About the service:

• Home Support Service, known as Short Term Intervention Team (STIT), is a domiciliary care agency registered to provide personal care to people in their own homes.

• Home Support Service primarily provide a reablement service. The reablement service provides people with support for up to six weeks to help them live independently following discharge from hospital. In some instances people receive ‘extended reablement’ longer than six weeks until a permanent care provider can be found. At the time of our inspection there were 242 people receiving support with personal care from the service.

People’s experience of using this service:

• Systems and processes were in place and followed to keep people safe.

• Risks relating to people, for example, for moving and handling and medication were assessed and actions in place to mitigate these.

• People were supported to remain as independent as possible.

• Infection control practices were described in people’s care and support plans.

• Accidents and incidents were monitored and analysed. Learning from these were discussed at group meetings with staff.

• People’s needs and choices were assessed in line with current legislation. People had consented to their care and treatment.

• Staff received an induction and training was provided.

• Advice was sought from a range of health professionals to ensure people had timely access to healthcare services.

• People’s individual needs were considered and appropriate equipment sought to support people’s needs.

• The service received lots of compliments and thank-you cards praising staff.

• People were involved in planning their care needs.

• Care plans were person-centred and contained detailed information about people’s preferences and lives.

• Information packs in people’s homes contained information about how to contact the service, make comments, complain and complete surveys about the service they had received.

• The service works in partnership with other providers and closely with the health service to deliver seamless care to people using the service. The service is running pilots to improve the quality of the service.

• We have made a recommendation that the provider amends the service’s statement of purpose and registration with CQC as these were not consistent with the service provided.

Rating at last inspection:

• At our last inspection the service was rated good at the last inspection (4 November 2016).

Why we inspected:

• This inspection was part of our scheduled plan of visiting services to check the safety and quality of care people receive.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

This inspection took place on the 14 and 29 September 2016 and was unannounced. The agency was previously inspected in October 2013, and at the time was meeting all regulations assessed during the inspection.

The service had 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 Support Service is an agency providing personal care to people in their own homes. The service provided is a re-enablement service and provided care and support to people when they came out of hospital for a period up to six weeks. During this time people were assessed to determine if they could manage on their own or required a permanent care package, which would then be provide by a different provider. The service was provided throughout Sheffield. The service supported between 300 and 500 people, this changed weekly as on average 80 new packages were taken each week and others discharged. At the time of our inspection 389 people were receiving a package of care. Length of visits depended on people and the frequency of visits ranged from one visit per week to four visits per day depending on people individual needs. Visits would be reduced as people improved and their needs decreased.

We received positive feedback from people we spoke with. They told us that, “They are willing, kind and very courteous; really happy with them.” Another person said, “Nothing is too much trouble, I can’t complain about anything.”

People told us they felt safe when staff visited and staff did their best to enable them to maintain their independence. We saw there were robust systems in place to manage risks to people. For example, we saw staff had made referrals to the falls team and referrals for equipment to keep people safe. This demonstrated that they had acted on the information gained at the assessment which ensured people were safe.

The service actively involved people in their assessment. This was carried out on the day they were discharged form hospital. Assessment officers met the people at their home with family members to go through the support required. This meant peoples choices, likes, dislikes and decisions were incorporated into the plan of care and support.

The registered manager told us that all staff were trained to undertake risk assessments which meant they could identify any issues both in the home environment or risks to people’s safety while in the community. The service also had clear lone worker policies which protected staff when working alone in the community.

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, pain relief medication which may be needed to ensure people were pain free to mobilise and be able to support themselves. However, we identified that medication procedures and systems required some improvements.

People and their relatives knew how to make a complaint and were able to share their views and opinions about the service they received. The provider listened to all complaints and made sure people were confident their complaints would be taken seriously. There were also surveys in place to allow people and their relatives the opportunity to feedback about the care and treatment they received.

The service promoted an open and honest culture and the managers and care co-ordinators were transparent in their discussions with us. Staff spoke highly of their teams and felt well supported by their care co-ordinators. The s

We visited the service on 9 October 2013 as part of our scheduled inspection programme. As part of our inspection visit we telephoned 40 people, their relatives or representatives. We were also able to speak directly with fifteen people who used the service and seven relatives of people who used the service. We also spoke with two care workers and two managers.

Before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes.

Care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. People who used the service told us that they were happy with the care and support they received at Home Support Service. One person told us, “It’s been brilliant, they’ve [care workers] been very good.”

People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines.

People were cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard.

The provider had an effective system to regularly assess and monitor the quality of service that people receive.

On 18 September 2012 we visited the office and carried out an inspection. On 19 September we telephoned five people who used the service and their close relatives to seek their views. The people who used the service said that they were happy with the care and support they received. They said they felt confident to take any concerns to the managers and they made several positive comments about the staff.

People said that staff respected their privacy and dignity and encouraged them to be as independent as possible. Comments included, “The care workers are cheerful and reassuring” and “My carer is lovely.”

People’s relatives told us they were happy with the service provided and the care workers were very reliable and supportive. One person’s relative said the particular support manager they spoke with regularly was ‘down to earth’, helpful and responsive.