Archived: Home Instead Senior Care Also known as Tony Flaherty Ltd

Home Instead Senior Care provides personal care for people in their own homes. The office is based in the Earlsfield area but provides care to people in Wandsworth, Lambeth and Dulwich. At the time of the inspection there were approximately 80 people using the service.

There was a registered manager at the service; however she was not managing the service at the time of our inspection. The owner was in the process of registering with the CQC at the time of our inspection. A registered manager is a person who has registered with the Care Quality Commission 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.

Care workers were known within the organisation as ‘caregivers,’ we have called them this in the report.

People and their relatives told us that caregivers were responsive to their needs and praised them for their caring attitude and empathy towards them. The minimum length of a visit was one hour. This helped to develop caring relationships with people as it meant that caregivers were not rushed and had time to sit down and speak with people and look out for their wellbeing. Both people using the service and caregivers felt the time given to them was beneficial and it made the caring seem more human rather than task based and time pressured.

People said they were offered choices and caregivers asked for their consent before supporting them with personal care. Caregivers were aware of the importance of privacy and maintaining people’s dignity when supporting them with personal care and gave us examples of how they did this. People and their relatives said they felt safe in the presence of caregivers.

The provider included people’s background and a life profile in their care plans so that a more personalised service could be provided. Caregivers were matched to people based on their skills, their interests and other factors such as language were considered.

People and their relatives told us there were no issues with timekeeping and caregivers were on time. A system was in place which alerted office staff if caregivers were running late.

The provider had thorough recruitment checks in place which helped to ensure caregivers were safe to work with people. Each caregiver was required to submit four references about their suitability for a role in care. They were also required to submit evidence of eligibility to work and criminal background checks. Caregivers completed an induction programme which helped them to prepare for their roles and they shadowed more experienced caregivers before supporting people unsupervised.

Ongoing training was provided by refreshing training every year. People were also provided with more in depth training around caring for people with dementia, in line with the provider’s aim of being a specialist dementia care provider. Although caregivers told us they felt supported, there were gaps in some of the one to one supervisions which was not in line with the provider’s own policy of four supervisions in a year.

The provider completed a thorough needs assessment when people first started to use the service, this included their support needs in relation to nutrition, medicines, mobility and other personal care support needs. Risk assessments were also carried out to help ensure people were supported in a safe manner. This information was used to develop person centred care plans that were individual to each person. People were provided with a copy of their care records and there was evidence that consent was sought before care was started.

People and their relatives told us there was an open culture at the service. They said the provider listened to them when they raised concerns and they felt comfortable calling the office if they needed to change or talk about any aspect of their care. Relatives told us they were kept informed with any changes to their family member’s needs.

Unannounced spot checks took place to monitor the quality of service and people were asked for their feedback about the service, their caregivers and any other issues. Other audits, such as checking daily care records and surveys sent to people and caregivers from independent external companies were used to improve the service.

The provider had helped to facilitate some unique community events to support people. This included helping to set up screenings in cinemas for people and their carers. The owner was passionate about supporting people with dementia and had worked with various organisations to raise awareness around dementia and supporting people with dementia to lead fulfilling lives.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

People's care and support needs had been fully assessed. Potential risks to people had been identified and were acted upon by staff so that people were kept safe.

People were kept safe from infection because the service had infection control procedures in place, which meant staff wore protective clothing and took appropriate hygiene control measures. Staff understood their role in regards to infection control.

We saw the service carried out required checks on staff suitability to care for people safely. Criminal record And Identity checks were carried out on staff before the commenced work. One person told us, 'The staff are of an exceptional calibre, they are always smart and tidy.'

People were supported by staff who had the knowledge and skills to deal with foreseeable emergencies. They had received first aid training which was regularly updated. People receiving support and care were given handbooks which had emergency numbers that they could call.

Is the service effective?

People's social, health and support needs were assessed with them and they were involved in reviewing their care plans. People told us the service met their identified needs. One person we spoke with said, 'Staff always talk to me about what I require, they definitely meet my needs.' Staff were able to explain how the Mental Capacity Act 2005 related to their service. People told us staff always involved them in reviews of their care packages and changes were only made with their consent.

Is the service caring?

People were supported by kind and attentive staff. Staff were able to explain how they supported people to maintain their dignity and deliver services in a caring way. Care plans included details of how people liked to be supported. People told us staff were, 'friendly' and 'caring.' One person said, 'We have six staff who regularly work with us, they are all caring.'

Is the service responsive?

We saw the service had a system in place to respond to complaints and comments. The service had asked people's view of the service and responded to what people told them. Records showed people needs were assessed before they signed agreements to receive the service.

Is the service well-led?

Staff were clear about the aims and objectives of the service. Quality assurance processes were in place to check what people thought about the service. We saw the service had sent feedback forms to people who used the service and their relatives. The service carried out regular telephone monitoring of visits. The service took account of what people told them in the feedback forms. One person we spoke to told us, 'I find both the carers and back office staff professional. The management have always dealt with any issues I raise.'

People were involved in choosing the type of care and support they needed and when they needed it. Someone said "The quality of care we have received is all we could have wished for".

They said the quality of care they received was very good and they felt safe receiving the service. They commented "I'm generally pleased with everything".

People did not tell us about the support staff received from the agency or the quality assurance system in place. They did say that the agency office staff often contacted and visited them to see that they were satisfied with their service and the staff providing it.

We saw that people received a lot of clear, accessible information to help them decide if they wanted the agency to provide them with a service.

The service provided was of good quality with people's needs being met.

There was a safeguarding policy and procedure that staff had read, understood and followed.

Staff received thorough induction training and were part of a rolling training programme that was monitored. They also received regular supervision and an annual appraisal.

There was a quality assurance system that was efficient and thorough. It included regular contact with people using the service, spot checks and an annual questionnaire.