Home Instead Weston super Mare, Clevedon & Burnham on Sea

People’s experience of using this service: The staff worked very hard as a team to help people live independently and safely at home for as long as possible and genuinely cared about doing so.

People were exceptionally well matched with their regular care staff team and people spoke positively about the staff who visited them. Staff went ‘above and beyond’ for people and people said they were happy to do so.

The service worked very hard to provide people, relatives and the local community with information that would improve their safety, independence and awareness. This included arranging an event that aimed to provide people with information about services and products that were relevant to them and offering people the chance to attend complimentary workshops and training for people, relatives and the community.

People told us the service was responsive to their needs. This included encouraging people to retain control of their lives, choices and independence. People told us they felt comfortable to raise concerns and complaints and these were dealt with appropriately by the registered manager.

There was a team mentality and staff worked with each other and organisations to achieve good outcomes for people. When required, staff supported people to access the healthcare that they needed.

People and their relatives told us the service was safe. Risks to peoples’ safety were assessed and there were systems in place to keep people safe from potential harm. Staff spoke confidently about actions they would take if abuse was suspected and referrals were made to the Local Safeguarding team when required.

People told us their medicines were managed safely and relatives confirmed this. Body maps were used to guide staff about what creams should be applied and where. Staff used gloves and aprons to help prevent the spread of infection.

People were assessed, and care plans included detailed information to guide staff about what the person needed and how this could be achieved. The care people received was provided by suitably qualified and well-supported staff.

People told us that staff listened to their wishes and that care was only provided if the person consented. If the person was assessed as lacking capacity to consent, a best interest decision was completed in partnership with the person’s loved ones and relevant healthcare professionals.

People, relatives and staff spoke positively about the registered manager, management team and provider. There was a clear management structure and staff were aware of their responsibilities. The registered manager and provider had oversight of the service and were involved with the daily running, checks and auditing.

At the time of our inspection no one was receiving end of life care.

Rating at last inspection: Good (December 2016)

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

Follow up: We will continue to monitor the service through the information we receive. We will inspect in line with our inspection programme or sooner if required.

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

Home Instead Senior Care provides domiciliary care and support to 89 people living in North Somerset and 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; Help within the home covering all aspects of day-to-day housework, shopping, meal preparation and other household duties. The service also provides companionship services such as escorting people on visits or appointments, simple conversations and company. Of those 89 people 30 received personal care and the remainder received help in their home or companionship. We only inspected those people receiving personal care during this inspection, as this is the service that is registered with The Care Quality Commission. The staff who support people are known as ‘CAREgivers’ we called them this in the report and office personnel are referred to as office staff.

There was a registered manager in post at the time of this 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.

The service provided good support to people and was proactive to ensuring people’s safety and was responsive to people’s needs. CAREgivers knew how to identify abuse and what they should do if they suspected abuse. People felt safe and knew their care staff well. People were supported by staff who had satisfactory checks prior to starting their employment. Staff’s empathy to the caring role was explored as part of the interview process.

The service identified risks to people’s safety and was proactive at reducing risks through specialist equipment and technology. The registered manager gave two examples of how they had identified risk and had sought imaginative ways to keep those people safer.

People, their relatives and CAREgivers all felt the service was well-led and provided a high standard and excellent care. All were 100% satisfied with the care and service provided. The service was an active part of the local community. It provided information, training, coffee mornings and worked in partnership with different organisations to benefit the local community and staff.

There was a positive culture that was person-centred and that ensured people were at the heart of the service. One person told us, “When you ring the Office they will always try to help and see if they can do something for you. I would definitely recommend them.”

The provider had systems in place to monitor the quality of the service and an annual audit was undertaken by the franchises main office. The last audit undertaken was in September 2015 all actions identified had been taken.

People’s care and support was planned proactively and in partnership with them. The service actively promoted local activities, clubs and social activities to enable people and the local community to benefit from an enhance sense of well-being.

People and relatives were complimentary about the care and service they received. People were very positive about how responsive the service was to their changing needs and the support provided when changes had arisen. The service had a complaints procedure in place which dealt with complaints appropriately.

People were happy with how staff administered their medicines and felt they received it on time.

People and their relatives felt positive about the caring attitudes of the CAREgivers. All confirmed they were happy and that staff treated them with kindness and respect.

People had developed caring relationships with people. The service ensured any changes to people’s planned CAREgiver was feedback so people knew who to expect.

People received care from CAREgivers who had been introduced to them to ensure that people were involved and happy with their allocated CAREgiver.

People were supported by staff who received training in order that they could carry out their roles effectively and competently. People told us, “I have been with them a long time they are very good and I would definitely say they know what they are doing” Another person told us, “Yes I have confidence that they know what they are doing”. Staff told us, “We are introduced to new clients and shadowed when we first start to get to know what is needed” and “If you are unsure the Office support is unfaltering.

The service was proactive in working with health care professionals to enable CAREgivers to be skilled at providing personalised care to people they supported.

Staff received supervisions and appraisals and felt supported by the registered manager and office co-ordinator. People were supported by staff to make decisions about their care in accordance with current legislation. Where people were unable to express their wishes, relatives were part of developing people’s care and support needs that reflected the persons’ likes.