About the service:

Surrey Heath and Farnham Area Reablement Service is a Surrey County Council service. It is a domiciliary care agency located at Surrey Heath Borough Council offices. The service provides short term reablement support and/or domiciliary care to a wide range of people in their home following either a hospital admission, or a change to the person’s ability or independence. The service support people to regain lost skills, learn new ones, and generally increase their ability and independence.

The service also provides support to people living in four extra care schemes where people lived in their own self-contained flats. These schemes were staffed 24 hours a day.

At the time of our inspection there were 26 people receiving personal care from the reablement service and 33 people in the extra care schemes.

Rating at last inspection:

Good (published 2 November 2016).

Why we inspected:

This inspection was a scheduled inspection.

People’s experience of using this service:

People, professionals and their families described the staff as caring, kind and friendly. People were supported 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.

People and relatives told us they were happy with the service, and that staff had a good understanding of their needs and preferences. People were protected from avoidable harm as staff understood how to recognise signs of abuse and the actions needed if abuse was suspected. There were enough staff to provide safe care and recruitment checks had ensured they were suitable to work with vulnerable adults.

Staff understood the actions needed to minimise the risk of any avoidable harm. The service was responsive when things went wrong and reviewed practices in a timely manner. Medicines were administered and managed safely by trained staff.

The service had an open and positive culture that encouraged reablement of people and involvement of their families, staff and other professional organisations. Leadership was positive and promoted good teamwork. People, professional’s and relatives spoke highly about the management and staff had a clear understanding of their roles and responsibilities.

Checks of safety and quality were made to ensure people were protected and received a good quality service. Work to continuously improve was noted and the registered manager was keen to make changes that would impact positively on people's lives.

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

A full description of our findings can be found in the sections below.

Follow up:

We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.

This inspection took place on 30 September and 11 October 2016. The inspection was announced. The provider was given 48 hours’ notice because the location provides a reablement care service and we needed to be sure that someone would be in.

Surrey Heath Reablement Service is a domiciliary care service that provides personal care and support to people in their own home to promote recovery, independence and social inclusion for up to a maximum of six weeks. At the time of the inspection there were 11 people using the service.

There was a registered manager in place. 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.

People were protected against identified risks. The service had in place risk assessments that identified the risk and gave staff guidance on how to minimise the risk. People were protected from the risk of harm and abuse as staff were aware of the different types of abuse and the correct procedure on reporting their concerns. Staff received on-going safeguarding training that equipped them with the skills in dealing with suspected and actual abuse.

People received their medicines safely and in line with good practice. The service carried out assessments of people’s needs around safe medicine management. People were supported to receive their medicine in line with their agreed support plan. Systems in place identified medicine errors and action taken to minimise the risk of unsafe medicine management were effective.

People were not deprived of their liberty unlawfully. Staff had sound knowledge of the Mental Capacity Act 2005 [MCA] and Deprivation of Liberty Safeguards [DoLS]. Staff were aware of the correct procedures when supporting people who were unable to make informed decisions and would follow the legal requirements outlined in the MCA and DoLS.

People received care that was person centred and tailored to their individual needs. Care plans detailed people’s health, care and medical needs and gave staff guidance on how to effectively support people in line with their preferences. People and their relatives were involved in the development of their care plans, which were reviewed daily to ensure they reflected their changing needs. People’s consent to care and treatment was sought prior to care being delivered. People were given information in a manner they understood to enable them to make decisions about their care. Where consent was not given staff followed the correct procedures.

People received support from sufficient numbers of suitably skilled and knowledgeable staff, to meet their needs. The service had robust recruitment procedures in place to ensure staff were safe to work with people using the service. Staff files contained Disclosure and Barring Services [DBS] checks, references and photographic identification. The service matched people’s needs to the number of staff providing their support and this was flexible to meet people’s changing needs. Staff underwent regular training to enhance their skills and knowledge and reflected on their working practices through supervisions and appraisals.

People were encouraged to participate in activities and reduce the risk of social isolation. Staff supported people where possible to access their local community and day centre as agreed in their care package. Staff were aware of the importance of protecting people from the risk of social isolation and shared their concerns with the registered manager where appropriate. People were encouraged to enhance their independence.

People were aware of the procedure to raise their concerns and complaints. People were satisfied that their concerns and complaints would be listened to and action taken to resolve the issue. The

This service is known as Surrey Heath Reablement Service and the provider is Surrey County Council. At the time of our inspection the service was providing care and support to 17 people in their own homes.

Both people that we spoke with told us that they were happy with the support that was provided for them. One person told us, “They are encouraging without being bossy, which I like. They always remind me about me about my pills too”. Another person said, “They’ve got me moving about the place like I never thought possible. I’m ok with the food now too”.

We saw that guidance regarding safeguarding people from abuse was available to staff and that they had received recent relevant training. When asked if they felt safe with staff one person we spoke with told us, “Oh yes. You couldn’t fault them. They have a very relaxed and caring way with them”.

The staff recruitment process was found to be thorough and we noted that the skills and experience of potential staff were tested for their suitability to carry out the role.

We found that there were effective procedures in place to assess and monitor standards of care and support provided also, that the service responded appropriately to feedback.

We observed that there was an effective complaints system in place, although not used, and that people were informed regarding making complaints and comments about the service.