Reablement & Independence Service

The service operated three separate care pathways. Some people received support as part of discharge to assess arrangements, meaning they were supported short term following hospital discharge. Some people received reablement support, meaning the service worked with them to regain more independence with daily activities. Some people also received end of life care.

Not everyone who used the service received personal care. 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.

We found some policies and procedures were not in line with best practice. We made recommendations the service develop their approach in relation to handling complaints, staff awareness of people's nutritional and swallowing needs, and recommended the service review the end of life care policy.

People were given telephone numbers to use if they needed to seek assistance or raise a concern. People told us their experiences of contacting the service had been generally positive. One person told us, "I have found they answer the phone very quickly and are helpful when you want to make changes to when the carer is wanted or not."

We found safe care and treatment was not always provided. People were not always safeguarded from risks to them, including infection control risks in relation to COVID-19. Safe medicine practices were not always followed. Accident and incidents relating to people using the service were not effectively monitored to identify wider learning for the service.

Some people told us they received safe care and spoke positively about the outcomes the service had helped them achieve. People were supported to use aids and equipment to help regain more independence with day to day tasks. One family member told us, "Alongside the equipment and adaptations, staff have trained my relative to use them. They have gone from not being able to get in or out of their bed but now

they are really trying and their mobility has improved and what they have taught us has lessened their risks of falling."

People's experiences of using the service were not always person-centred and caring. We found people were not always asked their likes, dislikes or preferences when their needs were assessed. Most people spoke positively about the staff who supported them but some people raised a concern about not receiving regular carers. Comments included, "They are all nice ladies who come and know exactly what they have to do" and "The carers were outstanding, anticipating and encouraging." A third person commented, "It is difficult to know just how much knowledge and training carers have had. There is a care plan and…we have had eight to ten different carers in just two weeks which is not really satisfactory."

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.