Plymouth City Council Independence@Home Service

At the time of the inspection the service was supporting 105 people. This included a small number of people who had been assessed as requiring longer-term care and for whom alternative care provision was not yet available. The service was also supporting some people who were receiving care at the end of their life.

Not everyone who used the service received personal care throughout the period of time they were receiving support. Once people became independence with their personal care, the service supported people with domestic tasks until they are assessed as safe with these tasks, or if alternative support was required in the long-term. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

Staff were described as kind, caring and compassionate, and people said staff were well trained. Staff told us how much they enjoyed working for the service. They said they were proud of the support they provided to people and had a great sense of achievement when people regained their independence.

Risks to people's health, safety and well-being were assessed and management plans were in place to ensure risks were mitigated as much as possible. Staff were aware of their responsibilities to safeguard people.

There were sufficient numbers of staff employed to ensure people's needs were met. People were not provided with specific visit times but a time period, such as morning, lunchtime or evening. Staff were not restricted to a length of time they were required to be with people. As the service was a reablement service, staff spent as much time with people as needed to undertake the task people were being supported with. People and relatives told us they were happy with this arrangement. If they did require a visit at a certain time, for example, with time specific medicines or to be ready for an appointment, the service accommodated this. If staff were going to be very late, people said staff would contact them.

The service's aim was to "enable not disable" and people were fully involved in their assessments and the development of their care plans. People discussed their progress with staff which included looking at different ways to undertake tasks or to become familiar with using equipment to make tasks safer and easier. However, not all care plans held detailed information about what people were able to do for themselves, or specific guidance for staff about how to meet people's care needs. We discussed this with the registered manager and deputy manager who took immediate action to review and update people's care plans, and records where necessary.

Where people were supported with their medicines, this was done safely, and people received their medicines as prescribed.

Quality assurance and governance systems were in place to assess, monitor and improve the quality and safety of the service. The registered manager maintained a service improvement plan and carried out regular audits and reviews of the service.

People were supported to have maximum choice and control of their lives and staff supported support them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.