Home Instead Senior Care - Bourne

Home Instead Senior Care provides personal care and support for adults in their own homes. The service can provide care for adults of all ages. At the time of our inspection the service was providing support for 49 people. The service covered Lincoln and surrounding areas.

People’s experience of using this service:

People were very satisfied with all aspects of the service provided and spoke highly of staff and the registered managers. People who used the service told us they were treated with compassion and kindness and that their privacy and dignity were respected.

People who used the service and relatives we spoke with told us they felt staff provided safe and effective care. Staff turnover was low which people and relatives valued. People were supported by a small team of staff that understood their needs.

We found that there were systems, processes and practices were followed to safeguard people from situations in which they may experience abuse including physical harm. Risks to people’s safety had been assessed, monitored and managed so they were supported to stay safe while their freedom was respected.

People received their medicines as prescribed. Medicines Administration Records (MARs) reviewed had been completed by staff and were regularly audited by management.

Background checks had been completed before new care staff had been appointed. People were protected by there being arrangements to prevent and control infection and lessons had been learnt when things had gone wrong.

Staff had received all the training required to support people safely. Staff received regular supervision and annual appraisals and were able to reflect on the care and support they delivered. Staff were able to identify further training in addition to their mandatory training.

People 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.

People were supported to eat and drink sufficient amounts to meet their nutritional needs when required. People had been supported to live healthier lives by being supported to have suitable access to healthcare services so that they received on-going healthcare support. Suitable arrangements had been made to obtain consent to care and treatment in line with legislation and guidance.

People received personalised care that was responsive to their needs. Care staff recognised the importance of promoting equality and diversity by supporting people to make choices about their lives. Confidential information was kept private.

There was strong sense of leadership in the service that was open and inclusive. The registered persons focused on achieving positive outcomes for people and their staff.

People benefited from there being a robust professional management framework that helped care staff to understand their responsibilities so that risks and regulatory requirements were met.

The service encouraged feedback from people who used the service, relatives and care staff. Views were gathered through questionnaires, telephone conversations, regular face to face meetings at their home or in the office.

One complaint had been received in the last 12 months and this had been responded to appropriately. People were introduced to lay advocates if necessary.

Quality checks had been completed to ensure people benefited from the service being able to quickly put problems right and so that people could consistently receive safe care.

Good team work was promoted and care staff were supported to speak out if they had any concerns about people not being treated in the right way. Staff were clear about the vision and values of the service. In addition, the registered persons worked in partnership with other agencies and stakeholders to support the development of joined-up care.

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

More information is available in the full report.

Rating at last inspection:

Good (report published 17 May 2016)

Why we inspected:

This was a planned inspection based on the rating at the last inspection. The service remained rated good overall.

Follow up:

We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

The service provides personal care to people in their own home. The office is located in Bourne in Lincolnshire and they provide care to people living in the surrounding area. At the time of our inspection they were providing personal care for around 20 people.

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.

The provider and registered manager were committed to providing a high quality service to people. The work schedule ensured that care calls were appropriately spaced so that staff always arrived at people’s homes when expected and care was not rushed. Furthermore the registered manager matched people receiving care to staff to support a compatible relationship and always introduced the member of staff to the person.

Staff were supported by a flexible training programme tailored to each individual member of staff’s training needs. This ensured staff provided person centred care and that they were aware of how to support people with different conditions. Staff received supervision and appraisals to monitor their performance and spoke highly of support that was always available from the office staff, registered manager and provider.

Care staff had an in depth knowledge of people’s care needs and abilities which was supported by neat, orderly and detailed care plans and briefings from the registered manager about the individual needs of people. This ensured care staff had the knowledge to identify where people were unwell and needed extra help. The provider and registered manager had recognised the importance of family relationships and monitored the health and well-being of other people in the home. People’s medicines were safely managed with their participation.

Staff supported and encouraged people to be involved with their care and to maintain their independence wherever possible. People’s abilities to make decisions were assessed and recorded and staff supported people’s decisions while at the same time risks to people were minimised. Staff were quick to raise concerns with the office if they thought a person was at risk of harm and were confident that the office staff would take appropriate action. At the same time staff knew how to raise concerns with external agencies if needed.

Staff respected people’s privacy and understood that it was important that people trusted them. They were clear on what information could be shared with other members of the family. Staff understood what was important to people when receiving care and ensured that care was flexible to meet their needs. The provider had recognised how hard it was for people to care for a loved one and provided guidance and support to help people stay connected and enjoy their family relationships.

People were encouraged to raise complaints and concerns. The office staff ensured people knew how to complain when they rang to ensure that the care provided was meeting people’s needs. The staff, registered manager and provider all took action to resolve any issue raised and prevent reoccurrence.

The staff, registered manager and provider all took pride in the company and the quality of care they provided to people. People using the service and staff were asked about the quality of service provided and action was taken to improve the service in response to their feedback. The provider had robust systems in place to monitor the quality of service provided and took action to ensure the service provided was good. The provider had developed links with healthcare professionals and charities to ensure the care provided was up to date with the latest guidelines.

We found there were detailed care plans in place and these had been regularly reviewed. People we spoke with said they received care from the same staff group and told us staff were very reliable and efficient. One person said, 'The care is first class.'

Care workers received training on medication. We saw there was a robust system of auditing medication records once they had been returned to the office. This meant people could be assured that their medicines were being managed in a safe and appropriate way.

We found there were effective recruitment and selection processes in place. Records showed all necessary checks were completed before people started work. People who used the service were generally very complimentary about the staff. They told us the staff were friendly, caring and punctual. Comments included,'Super staff, very conscientious and kind' and 'We have found the staff excellent.'

People spoken with confirmed they were asked to complete a questionnaire about the service they received. They also confirmed they were made aware of the complaints process. They told us they felt able to complain and said they would do this by contacting staff at the office or speaking to the manager.