Supporting Independence Team

The Supporting Independence Team is a Hull City Council care at home service providing active recovery support to people in their own homes. It aims to be helpful, supportive, relevant and accessible to enable people to live as part of their community, by meeting their needs and supporting their rights and entitlements. It achieves this by working with people, with the view of setting and meeting of person- specific goals and to support individuals to re-gain their independence where possible. Where people are assessed as requiring long-term care, packages of support are sourced for them with private care at home providers. The service is provided to adults aged 18 and above, older people, people who have had a mild to moderate stroke, people who needed end of life care, people with mental health problems (in partnership with the NHS), people with physical disabilities, those with a mild learning disability and those who care for any of these groups of people. The service also provides emergency support and out of hours night time support.

Following on from the intervention by the active recovery assessment team, who work with the people to devise the initial support plan during the assessment process, The Supporting Independence Team deliver the active recovery support and monitor and review people's progress throughout this process. Thornton Court, where the care at home office is located, is a housing community facility where the people sign a temporary stay agreement during their Active Recovery rehabilitation before returning home, if they require adaptive premises to aid their recovery.

Not everyone using Supporting Independence Team receives regulated activity; Care Quality Commission (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.

The provider was required to have a registered manager in post. 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 legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. The registered manager had been in post for the last year with the service and for another two and a half years prior the re-organisation.

People were protected from the risk of harm and staff were trained in and knowledgeable about safeguarding people from abuse. Risk was safely managed. Recruitment of staff followed safe practices to ensure staff were 'suitable' to care for and support vulnerable people. Staffing numbers were sufficient to

meet people's needs. The management of medicines was safe and systems in place demonstrated there was a safe audit trail for handling all medicines. Staff followed good hygiene for safe control of infection.

Systems in place acknowledged and recorded when things went wrong and lessons were learnt to ensure problems or mistakes were not repeated. Staff enabled people to make choices and decisions wherever possible in order to regain control over their lives. People were cared for and supported by qualified and competent staff who were themselves regularly supervised and received annual appraisals of their personal performance. Staff respected the diversity of people and met their individual needs. Nutrition and hydration needs were supported to ensure people's health and wellbeing.

People's mental capacity was appropriately assessed and their rights were protected. Staff had knowledge and understanding of their roles and responsibilities in respect of the Mental Capacity Act (MCA) 2005 and they empowered people to make decisions for themselves. The registered manager followed the 'best interests' route and multi-disciplinary consensus where people lacked capacity to make their own decisions. Consent for support to take place was respected so that staff always sought people's cooperation and agreement before engaging in rehabilitation.

People were cared for with compassion. Staff got to know people's needs and preferences and were kind in their approach to encouraging independence. People directed and were fully involved in and their care. Their right to express their views was respected. The management team followed good principles of care, equality, dignity and respect, all of which was embedded in the ethos of service delivery. Wellbeing, privacy, dignity and independence were respected and encouraged.

Person-centred support plans laid the foundations for good care. They reflected people's needs well and were regularly at two and five weeks. They gave follow-on private providers the basis for continued support where this was necessary. An effective complaint procedure in place ensured people's complaints were investigated without bias. The service sensitively managed people's needs with regard to end of life preferences, wishes and care, when this was necessary.

The provider met the regulation on quality assurance and systems used were effective. Audits, satisfaction surveys, meetings, and 'spot checks' on staff ensured there was effective monitoring of service delivery. Culture was person-centred, progressive, open, inclusive, empowering and ensured good outcomes for people. The registered manager understood their responsibilities and practiced a management style that was professional, open and approachable. The registered manager strove for continuous learning and good practice at every opportunity. The service fostered good partnerships with other agencies and organisations.

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