About the service:

• The service’s office is based in the Maidenhead town hall. Care is provided in the surrounding areas.

• The service provides personal care to adults who are recovering from hospital admissions, receiving rehabilitation or need short term personal care until alternative care arrangements are made.

• The service is operated by a trading body of a local authority. They work in partnership with another local authority to provide personal care to people in the local community.

• At the time of our inspection, 25 people used the service and there were 46 staff.

People’s experience of using this service:

• The provider had made good improvements to the service since our last inspection on 7 November and 8 November 2017.

• Staff received better training, induction, supervision and support so they could effectively perform their roles.

• The registered manager had resolved issues surrounding the recording, investigation and analysis of incidents and accidents.

• Governance of the service had improved. Sufficient better checks and audits were carried out to determine the quality of the care. The provider had promptly acted on some areas already identified for improvement.

• People and relatives told us the staff were kind, friendly and dedicated. They said staff knew people’s needs well.

• The provider used their staff, leaders and management team to achieve compliance with the regulations. The provider had provided the necessary support to enable satisfactory organisational change.

• The service met the characteristics for a rating of “good” in all the key questions we inspected. Therefore, our overall rating for the service after this inspection was “good”.

• More information is in our full report.

Rating at last inspection:

• At our last inspection, the service was rated “requires improvement”. Our last report was published on 21 December 2017.

Why we inspected:

• All services rated “requires improvement” are re-inspected within one year of our prior inspection.

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

Follow up:

• We will continue to monitor the service to ensure that people receive safe, compassionate, high quality care. Further inspections will be planned for future dates.

Our inspection took place on 7 November and 8 November 2017 and was announced.

This is our first inspection of the service because the provider of the service changed in April 2017.

The Short Term Support and Rehabilitation Team provides intermediate care to people recovering from injury or illness that require rehabilitation. The service also prevents unnecessary hospital admissions and provides palliative care. This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats. It provides a service to adults. Only personal care is regulated by us, and our inspection has excluded evidence about other support types offered by the service. Based in the Maidenhead Town Hall, the service only provides support to residents of the Royal Borough of Windsor and Maidenhead. At the time of our inspection, 58 people used the service and there were approximately 40 staff.

The service is required to have a registered manager as part of their conditions of registration with us. 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 our inspection, there was no registered manager. However, the manager had made an application to register with us, which was in progress.

People were protected from abuse and neglect. We found staff knew about risks to people and how to avoid potential harm. Risks related to people’s care were assessed, recorded and mitigated, although sometimes information was not detailed enough. We made a recommendation about the way people’s care information is recorded. We found appropriate numbers of staff were deployed to meet people’s needs. People’s medicines were safely managed.

The service was compliant with the requirements of the Mental Capacity Act 2005 (MCA) and associated codes of practice. People were assisted 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.

Improvement in the amount of staff training, supervision and performance appraisals was required to ensure workers had the necessary knowledge and skills to effectively support people. There was collaborative working with various community healthcare professionals.

The service was caring. There was extensive complimentary feedback from people who used the service. People told us they were able to participate in care planning and reviews and some decisions were made by staff in people’s best interests. People’s privacy and dignity was respected when care was provided to them.

Care plans were person-centred and contained information of how to support people in the right way. We saw there was an appropriate complaints system in place which included the ability for people to contact any office-based staff member or the management team. People and relatives told us they had no current concerns or complaints. We made a recommendation about the collection of feedback from people, relatives and stakeholders.

Accidents and incidents were not recorded in a consistent method and an accurate number of events could not be provided. Provider-level methods of good governance such as audits were not implemented at the service and the quality and safety of the service could not be adequately measured. A small number of service-level checks of the quality of care were in place, and this included a continuous action plan. Regular management and staff meetings were used to share important information. There was a positive workplace culture within the service.