Joint Community Rehabilitation Service

New members of staff undertook a thorough induction process with opportunities to shadow experienced staff and fortnightly supervision meetings throughout a probationary period. Support continued for staff with monthly supervisions and annual appraisals. Training was comprehensive with areas covered that were relevant to people's needs. Staff could choose training for their own personal development. Staff supported people to access health and social care professionals and visits were adjusted to fit around people's appointments. Some people using the service experienced variable mental capacity due to an early diagnosis of dementia or following a stroke. Staff had been trained in mental capacity and told us about the importance of providing choice to people and seeking consent. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People were treated with dignity and respect. People's privacy was respected but people were never placed at risk, staff whilst promoting independence always remained close to provide support if needed. The primary function of the service was to support people in regaining confidence and independence to enable them to live independently in their homes. Staff knew this and supported people in a caring way.

We looked at numerous care plans both at the office of the service and at people's homes. Care plans were person -centred, focussing on individual aims and goals that were reviewed and assessed weekly. The service had a complaints policy which was accessible to everyone, a copy being placed in people's care plan folder in their homes. Minor issues and concerns were recorded separately. All issues that were raised were dealt with appropriately with apologies offered if appropriate. Staff had received training in end of life care.

Provision of end of life care was not routine but staff knew the important elements of care provision at that important time. The service demonstrated strong leadership. A positive culture was evident throughout the service and by everyone we spoke with. A staff member said, "Working here is like a breath of fresh air." A professional told us, "It really works well, we receive consistently positive feedback." The registered manger understood the duty of candour and promoted an ethos of openness and honesty whilst constantly learning lessons and driving forward with improvements. This was evident with the service quality assurance process where all areas of the service were overseen and monitored by the registered manager and senior managers from the local authority. Everyone associated with the service were provided opportunities to provide feedback. JCR had established positive working relationships with their partners for example, GP's district nurses and hospitals. A professional said, "I thoroughly enjoy working with JCR. The team have a wealth of knowledge and a genuine pride in delivering exceptional service."