Archived: Home Instead UK Ltd

Home Instead UK is a care service providing personal care and support for people living in their own homes. At the time of inspection, the service provided support for 96 people.

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. At the time of this inspection, 32 people received personal care.

People’s experience of using this service and what we found

Feedback from people, their relatives and friends were that staff members genuinely cared about people, were exceptionally compassionate and put themselves out to ensure people received the care and support they needed. People and their family members told us about, and we saw examples of, how this approach had led staff to provide support that at times exceeded people’s expectations. People’s relatives told us that they felt included and supported emotionally by the approach from staff and the quality of the care provided for their family members. They praised the kindness and creativeness of the staff team.

People told us that all staff were respectful of them, their family life and their home. They adapted their approach in each person’s home, to ensure that they met the person’s preferences and actively searched for opportunities to promote people’s dignity. People’s autonomy was promoted and respected and they were supported to remain as independent as possible. The service provided for people was adapted as much as possible to meet people’s needs, often in a creative and insightful way. A culture of flexibility was embedded within the service.

People and their relatives told us that staff were not only respectful of their physical home; but also, of their privacy and family dynamics. One family member told us about the staff who visit their home, “He helps us feel comfortable; he always comes in with a smile… a breath of fresh air.” Another family member told us, “They are very thorough and perceptive… [they] analyse our needs at the time… I feel comfortable with them in my house.”

The culture within the service was progressive, dynamic, open and reflective. Every area of people’s care and support showed evidence of thoughtfulness, kindness, learning and ongoing improvements. There was a clear focus on providing the best possible support for people, that was absolutely reliable, safe and centred on their choices and preferences. Everybody’s feedback reflected this.

The service was safe. People told us that the calls they received were extremely reliable. The service had enough staff, and the schedules of people’s visits were planned so they had sufficient travel time between visits to ensure that they were not rushed. There was a series of audits and unannounced spot checks. These ensured that the support people received was in accordance with what they needed and had been agreed. Staff also received training and regular refreshers on safeguarding; and there were effective systems in place to help senior staff identify and reduce any risks in people’s support.

People and their family members told us that staff were very skilled and competent. Staff told us that they received exceptional support that enabled and inspired them to be effective in their role. One staff member told us, “I’m encouraged to grow. I feel supported in my role and this has promoted my confidence.” The effectiveness of staff training was constantly assessed.

Everybody we spoke with told us that all staff were excellent at listening to their views and ensuring that they were supported to make their own decisions. One person told us, “I felt listened to and respected and [after speaking up] everything ended up fine.”

The principles of the MCA were applied in a meaningful way within every aspect of people’s care and support. 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. We saw that on occasions staff had provided exceptional support when acting in a person’s best interests.

Each person had an individual care plan that contained all the details that the person wished to share about their care and support needs, daily routines and information about them as a person. People and their relatives told us that they were involved in or consulted about their care plans and reviewing the effectiveness of their care and support. Supporting people to maintain important relationships was a central part of people’s support. Some people told us that they had been supported to reengage in their local community. Staff were matched with people who they supported. The matching was based on the person’s wishes, staff personalities and what had worked previously.

People were supported to remain as healthy as possible. Any guidance and advice from healthcare professionals was recorded as part of people’s care plans. Family members told us that staff are very observant and vigilant in identifying any changes that may indicate a person may need to see a medical professional. One person’s family told us, “The carers see her every day; they are perceptive and know her well, we rely on them to spot things and we go to them for advice.”

The service was well led. The process for supporting people with complaints or concerns was open, honest and responsive. People told us they felt comfortable raising a concern. The manager had oversight of a system that recorded and acted upon any accident, incident or near miss; and any actions identified to prevent further occurrences were acted upon. They also set a positive example and showed a genuine interest in people, their family and friends; and they had a detailed plan of ongoing improvements of the service.

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 5 July 2017).

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.

On the days of this inspection there were 74 people using the service.

At the last inspection on 12 March and 9 April 2015 the service was rated Good. At this inspection we found the service remained Good.

There was not a registered manager in place at this service. A new manager had been appointed and had applied to be registered with the Care Quality Commission. 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 told us they were very happy with the service provided and that the staff were caring, kind and friendly. People said “It’s all going well, I am happy”, “The staff treat me nicely”, “The staff are absolutely wonderful” and “The staff do everything for me”.

Staff told us they enjoyed working at the service and providing support to people who used the service. They said they were supported by the office and management team and they appreciated on call support that was available to them.

Care plans were well documented and up to date. They gave clear guidance to the staff team. Risk assessments were undertaken for a variety of tasks which included moving and handling, falls and the environment. These were reviewed regularly and up to date. The management of medication was safe.

Staff were aware of how to report a safeguarding concern. They were aware of the policies and procedures available to safeguard people from harm and told us they would not hesitate to report any concerns.

Staff had received a range of training that included moving and handling, safeguarding, medication and fire awareness. A range of other training was available to the staff team. Staff told us that the training was good. Staff had access to supervision sessions, annual appraisals and were invited to attend regular staff meetings.

Staff recruitment files showed that robust recruitment processes were in place. Staff attended an induction process prior to working alone. Staff told us that they worked alongside an experienced staff member before going it alone. They confirmed the induction process was good and that they had the information they needed to perform their role.

People had access to information about the service. They said that they knew the information was in their care folder and some people had read this. Other people said they were not bothered about the folder but knew the information was available. An initial visit was undertaken by one of the management team prior to the service starting.

A complaints policy was available and each person had this information within the care folder. Processes were in place to deal with any complaints received.

Quality assurance processes were in place which included observations of staff to ensure that care and support standards were being maintained and reviews of people’s care. Audits were undertaken in relation to the service provided and these monitored the services safety and effectiveness.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

Further information is in the detailed findings below.