We inspected Reablement Service on 27 July 2017. We announced the inspection 48 hours before we visited to ensure that the registered manager was present on the day of the inspection. When we last inspected the service in May 2015 we found the provider was meeting the legal requirements in the areas that we looked at and rated the service as good. At this inspection we found the service remained 'Good'.

Reablement Service provides assessment and rehabilitation services for people in their own homes to promote their daily living skills and independence. In addition the service works in conjunction with health to provide a rapid response team and physiotherapy team. Nurses and care staff provide a rapid assessment service and care for people in crisis. The aim of the rapid response is to provide care and support to those people in their own homes whose informal care and support package has broken down unexpectedly and who may have had to go into a hospital or a care home because they were unable to manage at home. At the time of the inspection 60 people used the service.

The service had a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like 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.

We identified that some staff had not received fire awareness training since 2012 and some staff had not received this at all. We noted there were gaps or long periods of time in between for other training not considered mandatory by the provider such as catheter care, diabetes, nutrition, strokes and end of life. The manager told us this training would only be refreshed if staff requested further updates or if they supported people who used the service who had these conditions and needs.

We have made a recommendation about staff training on the subject of fire safety.

Staff understood the procedure they needed to follow if they suspected abuse might be taking place. Risks to people and the home environment were identified and plans were put in place to help manage the risk and minimise them occurring. Medicines were managed safely with an effective system in place. Staff competencies around administering medication were regularly checked.

There were sufficient staff employed to meet the needs of people who used the service. We found that safe recruitment and selection procedures were in place and appropriate checks had been undertaken before staff began work.

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 were supported to prepare meals of their choice.

People received the support they needed to help with their reablement. People’s care plans described the care, support and rehabilitation they needed. Care plans detailed people’s needs and preferences. People told us they were involved in all aspects of their care and rehabilitation.

The provider had a system in place for responding to people’s concerns and complaints. People were regularly asked for their views.

People received a consistently high standard of support and rehabilitation because staff were led by an experienced manager. The staff team were highly motivated, enthusiastic and committed to ensuring people regained their independence. There were systems in place to monitor the safety and drive the continuous improvement of the quality of the service.

We inspected Intermediate Care from May 5th until May 12th 2015. This was an announced inspection and we let the acting manager know we were inspecting two-days beforehand. We announced this inspection so we would be able to meet with staff providing support on the day. This meant that the staff and provider knew we would be reviewing the services that were provided.

The inspection team consisted of an adult social care inspector.

The Intermediate Care Team provides a free and flexible service to people in their own homes for a period of up to six weeks. Staff provide care, support, encouragement, rehabilitation and advice to people with the aim of assisting people regain their independence The service is available to people aged 18 and above who live in the Stockton locality and for example be someone who has been discharged from hospital after a hip replacement. The service supports people with meal preparation, attending to personal care, administering medication, mobilising, shopping, accessing community facilities and domestic support.

The service had a registered manager who had recently retired. A new acting manager was in place at the service. 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.

The acting manager and staff that we spoke with had a good understanding of the principles and their responsibilities in accordance with the Mental Capacity Act (2005). People told us they felt safe and staff understood how to recognise and report potential abuse. We saw there were systems and processes in place to protect people from the risk of harm.

We found people were encouraged and supported to take responsible risks. People were encouraged and enabled to take control of their lives.

People told us they were supported to regain their independence by experienced and knowledgeable staff. People told us that staff were reliable. Robust recruitment and selection procedures were in place and appropriate checks had been undertaken before staff started work.

Staff who worked at the service were extremely knowledgeable about the care that people received. People told us that they received person centred care. People who used the service told us they were very happy with the care that they received.

People told us they were supported to prepare food and drinks of their choice. This helped to ensure that nutritional needs were met. People told us they were encouraged and supported to be independent with meal preparation.

People were supported to maintain good health and had access to healthcare professionals and services. Where needed people were seen or referrals were made to the therapies team or other relevant health or social care professionals.

People told us they were supported by caring and compassionate staff. People we spoke with said they were happy with the care and support provided and could make decisions about their own care and how they were looked after.

People told us staff respected their privacy and dignity. Staff were aware of the values of the service and knew how to respect people’s privacy and dignity.

People’s care and support needs had been assessed by the referring agency before the service began. Some care packages were set up extremely quickly, often within a matter of hours to provide crisis support or a speedier discharge from hospital. Care records we looked at detailed people’s needs and there were clear records of the visits by each staff member that were reviewed by the management team at the service.

Appropriate systems were in place for the management of complaints. People and staff told us the acting manager was approachable. People we spoke with did not raise any complaints or concerns about the service and they told us they knew how to contact the service if they needed to.

There were effective systems in place to monitor and improve the quality of the service provided. Staff told us that the service had an open, inclusive and positive culture.