear procedures for supporting people with their medicines.

Staff had the skills and experience to ensure people received effective care and support. Staff were well supported and completed regular training courses. Staff demonstrated a good understanding of their roles and responsibilities under the Mental Capacity Act 2005 and put them into practice to protect people. People were supported with food and fluids and to maintain good health.

The staff provided a professional service which was kind, caring and respectful. People’s dignity and privacy were protected at all times and people were involved in their care and support to help increase their independence as much as possible.

People’s needs were regularly assessed and they were involved in the assessment of needs. Care plans were personalised and updated regularly as and when people’s needs changed. People’s views were always taken into account and they consented to their care.

People did not have any complaints about the service but knew how to complain if they had any concerns. Complaints received had been dealt with.

Good leadership could be seen at all levels.

We found two breaches of the Care Quality Commission (Registration) Regulations 2009. One was a continued breach of Regulation 18. You can see what action we told the provider to take at the back of the full version of this report.