We carried out a review of the data available to us about Home Instead Senior Care on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Home Instead Senior Care, you can give feedback on this service.
About the service
Home Instead Senior Care is a domiciliary care agency providing personal care to 96 people aged 65 and over at the time of the inspection.
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.
People’s experience of using this service and what we found
People were exceptionally well-supported. Staff and managers empowered people to be involved in their care and to express their individual needs.
Care was personalised and tailored to meet individual need, to ensure people had flexibility and choice. The provider was clear on people’s communication needs and used innovative practice to ensure they responded effectively to people’s care needs.
The leadership and governance of the service ensured high-quality care. Staff, people and relatives were exceptionally well supported by managers, who encouraged their involvement in the development of the service. Staff felt motivated and proud to work for the provider.
People were well supported to received safe care and treatment. Medicines were well managed, and the provider had taken steps to ensure best practice was implemented. Infection control procedures were efficient and well implemented. Staff were safely recruited to ensure they were fit and proper and able to carry out their roles. Staff understood their responsibilities in recognising and reporting potential signs of abuse. Risk assessments were comprehensive and identified potential areas of risk and guided staff to prevent and mitigate harm.
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.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was Outstanding (published 05 January 2018)
Why we inspected
This was a planned pilot virtual inspection. The report was created as part of a pilot which looked at new and innovative ways of fulfilling CQC’s regulatory obligations and responding to risk in light of the COVID-19 pandemic. This was conducted with the consent of the provider. Unless the report says otherwise, we obtained the information in it without visiting the provider.
The pilot inspection considered the key questions of safe and well-led and provide a rating for those key questions. Only parts of the effective, caring and responsive key questions were considered, and therefore the ratings for these key questions are those awarded at the last inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Home Instead Senior Care on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
Home Instead Senior Care provides domiciliary care and support to 185 people living in Wimbledon, Kingston and the surrounding areas. Home Instead Senior Care is part of a franchise that delivers care to people in many areas of the United Kingdom. This includes personal care such as assistance with bathing, dressing, eating and assistance with medicines. Other help provided covers all aspects of day-to-day housework, shopping, meal preparation and household duties as well as companionship services such as escorting people on visits or appointments, simple conversation and company. When we visited the provider 185 people were in receipt of a service; 85 received personal care and the remainder received help in their home or companionship. We only looked at the service for people receiving personal care during this inspection as this is the service that is registered with Care Quality Commission. The staff who support people are known as ‘caregivers,’ we have called them this in the report and office personnel are referred to as office staff.
The service had a registered manager. 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 service continued to provide outstanding support to people and was very responsive to people’s needs. The service also provided outstanding support to staff.
One person said “This is as good a service as it can be. I would be very happy to recommend it to anyone” and a relative commented “My relative now has a regular core of carers who know her very well. They treat her very kindly and speak to her with great respect, upholding her dignity and they are always very polite to other relatives in the house.”
People continued to be extremely well supported by caregivers to engage in activities to stimulate and promote their overall wellbeing. The provider had continued to recognise and respond to people’s needs by starting up several new not for profit clubs, as well as continuing to support clubs previously started. A new coffee and culture club had started at the Wimbledon Tennis club, a men only lunch club, a supper club and a new memory café at Kingston Hospital. Home Instead had also continued to sponsor the Alzheimer’s Singing for the Brain service. An observer at one of the clubs told us “Without exception the clients are enjoying the session and being encouraged and supported by the carer with them.” The caregivers gave many examples of where the positive feel of the activities had stayed with people throughout the week.
There was an extremely positive culture within the service, the management team provided strong leadership and led by example. The registered manager had developed a new structure to the office team which enabled the service to develop and grow. Staff support had been enhanced through a buddy system, effective training, systems to keep staff safe and recognition of staff’s dedication to the care of people. One person commented “Staff are very, very well trained. If my regular caregiver is away the caregiver who replaces her knows exactly what to do.” A caregiver said “The company supports its staff to care for clients to a high standard through a good support structure and training.”
The registered manager was an excellent role model who actively sought and acted on the views of people. Staff said Home Instead was ‘like being part of a family and we all really like one another.’ Home Instead continued to have clear visions and values that were person-centred and ensured people were at the heart of the service. Their principle objective is to provide supportive care and companionship which both enables and encourages people to remain independent, in their own homes, for as long as possible.
A healthcare professional commented “The management is experienced, caring and well-regarded locally, and we know that many clients’ lives are considerably better off thanks to the services they provide. We are fortunate to have them.”
People remained safe in their homes. Caregivers and office staff could explain to us how to keep people safe from abuse and neglect. People had suitable risk assessments in place. The provider managed risks associated with people’s homes, to help keep people and staff safe. Recruitment practices remained safe. Medicines continued to be administered safely. The checks we made confirmed that people were receiving their medicines as prescribed by staff qualified to administer medicines.
Staff were providing support in line with the Mental Capacity Act 2005. People were supported to eat and drink sufficient amounts to meet their needs. When required staff supported people to access a range of healthcare professionals.
People and relatives told us staff were caring, kind and efficient and staff respected their privacy and treated them with dignity. People’s needs were assessed before they started to use the service and care was planned and delivered in response to their needs. The provider had arrangements in place to respond appropriately to people’s concerns and complaints.
Staff we spoke with described the management as very open, approachable, positive and easy to get on with. Systems were in place to monitor and improve the quality of the service. The provider had audit systems for staff training and supervision and the national office conducted an annual standards renewal audit; this included scrutinising all aspects of the business. The last audit in 2017 was positive, with no actions to be taken. These systems continue to help ensure people received the care they needed as detailed in their support plans.
This inspection took place on 8 and 9 December 2015 and was announced. We told the provider one day before our visit that we would be coming. At the last inspection on 21 February 2014 the service was meeting the regulations we checked.
Home Instead Senior Care provides domiciliary care and support to 130 people living in Kingston and the surrounding area. Home Instead Senior Care is part of a franchise that delivers care to people in many areas of the United Kingdom. This includes personal care such as assistance with bathing, dressing, eating and medicines; home help covering all aspects of day-to-day housework, shopping, meal preparation and household duties; and companionship services such as escorting people on visits or appointments, simple conversation and company. Of those 130 people 60 received personal care and the remainder receive help in their home or companionship. We only looked at the service for people receiving personal care during this inspection as this is the service that is registered with Care Quality Commission. The staff who support people are known as ‘caregivers,’ we have called them this in the report and office personnel are referred to as office staff.
The service had a registered manager in post who was also the owner of the company. 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 service provided outstanding support to people and was very responsive to people’s needs.
One person said “The caregivers are super; they always go two steps further to help me.” A relative said “When I am struggling the caregiver just says ‘leave it to me, I’ll deal with it,’ and the problem is solved.” People were extremely well supported by caregivers to engage in activities to stimulate and promote their overall wellbeing. The provider had recognised and responded to people’s needs by starting up several not for profit clubs. A lunch club, an afternoon tea club, three memory cafes and sponsoring the Alzheimer’s Singing for the Brain service. Caregivers said these clubs gave people the ‘feel good factor’ which remained with people throughout the week.
There was an extremely positive culture within the service, the management team provided strong leadership and led by example. The registered manager had clear visions, values and enthusiasm about how they wished the service to be provided and these values were shared with the whole staff team. Their ethos was “To change the face of ageing and it is with extreme passion and commitment that we are here in your local community doing just that. Just because you are an older person doesn't mean your quality of life should diminish.” Staff had clearly adopted the same ethos and enthusiasm and this showed in the way they cared for people.
The registered manager was an excellent role model who actively sought and acted on the views of people. People and their relatives without exception told us they thought the service was extremely well managed. We found all staff were very positive in their attitude to the company and their role and said they were committed to the support and care of the people. Staff said Home Instead was different because the manager genuinely cared about all people and wanted to make it the best service.
People told us they felt safe with the support they received from the caregivers. There were arrangements in place to help safeguard people from the risk of abuse. Caregivers and office staff we spoke with understood what constituted abuse and were aware of the steps to take to protect people. Appropriate arrangements were in place in relation to administering and the recording of medicines which helped to ensure they were given to people safely. The provider had a thorough and comprehensive selection process when employing people. This helped protect people from the risks of being cared for by staff assessed to be unfit or unsuitable.
Caregivers told us they felt well supported by the registered manager and all the office staff and had appropriate training to carry out their roles. This training enabled staff to support people effectively. All staff had a good understanding of their responsibilities in relation to the Mental Capacity Act 2005. Records showed people were involved in making decisions about their care and support and their consent was sought and documented.
Positive, caring relationships had been developed with people. People and their relatives were consistently positive about the caring attitude of the staff. One word that was used by several people when asked about the care they received was ‘Excellent.’
People were involved and consulted about the type of care they wished to receive and how they wished to receive it. Everyone we spoke with confirmed that they had been involved in developing and deciding their care plans and that their views were listened to and respected. Caregivers supported people according to their personalised care plans and respected people’s privacy and treated them with respect and dignity. The people we spoke with were positive with their views and experiences of the service and the ability of caregivers to respond to their changing needs.
The provider had up to date complaints and whistleblowing policies and procedures which gave processes to follow and time scales to adhere to. This helped to assure people and staff that their concerns were taken seriously and addressed quickly.
The registered manager told us they encouraged a positive and open culture by being supportive to staff and by making themselves approachable with a clear sense of direction for the service. People were regularly asked for their opinion on whether their objectives for the service they were receiving were being met. Staff regularly monitored the quality of the service by speaking with people who received a service.
The provider had quality assurance systems in place to monitor the quality of service people received. The provider had audits systems for staff training and supervision and the national office conducted an annual standards renewal audit; this included scrutinising all aspects of the business. The last audit in January 2015 was positive, with no actions to be taken.