Harrall Care Services Limited t/a Home Instead Senior Care

People’s experience of using this service:

People were supported to have maximum choice and control of their lives. People and their relative’s felt this was a fantastic service.

There was a strong ethos of learning, when things went wrong, lessons were learned and shared with staff to support learning and understanding. Changes were implemented effectively ensuring best practice.

The provider had a twelve-week induction and training programme to develop and train staff. There was a support network to ensure staff had the confidence to grow. The training manager was passionate about good quality training. Staff told us they felt the training was excellent and were completely supported by the trainer. One aspect of the provider’s improvement plan included on line access for staff at any time to develop their needs further.

People, relatives and staff were complimentary about the positive outcomes people achieved. The provider’s systems and processes enabled staff to place the person at the centre of the care and support they received. People were supported to be independent.

People were supported to live and develop their skills and confidence in their own home. Staff were matched and introduced to people before they commenced their shift. The provider’s and registered manager ensured that people were supported by the same staff to ensure the development of relationships. This also meant people felt safer knowing what staff were supporting them.

The providers had an established staff structure with clear responsibilities for all staff. This ensured that communication was effective and the decision-making process for any actions identified to improve the service were taken promptly without any delay. Staff felt supported and confirmed that the management teams’ doors were always open.

The provider's governance systems were effective and ensured ongoing compliance. The providers had an improvement plan and was constantly developing the service. They had implemented an electronic monitoring and reporting system that had made a huge change to the way care and support was delivered.

The electronic system was live and gave real time information and allowed for immediate response and updates when required. The system also supported staff in delivering safer care and support, with prompts for staff and daily auditing and confirmation of completed tasks that were monitored by the registered manager and office staff daily.

All relatives were full of praise for Home Instead. They told us that the kind, caring staff who supported their families to grow, nothing was too much trouble and Home Instead had exceeded their expectations. People also confirmed they were delighted with the support they received.

Care plans were personalised, person centred with risk assessments developed for each identified risk to people`s health and wellbeing.

There was an extremely positive culture within the service, the management team provided strong leadership and led by example. The provider and the registered manager had a clear vision and strong values about how people were supported, this was echoed by all the staff we spoke with. Staff were proud to work for Home Instead and felt they were an active part of an organisation where they mattered, and their voice was heard.

The provider was engaged in supporting other organisations to learn and develop and gave talks on varied topics and provided learning to support other health and social care professionals.

The providers have opened a dementia café in the local community that supported people, their relatives and friends with invaluable advice and guidance. The dementia café provided a place for people to go and meet new friends for tea and coffee and take part in numerous activities.

Rating at last inspection: Good (report published 02 August 2016).

Why we inspected: This was a planned inspection based on the rating at the last inspection. The service has improved to Outstanding 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.

There was a manager in post who had registered with the Care Quality Commission (CQC). A registered manager is a person who has registered with the CQC 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 and associated Regulations about how the service is run. The registered manager was supported by service and assistant service managers responsible for the day-to-day operation of each location where people received care and support.

People told us that staff helped them stay safe, both at home and when out and about in the community. Staff received training for how to safeguard people from abuse and were knowledgeable about the potential risks of abuse and how to report their concerns. Robust recruitment practices were followed and there were sufficient numbers of suitable staff available at all times to meet people’s needs. People where necessary and appropriate were supported to take their medicines safely and at the right time by trained staff. Potential risks to people’s health and well-being were identified, reviewed and managed effectively.

People who received support, relatives and health care professionals were positive about the skills, experience and abilities of staff who received training and refresher updates relevant to their roles. Staff supported people to maintain good health and access health and social care services when necessary.

Staff obtained people’s agreement to the support provided and always obtained their consent before helping them with personal care and were aware of MCA requirements. People told us that staff supported them in a kind and caring way that promoted their dignity. We found that staff had developed positive relationships with the people they supported and were clearly very knowledgeable about their needs and personal circumstances.

People who received support were involved in the planning and regular reviews of the care provided and this was accurately reflected in their individual plans of care. The confidentiality of information held about people’s medical and personal histories was securely maintained.

People received personalised care and support that met their needs and took account of their preferences. Staff were knowledgeable about people’s background histories, preferences and routines. People were supported to pursue social interests relevant to their needs. They told us that the registered manager and staff listened to them and responded positively to any concerns they had. People were encouraged to raise any concerns they had and knew how to make a complaint if the need arose.

People, their relatives, staff and professional stakeholders were all complimentary about the management team and how the service operated. The management team monitored the quality of services and potential risks in order to drive continuous improvement.