Home Instead Bolton

Home Instead Bolton is a domiciliary care service providing personal care, support and companionship enabling people to remain in their own homes. At the time of the inspection there were 50 people receiving support from the service.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

People’s experience of using this service and what we found

The service placed people at the heart of the service and its values. It had a strong person-centred and local community-based ethos. The management and CareGivers were passionate about providing a high standard of person-centred care to clients when they needed it. Clients and relatives spoken with were eager to tell us how good the service was and how the CareGivers had become firm friends. They were complimentary about the reliability, kindness and flexibility of CareGivers and office staff. The registered manager told us that the service went out their way to accommodate clients wishes.

Client’s needs, preferences and wishes were met by a dedicated team who went out their way to get to know the clients well. This was done through initial meetings, matching clients and CareGivers and regular reviews.

The service was good at helping people to achieve positive outcomes and goals and helping clients to remain independent and allowing them to stay in their own homes for as long as possible. Clients were supported to maintain their interest and hobbies and to experience new pastimes.

Staff were safely recruited, well trained in both mandatory and specialist training as required. All staff spoken with were aware of how to report any concerns of abuse and were confident that these would be addressed by the registered manager. Staff felt supported by the registered manager and senior management. Staff felt listened to and felt very much involved in the organisation.

Clients were supported safely, and risk assessments about their care and support were assessed, met and regularly reviewed. Some clients were supported with their medication. Audits and checks were in place to show that medicines had been administered safely and as prescribed.

Clients and their relatives confirmed that all CareGivers treated them with respect for their dignity and privacy. The open, inclusive and supportive nature of the service meant that promoting equality and diversity and respecting people’s human rights ran throughout the whole of the service.

The service provided and supported clients with individual and community activities. Some clients had CareGivers who offered just companionship and spent time chatting and watching television together.

Clients care, and support plans were comprehensive and were followed in practice. Clients confirmed that CareGivers did what they were supposed do and often went above and beyond their daily tasks.

The leadership and the registered manager was dedicated to providing support and care to a high standard.

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

Rating at the last inspection

The rating at the last inspection was Good (Published 14 December 2016)

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

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

For the purpose of this report CareGivers are the preferred title of staff and people who use the service are referred to as clients.

There was a registered manager who was in charge of the day to day running of the service. 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 and associated Regulations about how the service is run.

Home Instead is a domiciliary agency providing personal care, support and companionship to people in their own homes. The agency operates across the Bolton borough. At the time of the inspection the service was supporting 52 clients with various care needs including personal care. There were also 46 clients supported with domestic tasks such as shopping and household tasks and companionship for trips and appointments. The majority of the visits undertaken were for one hour or more. There were also some 30 minute visits for where CareGivers supported clients with prompting or administering medication. The agency had 52 CareGivers with a further seven CareGivers who were in the process of completing their induction.

The service was flexible which meant that times of visits could be changed if clients had appointments they needed to attend and wished a Caregiver to accompany them. One client spoken with told us, “The service is excellent they [Caregiver] will change my visit time to suit my needs and any appointments”.

CareGivers working at the service were safely recruited and were able to complete training to meet the support the clients needed. The service also enabled Caregivers to undertake nationally recognised training to help them progress in their work. The service prided themselves on supporting clients living with dementia.

Home Instead participates in the City & Guilds Accredited Training Programme for Alzheimer's & Dementia Care. One of the directors was accredited by the Alzheimer's Society as a Dementia Friends Champion. This awareness programme was offered to all Home Instead staff and also to groups in the local community. Home Instead also ran free Family Workshops in the community for family members supporting those living with dementia.

We received some outstanding feedback from clients spoken with and from families. One client told us, “Fantastic service” another said “Absolutely excellent “. One relative told us, “We have peace of mind knowing that our [relative] is being supported by excellent carers”.

Clients spoken with told us they felt safe knowing that Caregivers would do their best to enable them to maintain their independence. We saw there were robust systems in place to manage risks to clients. For example referrals to the falls team for equipment to keep clients safe. This demonstrated that they had acted on the information gained at the assessment.

We saw that a comprehensive assessments were completed with the client and their family, where appropriate enabling them to make choices about the support they required. The assessment formed the baseline of the care records. Clients spoken with told us they had a care record in their home and these were completed after each visit.

CareGivers did not wear uniforms as following consultation with clients it was found they preferred Caregivers not too especially when accompanying them on trips and outings. All CareGivers carried an identification badge at all times. There was a dress code policy which CareGivers adhered to.

Clients told us that they were introduced to their CareGivers prior to the package of care commencing. If the CareGiver was on annual leave or sick leave the CareGiver offering care would be introduced to the client by the registered manager or senior staff. One relative spoken with told us that the same CareGiver provided care and support to their relative. They felt it was important in providing good, consistent care.

People spoken with said that CareGivers were polite and respectful and treated them with dignity at all times especially when helping with personal care tasks. One client told us, “All the people I have met have been lovely; they have all gone out of their way to support me”.

Clients and family members spoken with knew how to make a compliant and were able to share their views and opinions about the service they received. This was done with regular telephone calls and home visits by the registered manager and senior staff. There was also a satisfaction questionnaire to allow clients and their relatives the opportunity to feedback on the quality of the service and the care provided.

The service promoted an open and honest culture. The registered manager and the two directors were transparent in their discussions with CareGivers. Caregivers told us they were supported by the directors who were based at the Bolton office and by the registered manager and the management team. CareGivers spoken with told they thought the service provided ‘excellent care’ and described the support from the registered manager as ‘Brilliant’. Caregivers told us they were confident that they could raise any concerns or issues knowing that these would be listen to and taken seriously.

The registered manager and the directors were committed to continuous improvement and feedback from clients and relatives whether positive or negative was used as an opportunity for improvement and development. Clients and their relatives spoke very highly of the registered manager. They told us they thought the registered manager ran an excellent service which led to a good, happy staff team that helped ensure they received a high standard of care and support.

The registered manager demonstrated a good understanding of the importance of effective quality assurance systems. There were processes in place to monitor quality and understood the experience of clients and their relatives.

Where areas for learning and development had been identified, appropriate action was taken or considered. For example the directors and the registered manager were looking at end of life training. This would support CareGivers in providing care to clients in their homes who were

nearing the end of their life.

People we spoke told us. 'The service is brilliant. They let you know if there is a problem and they are running late, but that hardly ever happens'. We were told, 'They never let you down, they are really good, and the service is excellent'.

We saw written feedback from some people who used the service their comments included: 'The office staff are courteous and professional at all times' and 'The quality of the service is good, no changes are required'.

One member of staff spoken with told us, 'Everything is fine, I have no concerns'.