About the service:

Mid Surrey Area Reablement Service is a domiciliary care agency. It provides personal care to people living in their own houses and flats. It provides a rehabilitation service to people over the age of 18 for up to six weeks.

Not everyone using Mid Surrey Area Reablement Service Limited receives regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided. For more details, please see the full report which is on the CQC website at www.cqc.org.uk

People’s experience of using this service:

People and relatives told us they felt they and their loved ones were safe, and staff were aware of their role in safeguarding people from abuse. Risks to people were appropriately recorded and managed. There were a sufficient number of staff to meet people’s needs, and checks were in place to ensure that staff were recruited safely.

People’s rights were protected in line with the principles of the Mental Capacity Act 2005. Integrated working with healthcare professionals meant that referrals were completed in a timely manner where required. Staff were up to date with training and received supervision on a regular basis. Staff felt that the communication within the service was effective.

People and relatives told us staff were extremely kind and caring, and were respectful of their homes. People were actively involved in reviews and decisions around their care. The core value of the service was to promote independence, with 60% of people reaching the baseline they had been at before becoming unwell. Staff respected people’s privacy and dignity by delivering personal care behind closed door.

People received person centred care that supported them to reach their own personal goals. The service had not received any complaints, but people were aware how to raise a concern if they needed to. Although it was rare for the service to deliver end of life care, staff had received training in preparation and had links with the local hospice.

Staff felt the management team were approachable and felt valued. Robust quality checks allowed the service to identify and resolve any issues or improvements. People and staff were asked for feedback on the service regularly, with any suggestions from this being implemented. There was a proactive approach to signposting people and relatives to local organisations that could offer on going support once their reablement support was over. The provider had run a project which they hoped would improve the quality of the service.

Rating at last inspection:

At the last inspection the service was rated Good (27 September 2016).

Why we inspected:

This was a scheduled comprehensive inspection. We inspect all services rated as 'Good' within 30 months to ensure that we regularly monitor and review the quality and safety of the service people receive.

This inspection took place on 28 and 31 August and was announced. The last Care Quality Commission (CQC) inspection of Epsom Reablement Service was carried out on 2 January 2014, where we found the service was meeting all the regulations we looked at.

The primary role of the service is to provide people living in their own homes with personal care and support to enable them to maximise their independent living skills after a person’s physical care needs had changed either after being discharged from hospital or following an accident or illness. Support is offered free of charge usually for up to six weeks while a person’s needs are assessed by the reablement team. Staff providing the majority of the care and support are called ‘reablement assistants’. The provider also works closely with other health and social care professionals, such as occupational therapists, GPs, district nurses, hospital staff and social workers. At the time of our inspection the provider was supporting 38 adults, most of whom were older people who had physical care needs.

The service had a registered manager in post who was also responsible for managing two other reablement services for Surrey County Council. A registered manager is a person who has registered with the CQC to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People told us they were happy with the standard of care and support they received from the reablement service. People were provided with the support they required in line with their care plans, which included meeting people’s personal care needs and supporting people to become more independent. Staff were respectful of people’s privacy and dignity. Our discussions with people receiving a reablement service, their relatives and community based health and social care professionals supported this.

People told us they felt safe when staff from the reablement team visited them at home. Managers and staff knew what constituted abuse and who to report it to if they suspected people were at risk. They had all received up to date training in protecting children and safeguarding adults at risk. Risks to people’s safety were identified and management plans were in place to minimise those risks. This included ensuring appropriate equipment was in place to support people safely whilst maintaining their independence.

Staff were knowledgeable about the people they supported. This included their personal preferences, daily routines and cultural and religious needs. Managers and staff regularly discussed people’s needs to identify if the level of support they required had changed.

Staff supported people with their nutritional needs. Where the service was responsible for helping people with their food shopping or preparing light meals staff took account of their dietary needs and preferences. Staff were knowledgeable about the signs and symptoms to look out for that indicated a person’s health may be deteriorating. If staff had any concerns about a person’s health, appropriate professional advice and support was sought. Where the service was responsible for supporting people to manage their medicines, staff ensured they received their prescribed medicines at times they needed them.

Staff supported people in line with their preferences and ensured they were involved in decisions about their care. Where appropriate, staff liaised with people’s relatives and involved them in discussions about people’s care needs. Staff were aware of who had the capacity to make decisions and supported people in line with the Mental Capacity Act 2005.

Staff had developed caring and friendly relationships with people they regularly supported. Home visits were coordinated to ensure staff with the right mix of knowledge, skills and experience were matched with pe

People using the service and two people acting on their behalf expressed satisfaction with service provision. Comments from people included, “All the staff are very good to me, I am happy with what they do and I feel they must be well trained. They gave me information about the service when they first came to visit me so I knew what to expect”. Also, “Staff are lovely and friendly, they are all very good and nothing is too much trouble. They help me to do things I am unable to do for myself, such as dressing and showering. They understand my needs and constantly check that they are doing things the way that I want them to”. We saw that people’s needs had been assessed and they had been involved in planning their support in ways ensuring their safety and wellbeing, promoting independence.

People told us that staff acted with their consent and in ways that kept them safe. We found staff to be trained to recognise indicators of abuse or neglect and informed of safeguarding procedures. Relevant checks had been carried out on staff to ensure they were of good character, fit to fulfil their roles and had the necessary skills and experience.

We saw effective quality assurance systems underpinned continuous service developments and improvements. Information about people's experience of the service had been sought and used to monitor risks and the quality of services. There were procedures for minimising risks to people in the event of emergencies.