Home Enabling Service is a domiciliary care service which provides personal care to people living in their own houses and flats in the community in the Rotherham area. The main part of the service provides support reablement packages designed to be short term, typically to assist people regaining independence after an injury or illness. The second part of the service is known as ‘Shared Lives’, which provides opportunities for adults to live or spend time with approved. Shared Lives ‘carers’ [this is the term used throughout the report to describe people caring for people as part of the Shared Lives scheme] and their families. The service mainly provides support to people in the following areas: learning disabilities, physical disabilities, sensory needs, older people, and people living with dementia.

At the time of our inspection the service was supporting 82 people who required assistance with their personal care needs.

The inspection took place on 7 and 15 January 2019 with the registered provider being given short notice of the visits to the office, in line with our current methodology for inspecting domiciliary care agencies. At our last inspection in June 2016 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.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for ‘Home Enabling Service’ on our website at www.cqc.org.uk’

The service had two registered managers in post at the time of our inspection. One leading the reablement team and one the shared lives team. 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 and associated Regulations about how the service is run.

People were very happy with the quality of the care the service provided and how it was run. They told us care workers met their needs and supported them to meet their aims and objectives. People told us their privacy and dignity was always respected and staff were competent in their work, caring, kind, friendly and helpful.

There were systems in place to reduce the risk of abuse and to assess and monitor potential risks to individual people. Concerns, complaints, incidents and accidents were being effectively monitored and analysed to reduce risks to people.

Recruitment processes helped the employer make safer recruitment decisions when employing staff. Care workers and shared life carers had undertaken a structured induction and ongoing training and support, to help develop their knowledge and skills so they could effectively meet people’s needs.

Medications were administered or prompted by staff who had been trained to carry out this role and whose competency was periodically checked.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. People had consented to their planned care and support. Staff understood the importance of gaining people’s consent and acting in their best interest.

People had been involved in care assessments and developing their support plans. Plans provided clear guidance to staff and carers, which assisted them to support people in the way they preferred.

People were enabled to raise complaints and concerns. The people we spoke with told us they would feel comfortable raising concerns, if they had any. When concerns had been raised the correct procedure had been used to record, investigate and resolve issues.

There were systems in place to continuously assess and monitor the quality of the service. This included obtaining people’s views and checking staff were following the correc

This inspection took place on the 29 and 30 June 2016 and was announced. The provider was given short notice of the visit. This was because we needed to be sure key staff would be available at the office. The service was previously inspected in February 2014, when no breaches of legal requirements were identified.

There was a registered manager who managed the day to day operations 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.

Home Enabling Service is a domiciliary care service, providing care to people in their own homes across the borough of Rotherham. Support packages are designed to be short term, typically to assist people regaining independence after an injury or illness. At the time of the inspection there were 61 people using the service.

We received some very good feedback from people we spoke with. They told us that the service was reliable and the staff were caring and respectful. One person said, “They saved our life. We were lost and did not know how we were going to cope. They [the staff] came, asked us what help we needed and it was there when we came home from hospital.”

People told us they felt safe knowing that they [the staff] would do their best to enable them to become independent again. We saw there were robust systems in place to manage risks to people. For example, the service organised for a key safe to be fitted which meant staff could gain access and the person did not have to leave their door unlocked. This demonstrated that they had acted on the information gained at the assessment to ensure the person was safe when they returned home from a stay in hospital.

The service actively involved people in their assessment which enabled them to make choices about the support they needed to help them back to independence. The service was flexible which meant times of visits could change if people had to attend hospital or any other health related appointments.

The registered manager told us that all staff were trained to undertake risk assessments which meant there was no delay in identifying equipment to help re-enable people who used the service. The staff were able to liaise with people’s GP’s and occupational therapist to make sure people obtained the equipment required to keep them safe while maintaining their independence.

A continual review of people’s support meant that the service could change the length of the visits as required to enable people to reach their full level of independence. Support staff were also able to signpost people to other agencies if they felt a person needed ongoing support once the programme of re-enablement was complete.

People were supported to take their medication safely and the care records identified the level of support needed for each person. The service ensured that priority for visits were given to support medication calls to ensure that people’s medication needs was given at the time prescribed. For example, Parkinson specific medications which may be needed to kick start people’s mobility. Also people who were required to take their insulin at a specific time.

Staff told us they felt supported and they could raise any concerns with the registered manager and felt that they were listened to. People told us they were aware of the complaints procedure and said staff would assist them if they needed to use it. People told us that they had contacted the office and found staff were helpful when dealing with any questions about the service.

People told us that staff were very professional and always respected their dignity when undertaking personal care tasks. Staff we spoke with were highly motivated to provide a good service to people they supported.

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We inspected this outcome because when we inspected the service in June 2013 concerns were identified in this area. At this inspection, which took place to follow up these concerns, we found the provider had robust systems in place for monitoring the quality of service delivery and responding to feedback.

People’s views and experiences were taken into account in the way the service was provided in relation to their care. One person’s relative told us: “They encouraged her to make her own decisions and be as independent as possible.” Another relative said: “All the carers were respectful of my father.”

People’s needs were assessed and care and treatment was planned and delivered in line with their individual care plan. The files we checked contained thorough, detailed care plans relating to all aspects of each person's care needs. They contained detailed information setting out exactly how each person should be supported to ensure that their needs were met.

All staff had received training in abuse awareness and protecting vulnerable adults in the previous year. There were resources available to all staff in relation to safeguarding. We asked a staff member about their knowledge of safeguarding and they told us that they had received relevant training.

Staff we spoke with told us that they felt well supported by their line managers. One staff member told us that their line manager was always accessible should they need to discuss any concerns. Another told us that the team they worked in was a very supportive environment.

The provider did not have effective arrangements in place for monitoring and assessing the quality of care people received. The registered manager checked to ensure things were happening, but did not have systems for scrutinizing quality.