Archived: Home Instead Senior Care

Home Instead Senior Care is a domiciliary care agency. It provides personal care to people living in their own houses and flats. It provides a service to older adults based in Budleigh Salterton, Exeter and East Devon area. Not everyone using Home Instead Senior Care receives the regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided. At the time of the inspection the branch provided personal care to 42 people living in their own home in the. The service employed 77 care workers, known as Caregivers.

Why the service is rated Outstanding.

People praised staff and said they were exceptionally caring and compassionate. Comments included, “Each carer provided warmth and loving care along with great attention to mums needs and interests,” “Nothing is too much trouble for them, they are so kind to her, explaining what they are doing.” Staff were matched with people based on their life, experiences, interests and hobbies. This helped them develop positive, meaningful relationships with people. They knew each person as an individual, and what mattered to them and treated people with the utmost dignity and respect. Staff went that extra mile to promote each person’s wellbeing and improve their quality of life. For example, taking one person to visit their old home and helping another person reconnect with old friends. The service had a strong, visible, person centred culture which people and staff described as “like an extended family.” Staff said, “The hour minimum visit gives us a chance to really connect with clients,” “I am proud to work with this friendly professional caring team that always puts the clients first.”

People were safe because there was an exceptionally strong emphasis on safety. Staff were skilled and proactive in recognising and reducing risk. They used innovative ways to support people to stay safe in their own homes, lead fulfilling lives and minimise restrictions on their freedom. Staff proactively helped people improve their health and reduce their risk of falling. The service held Falls Prevention Workshops for local community groups to spread message about how to prevent falls. They used an innovative mobile lifting chair to help people up, when they had fallen off the floor, which prevented unnecessary admissions to hospital. The agency has also extended this service to local people through their links with their local GP surgeries, NHS staff and Age UK at their local community hub.

People felt safer because staff worked with the police and the fire service to protect people from crime and improve fire safety. The provider promoted a ‘no blame’ culture, whereby staff were encouraged to speak up if they made mistakes or got things wrong. This was so wider lessons could be learned and safety improved.

People and families praised the exceptional skills of staff who supported them. Their comments included: “We are so grateful for the high quality, efficient and reliable care you provide.” Staff were well trained using best practice evidence and felt supported in their role. The service used innovative training methods to help staff understand people’s experience of becoming frailer, and experiencing visual impairment. They were proactive in ensuring people newly discharged from hospital had increased support.

People living with dementia received best practice care and the agency participated in dementia research. They promoted and encouraged people with dementia to live well. The service worked in partnership with local health and social care organisations to improve people's health. Staff taught people, relatives, staff and local people about the various types of dementia, and how it affected people. They signposted people to other local services and trained local volunteers in first aid and moving and handling.

People received an exceptionally personalised service that promoted their independence and enhanced their quality of life. People were at the heart of everything the service did, they felt valued and that they mattered. The agency worked in innovative ways to enrich people's lives and improve their wellbeing. For example, with the Alzheimer’s Society they supported a “Singing for the Brain” group in Exmouth, which used singing to bring people affected by dementia together in a friendly and stimulating social environment. To be more inclusive, the provider was about to start another group, Singing For Wellbeing”, at the Community Hospital Hub in Budleigh Salterton. This will promote wellbeing through singing for a wider range of older people.

People benefitted from a service was exceptionally well led. The provider had robust quality monitoring arrangements through which they continually reviewed evaluated and improved people's care. Professionals said, “The service is well led, the management team are always approachable and helpful, I always hear positive comments regarding them in the local community,” “Clients tell me how happy they are with the care they are receiving from Home Instead.” People’s feedback results and a range of awards showed the service was consistently high performing.

The provider had a ‘Carer of the month’ scheme that recognised, re-enforced and rewarded positive staff values, attitudes and behaviours. The agency was working with the local authority Devon County Council to promote careers in care positively. This was through staff featuring in a series of videos where they spoke about their rewarding experiences of working in care.

People were partners in their care. Their views, experience and contributions were sought and valued and used to make continuous improvements. The agency worked in partnership with local professionals and other organisations to develop joined up, innovative, flexible services and sustainable models of care that improved the health and wellbeing of local people. For example, they contributed to a successful campaign to reopen a closed community hospital as a “community hub,” which offered a range of services to local people. They supported a person, newly diagnosed with dementia, to influence policy by helping them to attend their local dementia alliance group.

Further information is in the detailed findings below

Home Instead Senior Care is a domiciliary care provider based in Budleigh Salterton, Devon providing personal care and support to 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 service supports 135 people living in Budleigh Salterton and the east Devon area including the city of Exeter. The service offered includes personal care such as assistance with bathing, dressing, eating and medicines. The service also offered 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 135 people, 35 received personal care and the remainder receive help in their home or companionship. We only looked at the service for people receiving personal care as this is the activity that is registered with Care Quality Commission (CQC). The staff who support people are known as ‘caregivers,’ we have called them this in the report. We have referred to the office personnel as office staff although they were also trained to provide personal care to people when required. The provider had 90 staff employed with 78 of these staff trained to deliver personal care.

When we visited there was 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.

People felt safe and caregivers were able to demonstrate a good understanding of what constituted abuse and how to report if concerns were raised. The safety of people who used the service was taken seriously and the registered manager and staff were well aware of their responsibility to protect people’s health and wellbeing. There were systems in place to ensure that risks to people’s safety and wellbeing were identified and addressed. Where there were issues the service responded well, investigated and addressed them in line with their policies and procedures. The provider drove forward support from caregivers who knew them well. People received a two week schedule of who was visiting and had always been introduced to new caregivers before they received support from them.

People received a service that was based on their personal needs and wishes. Care plans were personalised. Caregivers felt they had enough information to meet people’s needs, including receiving regular up to date information. Changes in people’s needs were identified and their care packages were amended to meet their changing needs. The service was flexible and responded positively to people’s requests where possible. People who used the service felt able to make requests and express their opinions and views. Health and social care professionals were regularly involved in people’s care to ensure they received the right care and treatment.

People spoke highly of the quality of care provided by the caregivers. They said they trusted the caregivers to have the skills to keep them safe. People had positive relationships with their caregivers and were confident in the service. There was a strong emphasis on the key principles of care such as compassion, respect and dignity. Nobody expressed any concerns about any of the care provided. People received their medicines on time and in a safe way.

People who used the service felt they were treated with kindness and said their privacy and dignity was always respected and had developed strong relationships with their caregivers. Everyone said their caregivers treated them respectfully and kindly and took extra time to make sure their needs were met.

Staff were supported and had opportunities for development. All caregivers said they were fully supported and valued by the registered manager, providers and the office team. They spoke positively about communication and how the management team worked well with them, encouraged team working and an open culture. There was a programme of training, clear career progression opportunities and one to one supervision that enabled caregivers to keep their skills up to date in order to support people appropriately.

The service had robust recruitment procedures in place for recruiting staff. When selecting caregivers the service placed an emphasis on the person’s caring nature rather than just previous experience in the care industry. There was outstanding leadership from the provider’s and registered manager who were well supported from a well organised management team and co-ordinated office arrangement. Caregivers were valued and had effective training and rewards which helped to ensure a stable and skilled staff team. Staff morale was very good and staff said they felt proud to work for Home Instead.

The provider had taken an important role in the local community. They had supported several towns in East Devon become more ‘Dementia Friendly’. The service and had been nominated and won various care awards. The providers had delivered dementia friends workshops in the local community for family and friends in how to care for people with dementia. They had also worked closely with the fire service, police and local authority to set up fire and fraud awareness initiatives.

The providers were very committed to continuous improvement. Feedback from people, whether positive or negative, was used as an opportunity for improvement. The providers 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 providers and registered manager demonstrated strong values and a desire to learn about and implement best practice throughout the service.