About the service: Home First is a reablement service that provides short term domiciliary care. It provides personal care to adults living in their own houses and flats. At the time of the inspection 48 people received personal care support from the service.

People’s experience of using this service:

Relatives told us family members were made safe by the care they received. Staff told us they had appropriate training, knowledge and support to keep people safe. Staff could tell us how they managed risk and behaviours that challenge while respecting the person and supporting their dignity.

People and relatives felt confident in staff, they told us there was a caring culture within the service and staffing levels were appropriate.

We looked at how the management team planned their rotas. Staff were given travelling time between visits to ensure people received their allocated and appropriate support.

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.

Care plans had been developed with people and their relatives being involved throughout the process. These were reviewed to reflect people’s current needs. The guidelines were under review to ensure outcomes were clear and measurable and promoted the person’s reablement. The management of risk was included within the care plan to minimise the likelihood of preventable harm occurring.

We saw staff files showed the registered manager used the same safe recruitment procedures we found at our last inspection. Staff told us training was ongoing and they received refresher training to update their knowledge.

There was a complaints procedure which was made available to people and their families. People told us they had not made a formal complaint. The service continued to have good oversight of relevant procedures through monitoring and auditing to ensure people received effective support and the service was well led.

The management team used a variety of methods to assess and monitor the quality of the service. These included questionnaires to seek their views about the service provided.

The service worked in partnership with outside agencies, health and social care professionals to ensure people received timely healthcare support.

Rating at last inspection: Good (Report published 03 May 2016)

Why we inspected:

This was a planned inspection based on the rating at the last inspection.

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 issues or concerns are identified, we may inspect sooner.

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

Rapid Response is located in Hereford. It is a crisis management domiciliary care agency which provides support to people in their own homes for a period of up to seven days. On the day of our inspection, there were 20 people using the service.

There was a registered manager at this service. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered providers and registered managers 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 who used the service were involved in their own care and treatment. They were involved in the initial assessment of their needs, and also in the review of their care. People who used the service were treated with dignity and respect and were given choices about how their care was provided. People knew who the registered manager was and how to raise any concerns or complaints. The registered manager and provider monitored how the service was provided.

Staff had the knowledge and training to support people. Staff knew how to recognise potential signs of abuse or harm and systems were in place to guide them in reporting these. Staff had a clear understanding of managing people’s individual risks and an understanding of where the service would not be able to respond to a person’s needs.

The provider and the manager understood the nature and limitations of the service and where the provider could not meet a person’s need, appropriate signposting to other services was provided.