Home Instead Senior Care

Home Instead Senior Care (Truro) provides people with personal care in their own homes. ‘Home Instead’ is an international franchise. This specific agency is operated by Kernow Care Services Limited. At the time of the inspection the service provided support for approximately 41 people, 19 of whom require personal care. The service provided support for people in the Truro area. The service works with elderly people.

The service did not have a registered manager. 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. However a manager had recently been appointed, and an application had been submitted for the person to be registered with the Care Quality Commission.

The service had satisfactory safeguarding policies and procedures. Staff were trained to recognise abuse, and what to do if they suspected abuse was occurring. Suitable risk assessment procedures were in place, and risk assessments were regularly reviewed.

Recruitment checks for new staff were satisfactory. For example, the registered provider obtained a Disclosure and Barring Service check and written reference check when the member of staff was recruited. When staff started to work at the agency they had to complete a satisfactory staff induction, which included relevant training which assisted the member of staff to carry out their job. The registered provider had a suitable system of staff supervision and annual appraisal.

Medicines procedures were satisfactory, and we were told the support people received in this area was good. Staff were trained in procedures to minimise the risk of infection. People and their relatives said staff were always clean and well dressed. Staff said they were provided with disposable gloves and aprons.

There were satisfactory procedures to assess people to check they were suitable to receive support from the service. Subsequently staff developed comprehensive care plans for people and these were regularly reviewed.

Where people received support to prepare meals. Procedures to monitor food eaten and fluid intake, if and where necessary, were satisfactory.

We were told none of the people who used the service lacked mental capacity, and could make decisions for themselves. If people did loose capacity, the service had suitable systems were in place to meet legal requirements and ensure people’s rights were protected.

We received positive support about staff attitudes. Comments included; “Very good,” “Staff are very nice,” “Very kind” and “Staff are lovely.” Staff worked with people to maximise people’s independence.

The service had a complaints procedure. People said they would approach staff or management if they had a concern.

Management were viewed positively by the people who used the service and staff who we contacted.

The staff team said they worked well together. People and their relatives viewed staff positively and staff were viewed as caring.

Quality assurance processes were satisfactory to monitor the service was working effectively, and pick up and address shortfalls in service provision.

Home Instead Senior Care is a domiciliary care provider based in Cornwall providing personal care and support to 49 people in their own homes. 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; home help covering all aspects of day-to-day housework, shopping, meal preparation and household duties; and companionship services such as escorting people on visits or appointments, simple conversation and company. Of those 49 people 27 received personal care and the remainder received help in their home or companionship. We only looked at the service for people receiving personal care during this inspection as this is the service that is registered with Care Quality Commission. The staff who support people are known as ‘caregivers,’ we have called them this in the report.

The service had a registered manager in place. 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 felt safe when being supported by caregivers from Home Instead. No-one reported any concerns about the care provided. Staff had received training in safeguarding children and adults and had guidance available in case they needed to raise a concern outside of the organisation. Staff told us they were aware of recent changes to local reporting arrangements.

There were sufficient numbers of staff to meet the needs of people who used the service. The owner and registered manager spoke of the importance of recruiting the right people for the job. There was an emphasis on matching caregivers with people to help ensure they had shared interests and beliefs. One person told us; “We [the person and caregivers] have common ground.”

People were supported by small teams of caregivers and this contributed to the ability of caregivers to form trusting relationships with the people they supported. One person told us when they had started using the service they had stressed to the registered manager how important continuity of care and punctuality was to them. They told us; “They have been spot on, I wouldn’t criticise them at all.”

Care visits lasted a minimum of one hour and staff told us this was significant factor when developing relationships with people and providing a person centred service. The ethos of the service was that providing companionship was as important as meeting people’s health needs. Caregivers arrived on time and stayed for the allocated time. No-one reported any missed visits and people told us late visits were rare and they were always kept informed.

Induction and training was thorough and updated regularly. Staff were supported by a robust system of supervision and appraisal and regular staff meetings. Staff said they felt very well supported and were proud to work for the organisation. They told us they felt part of a team and believed they were valued by the management team.

The registered manager was flexible in their approach to ensuring people’s needs were met. They recognised that people’s needs fluctuated and spoke regularly with people to identify any changes quickly. They used a call monitoring system to highlight when visits were becoming longer and possibly indicating that the person needed an increase in their support package.

The service provided outstanding levels of care and put the person’s needs and preferences at the forefront of care planning and decision making. People who used the service, relatives and healthcare professionals were unanimous in praising the compassionate and professional care provided by staff. People and families, where appropriate, were encouraged and supported to contribute to care planning and review.

People’s preferences, likes and dislikes were identified and respected. Care plans contained information to guide staff on how to support people according to their preferences. Staff knew people well and had developed an understanding of their needs over time. People’s right to independence and choice and control was recognised and respected.

The service had a complaints policy in place. People who used the service were made aware of the complaints procedure and told us they knew how to make a complaint and who to, should the need arise.

People who used the service, relatives and healthcare professionals were consistent in their praise of the leadership of the service. The owner, registered manager and all staff demonstrated a shared approach to care and support that put people at the centre of the support. The importance of talking with people and spending time with them was recognised by everyone.

Home Instead was a well-managed and well-organised service. There were clear lines of responsibility and accountability in place. A robust system of audits helped ensure the standards set by the national office were adhered to. The owner and registered manager told us they hoped to develop and grow the service further. However, they recognised the need to ensure existing care packages were stable and well established before accepting new packages.

We visited three people and their family members in the community and spoke over the telephone with three people who use the service and asked them about how their views and experiences were taken into account in the way the service was delivered in relation to their care. One person said "I am sitting all day on my own and I look forward to the staff coming". Another person told us that "I have continuity of staff which is what I want".

We spoke with the manager and two members of staff, and contacted three staff over the telephone. One member of staff said that "I am very happy with the training I receive". Another member of staff said that "I am happy working for the agency because we all work closely together as a team".

People were protected from the risks of unsafe or inappropriate care and treatment because up to date, accurate and appropriate records were maintained.

All of the people that we spoke with about the care that they receive were complementary about the service. Comments included, 'It's like a friend coming round to look after you', 'Very very good' and 'Excellent, observant and sympathetic'.

People experienced care, treatment and support that met their needs and protected their rights.

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

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

There was an effective complaints system available. Comments and complaints people made were responded to appropriately.