About the service:

Lewisham Enablement Service is a domiciliary care agency. It provides personal care to adults living in their own houses and flats. People also receive support through rehabilitation. This approach helped people to improve their level of independence following an accident or deterioration in their health. Rehabilitation was scheduled to be in place for up to six weeks, therefore the numbers of people using the service could vary each week. At the time of this inspection 90 people were using the service.

People's experience of using this service:

There were established safeguarding processes in place that were followed by staff. This helped staff to manage and report allegations of abuse while protecting people.

Staff assessed people to identify risks to their health and wellbeing. Plans were put in place to manage any risks found.

People were supported by staff when taking medicines. Medicine administration records were completed and audited for accuracy.

The provider and registered manager followed a robust recruitment process to employ suitable staff.

People and relatives contributed to an assessment of their care, treatment and support needs. An individual plan of care was developed and regularly reviewed which detailed people’s individual support requirements.

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.

Staff contacted people and their relatives for their opinions of the service. People gave positive responses and feedback regarding the care and support they received.

People said staff were kind and respectful to them and their dignity and privacy was protected when people received personal care.

People chose the activities that they wanted to take part in, staff supported people to access their local community to continue to enjoy them.

People, relatives and staff said the service was well run. They said that the management team were available when they needed support or advice.

There were established systems used for monitoring and reviewing the quality of care and service delivery.

Rating at last inspection: At the last inspection on 11 August 2016, the service was rated overall Good. (Report published on 16 September 2016).

Why we inspected: This was a planned inspection based on the rating of the service 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 concerning information is received, we may inspect sooner.

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

This inspection took place on 11 August 2016. The provider was given 48 hours’ notice as they are a domiciliary care provider and we needed to be sure staff would be available to meet with us.

This is the first comprehensive inspection of the service by the Care Quality Commission (CQC) since registration in January 2015.

Lewisham Enablement Service provides up to six weeks support to people in their own homes to support them to regain their independence or to learn new skills. At the time of our inspection they were providing support to approximately 86 people. Due to the nature of the support the number of people receiving a service varied from week to week.

The service had a registered manager in post. 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.

Staff knew how to keep people safe from harm and understood their responsibility to report any concerns to their managers. The service carried out and completed risk assessments before people started receiving a service. Care plans and risk assessments were personalised.

People received support from staff with sufficient knowledge and experience to meet their needs safely. The service monitored and reviewed people’s progress and involved other healthcare professionals as appropriate.

There were enough staff to meet people’s needs. The provider’s recruitment process was robust and ensured that suitable staff were recruited in a safe way. People received the support they required to take their medicines safely as prescribed.

Staff felt supported in their role and received the training which enabled them to plan and deliver people’s support safely and competently. Staff received regular supervision and annual appraisal in line with the provider’s policy. Staff sought consent from people in line with legislation and guidance and provided their care as they wished.

People were supported with their nutrition and hydration needs as they required. Staff knew and respected people’s needs and preferences. The service supported people to access healthcare services as required and had good links with community health services.

People were happy about their care and said staff were kind and caring. People and their relatives were involved in planning people’s support and care. Staff assessed people’s needs and plans were in place to keep them safe and to ensure they received the support they required.

People were encouraged to be as independent as possible. The service had a robust complaints policy and procedure which the registered manager used effectively to resolve people’s concerns.

The quality assurance and audit processes in place were not sufficient as they did not monitor all aspects of care provision at the service. Staff felt the registered manager listened and acted on their concerns. People’s feedback and views were used to develop the service.