North STSS Berwick, a reablement and crisis intervention domiciliary care service, retained its Outstanding overall rating at the September 2023 inspection, with Safe and Well-led both rated Good. The service demonstrated consistent, safe, person-centred care with strong leadership, effective partnership working, and an open learning culture.
Strengths
· Stable, mutually supportive staff team with continuity of care for people using the service
· Proactive partnership working with external professionals including hospitals, social workers and nurses
· Strong registered manager oversight with clear deputising arrangements and weekly MDT attendance
· Open, inclusive culture with debriefs and reflective practice embedded following incidents
· Regular feedback sought from people and relatives to drive continuous improvement
Quality-Statement breakdown (10)
Systems and processes to safeguard people from the risk of abuse
safe:
Good
safe: Assessing risk, safety monitoring and managementGood
safe: Staffing and recruitmentGood
safe: Using medicines safelyGood
safe: Preventing and controlling infectionGood
safe: Learning lessons when things go wrongGood
well-led: Promoting a positive culture that is person-centred, open, inclusive and empowering; Continuous learning and improving careGood
well-led: How the provider understands and acts on the duty of candourGood
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirements; Working in partnership with othersGood
well-led: Engaging and involving people using the service, the public and staff, fully considering their equality characteristicsGood
North Locality Homecare (Berwick) achieved an Outstanding overall rating at its June 2017 inspection, with particular excellence in its integrated reablement model that enabled people to regain independence, facilitated hospital discharges and reduced long-term care dependency. No failure themes were identified; the service demonstrated exemplary person-centred care, flexible staffing, robust governance and highly effective multi-disciplinary partnership working.
Strengths
· Exceptional reablement outcomes enabling people to regain independence, confirmed by people, relatives and health and social care professionals
· Highly flexible and person-centred approach with no fixed call times, described by staff as 'not a time keeping service'
· Integrated multi-disciplinary model combining health and social care, facilitating safe hospital discharges and avoiding unnecessary admissions
· Strong leadership with a highly regarded registered manager and clear emphasis on continuous improvement through audits and action plans
· No missed calls and no medicines errors recorded; research-based assessment tools (COPM, Tinetti, Falls Risk) used to optimise outcomes
Quality-Statement breakdown (20)
safe: Safeguarding policies and procedures in place; staff knowledgeable about action to take if abuse suspectedGood
safe: Medicines managed safely; medicines administration records completed accuratelyGood
safe: Safe recruitment procedures followed including DBS checks and referencesGood
safe: Sufficient staffing levels confirmed by people, relatives and staff; computerised system used to allocate and monitor workersGood
effective: Staff training in safe working practices and service-specific needs; community matron delivered specialist trainingGood
effective: Supervision sessions and appraisal system in place to review performance and identify development needsGood
effective: Mental Capacity Act principles followed; verbal consent sought before every care taskGood
effective: People supported to achieve independence with nutritional needs; in-house physiotherapists and OTs availableGood
caring: Staff exceptional at enabling independence; every small step documented in care plansOutstanding
caring: Care planned proactively in partnership with people; inclusive involvement so people felt consulted, listened to and valuedOutstanding
caring: Privacy, dignity and confidentiality upheld; staff knocked before entering and avoided faxing referrals for data protectionOutstanding
caring: Responsive end of life care signposting; Macmillan social worker described the service as 'absolutely amazing'Outstanding
responsive: Exceedingly flexible visit scheduling with no clock-watching; calls extended as needed to meet individual needsOutstanding
responsive: Multiple accessible referral routes including self-referral; research-based assessment tools used for best outcomesOutstanding
responsive: Weekly supervisor reviews; quarterly 'Two minutes of your time' surveys; complaints procedure with lessons learnt documentedOutstanding
responsive: Social isolation addressed through partnership with support planners and referral to community activitiesOutstanding
well-led: Registered manager highly regarded by staff and professionals; integrated health and social care leadership modelOutstanding
well-led: Strong continuous improvement culture; all aspects audited, action plans produced, 'You said, we did' reports completedOutstanding
well-led: NICE guidance fully adopted; integrated model reduced long-term care need (only 78 of 944 referrals required ongoing care)Outstanding
well-led: Good practice shared with other providers; placements offered to therapy students; community partnerships with food bank and falls programmeOutstanding