Home Instead Senior Care

People’s experience of using this service:

People and their relatives told us they felt very safe using the service. The service was extremely reliable, and the care staff were timely. One person said, “They are always on time. That helps tremendously; it helps us organise our lives.”

There were robust systems in place that ensured the service was very reliable. There was an electronic system which alerted staff if somebody’s visit was later than expected. Action was then taken to investigate and ensure people were safe and received their visits as required. One person’s relative told us, “The system works brilliantly; it gives me reassurance as I live far away.”

The recruitment of new staff was safe and staff members were trained in safeguarding vulnerable adults. There were appropriate risk assessments in place for risks that may arise when providing care and support for people and how these risks would be reduced. People were supported to take their medication safely.

People and their relatives praised the skills and approach of staff members. One person’s relative said. “They are outstanding. The staff say how much they enjoy caring for [name], which is very reassuring for me.”

At the service there was a strong focus on maximising training and support opportunities to enable staff to be as effective as possible in their role. All staff members were very positive about the training and support they received. They told us they felt well supported, well equipped for the role, happy and were looked after by senior staff. A personal interest was shown in each staff member.

The training process was creative with a focus on developing the empathy, compassion and interpersonal skills of staff to ensure positive relationships were developed with people using the service. Staff members told us that during supervision meetings they were supported in developing their relationships with people.

People were truly respected and valued as individuals. People told us that staff were caring and supportive of them. One person said, “I feel happier when they [care staff] are here.” Another person had written to the service saying about their care giver, “They have been the perfect care giver. She has supported us with total professionalism. Always on time, a shoulder to cry on, a helping hand when needed and totally honest in every way.”

People were treated with the upmost dignity and their privacy was deeply respected. One person told us, “Carers coming into our home is an intrusion; but they make it as easy as possible.” Another person’s care plan contained information for staff on how to ensure their visits did not excessively interrupt the person’s day. The visits were planned around the person’s favourite television programs and family events. Staff knew when the person wished to have personal space.

Staff spoke very positively about people and their role. One staff member told us, “It’s a massive privilege to support people in their own homes.”

The service was working within the principles of the Mental Capacity Act. People’s consent to their care was sought during the assessment and care planning process. Their permission was sought before care and support was provided even if this had previously been agreed and was in a person’s support plan. This showed people respect in their own home and acknowledged that people may change their minds. People were supported to remain in control of their lives as much as possible.

Each person had an individualised, person centred care plan. Care plans were set out as a series of outcomes that people wished to achieve and had clear details of what support a person agreed they needed to safely achieve these outcomes. People’s care plans also contained details of what people were able to do for themselves or could achieve with some support. People and their relatives told us that they were involved in putting together their care plans. If appropriate the service also worked closely with health professionals in the design and delivery of people’s care.

People and their relatives told us that the service was well-led and of high quality. One person’s family member told us, “I was very nervous of going through an agency. But the compassion and respect [name] and I get are amazing.” One person said that they could not have coped without the service they received. They said, “It was the best thing I could have done.”

Rating at last inspection: At the last inspection the service was rated Good (June 2016).

Why we inspected: This was a planned inspection based on the rating at the last inspection.

Follow up: Ongoing monitoring.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Home Instead Senior Care is a domiciliary care provider based in Stone, Staffordshire, providing personal care and support to people in their own homes. At the time of this inspection 142 people used the service.

The service had a registered manager who had been in post since July 2008. 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 were supported in their own homes and told us they felt safe and comfortable with the service provided. Systems were in place to ensure that people who used the service were protected from the risk of abuse. The registered manager and caregivers had received training in safeguarding adults from abuse and were aware of the procedures to follow if they suspected that someone was at risk of harm.

People were offered support in a way that upheld their dignity and promoted their independence. Care and support plans were written in a personalised way based on the needs of the person concerned to ensure the caregivers had information on people’s preferences so that individualised care and support was provided.

Caregivers exhibited a good value base, people told us the caregivers were kind and caring. The principles of the Mental Capacity Act 2005 were followed to ensure that people's rights were respected.

People’s medicines were managed safely; caregivers were well trained and supported people with their medication as required. People were supported to access external healthcare professionals and other agencies in order to ensure their healthcare needs were fully met.

Robust systems were in place to ensure that people were supported by caregivers who were of good character and able to carry out the work. Caregivers received full induction training, annual updates and refreshers to ensure they were fully skilled to provide the support. Caregivers had regular opportunities to meet with their seniors either on a one to one basis or in caregiver’s meetings.

There were clear lines of management responsibility. Caregivers told us they felt supported to fulfil their role and the registered manager and provider were approachable. Systems were in place to continually monitor the quality of the service.

The provider was very committed to continuous improvement. Feedback from people, whether positive or negative, was used as an opportunity for improvement. The provider and registered manager demonstrated a good understanding of the importance of effective quality assurance systems. There were processes in place to monitor quality and understand the experiences of people who used the service. The provider and registered manager demonstrated strong values and a desire to learn about and implement best practice throughout the service.

The manager told us that there were people that used the service who would not be able to speak with us over the telephone. With the permission of the person and their representative we arranged to visit them in their own homes. We spoke with people and observed the support being provided. One person told us: 'I have been able to remain at home; the help I receive from the carers is wonderful".

We saw that people who used the service had consented to their care, treatment and support or had been supported to do so by significant others.

We found that people's care and welfare needs were being met. People who used the service told us they were very satisfied with the service provided. One person said: "Nothing is too much trouble; in fact the carers go the extra mile to help. They are all very kind, helpful and friendly".

We saw that the service was following the correct recruitment procedures when employing new staff.

Staff received the training they needed to do their job effectively.

We saw that the provider had systems in place for assessing and monitoring the quality of service they provided.

The manager told us that any referrals for the service were carefully considered before a care package was offered. This meant that people can be assured that their care needs will be fully met. People who used the service had a care and support plan that was discussed and agreed with them.

Staff told us they had received training in safeguarding vulnerable people. We saw systems were in place for the action needed when and if any concerns were identified.

During our inspection we identified that systems were in place to assess and monitor the quality of the service.

We looked at five key outcomes to establish whether people were involved and participated in the service they received; whether care was provided appropriately; whether the agency could adequately ensure people's safety; whether staffing was adequate and whether there was a system for ensuring ongoing quality assurance within the agency.

Home Instead Senior Care was compliant in these five outcome areas.