Home Instead

At our last inspection in October 2016, we rated the service ‘good’. At this inspection we found the evidence continued to support the rating of ‘good’ and there was no evidence or information from our inspection and on-going monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Why the service is rated ‘good’.

People told us they felt safe using the service. Care workers understood about protecting people from the risk of abuse and had undertaken training on safeguarding. Improvement had been made to how people’s medicines were managed. This ensured better recording was in place to provide clearer audit trails. Risks to people’s safety had been assessed and the service had action plans in place where risks were identified, to mitigate the likelihood of injury or harm.

There were enough staff to support people. They had been recruited using robust procedures. Staff told us they received good support and training. They could access managers when they needed advice or came across emergency situations.

People were supported with their healthcare and nutritional needs, to help keep them healthy and well. We have made a recommendation about the recording of meal and snack provision.

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.

People spoke positively about their care workers. Managers checked care worker practice by carrying out unannounced visits to people’s homes whilst they received support (with their permission). This included checking to see people’s cultural values and beliefs were respected and that staff offered choice and treated people with dignity. People could provide feedback about their care during reviews and through quality assurance surveys.

People’s needs had been assessed before they received support. Care plans were then produced which outlined the support they required. These were kept under review and updated as necessary. Care workers and managers were responsive to people’s changing needs and worked with health and social care professionals to promote their well-being. People’s complaints were responded to appropriately.

There were clear visions and values at the service. Staff described an open and transparent culture and said they would be confident in raising any concerns about people’s care.

The provider looked at ways of continual improvement for the service. Audits and surveys were carried out to check the quality of people’s care.

Further information is in the detailed findings below.

This was the service’s first inspection since changes to its registration in March 2014.

Home Instead Senior Care provides care to people in their own homes. At the time of our inspection, around 70 people received support with their personal care needs in the High Wycombe and surrounding areas. Most people who received a service were older people. Home Instead Senior Care provides a minimum of one hour visits.

The service had a registered manager in post. 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.

We received consistently positive feedback from staff and people who used the service. Comments from staff included “The best thing with Home Instead is it feels like an ideal service provider in an ideal world. It's almost perfect,” “I wish I made my choice to work in the care industry years ago. They have supported me with full training and additional training courses on Alzheimer’s and epilepsy, which I have been able to use with my clients. If I find any problems arise or need support, my senior and care manager are only a phone call away and they have always helped me where needed.”

People who used the service told us care workers treated them with dignity, respect and were caring in their approach. General comments about the service included “They are very, very good,” “ They will help you out with whatever you need. I can talk to them all very easily,” “I haven’t met a carer that I don’t like. I trust them” and “Everything I need they do. They are good at what they do.”

A relative told us “Mum used to be fiercely independent and it was a struggle getting her to have the carers to help her. They helped her to stay in her home longer, which is what she wanted.”

There were safeguarding procedures and training on abuse to provide staff with the skills and knowledge to recognise and respond to safeguarding concerns. Risk was managed well at the service so that people could be as independent as possible. Written risk assessments had been prepared to reduce the likelihood of injury or harm to people during the provision of their care.

We found staff had not followed safe practice for handling and managing people’s medicines. For example, accurate records had not always been maintained of when staff administered medicines.

We found there were sufficient staff to meet people’s needs. Staff told us support systems were effective and they could always obtain assistance when they needed it, such as in emergency situations. There was an on-going training programme to provide and update staff on safe ways of working. Recruitment procedures used at the service were robust, to make sure people were always supported by staff with the right skills and attributes.

People’s care needs had been assessed. This information was then used to develop care plans, which outlined the support people required. Information had been kept up to date as people’s needs changed.

People knew how to make a complaint if they needed to. Two complaints had been received, both of which had been responded to by the provider. We saw numerous compliments had been made by people or their relatives.

The quality of people’s care was monitored through spot checks, reviews of care and an annual quality assurance survey which was carried out by an external company. The findings of the 2016 survey showed the service was performing well.

We found a breach of the Regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was in relation management of medicines. You can see what action we told the provider to take at the back of the full version of this report.