Home Instead East Hertfordshire and Uttlesford

Home Instead Senior Care is a domiciliary care agency. It provides a range of services, including personal care, medication support, meal preparation and supports people to access the community and remain as independent as possible whilst living in their own home.

Not everyone using Home Instead Senior Care received a regulated activity; CQC only inspects the service being received by people provided with 'personal care'; help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided. At the time of the inspection,120 people using the service received the regulated activity of personal care.

People’s experience of using this service:

Staff supported people to make significant improvements to their lives. People received individualised care and support that was responsive to their needs. Assessments focused on people’s individual needs and preferences and provided information for staff about how to support people to improve or maintain their independence in their own home.

People were supported to achieve outcomes and overcome barriers to living their best lives, by staff who understood the value of person-centred care. Staff worked in innovative ways, having excellent knowledge of people in their care and adapting constantly their approach people.

People told us staff were caring and kind and talked about having close relationships and friendships with them. Care staff were skilled in delivering people's care in the way they preferred, and which improved their quality of life.

Staff understood how to keep people safe and protect them from harm. Risks to people's everyday lives had been assessed. Systems were in place to ensure people received their medication safely. Staff were recruited safely and there were enough staff to meet people’s individual needs. Incidents and accidents were investigated, and actions were taken to prevent recurrence. Staff understood their responsibilities to prevent the spread of infection whilst working in and between people's homes.

People were assessed to ensure the service could meet their needs. Staff completed training and received support and supervision to enable them to carry out their roles and responsibilities. Staff worked well with external professionals to promote people’s health and wellbeing.

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.

Staff respected people's life histories, diversity and personal preferences when delivering care. The provider actively sought feedback from people using the service and their relatives. This information was used to develop and improve service delivery.

Staff were supported by a management team who had a clear vision for the service. Systems and processes were in place to monitor the service and identify and drive improvement. To ensure people using the service were supported in the most effective way the service worked in partnership with other health and social care organisations.

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 good (published 15 November 2016).

Why we inspected:

This was a planned inspection based on the previous rating.

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.

There was a registered manager in post 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.

People had care plans that were personalised to their individual needs and wishes. Records contained detailed information to assist care workers to provide care and support in an individualised manner that respected each person's individual requirements and promoted treating people with dignity.

People were cared for safely in their own home. There were risk assessments in place to mitigate any risks which supported people to live independently. Staff understood the need to protect people from harm and knew what action they should take if they had any concerns. Staff understood their role in caring for people with limited or no capacity under the Mental Capacity Act 2005.

Staffing levels ensured that people received the support they required safely and at the times they needed. The recruitment practice protected people from being cared for by staff that were unsuitable to work in their home.

People received care from staff that were compassionate, friendly and kind and who would go the extra mile to support people and their families. Staff had the skills and knowledge to provide the care and support people needed and were supported by a management team which was receptive to ideas and committed to providing a high standard of care.

The registered manager supported a management team which was approachable and supportive. There were systems in place to monitor the quality of the service provided and actions taken to improve the service. Staff and people were confident that issues would be addressed and that any concerns they had would be listened to.

People who used the service received appropriate care and support that met their individual needs. We found that people's plan of care was developed with them or those acting on their behalf. One staff member told us, 'Before I walk through a client's door I know what they like for breakfast, how they like to be supported, even what hobbies they have.'

People's health, safety and welfare was protected when more than one provider was involved in their care and treatment. This was because the provider worked in co-operation with others.

We found that people were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines.

People were cared for, or supported by, suitably qualified, skilled and experienced staff.

The provider used a range of systems to monitor the quality of service they provided to people. We saw that one person had commented in a recent satisfaction survey, "Please pass on my praise, a very grateful client who would be lost without them."

People told us they were treated respectfully and their privacy and dignity was considered at all times. They told us that they had copies of their care plans and documents telling them about the service. People also told us that the staff were very good and professional and they usually got the same carers visiting them. They said the visits were usually on time and they were contacted if their care worker was going to be late.

People we spoke with told us that the staff team were very good and reliable. They said they considered the staff to have been well trained and believed that the managers provided them with the necessary support to do their work.

People said they felt confident to share their views and opinions and felt listened to by the staff and management team.