Home Instead Senior Care

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

This means we looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture. At our last assessment we rated this key question outstanding. At this assessment the rating has remained outstanding. This meant service leadership was exceptional and distinctive. Leaders and the culture they created drove and improved high-quality, person-centred care.

This service scored 93 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a very clear shared vision, strategy and culture. This was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and an exceptional understanding of the challenges and the needs of people and their communities.

Leaders promoted values that were understood by staff and reflected in day‑to‑day practice. Leaders demonstrated a clear and well communicated vision focused on providing high quality, safe and compassionate care. The involvement of the director, as well as a strong, management structure positively impacted the service. The organisation actively sought opportunities to learn and improve through partnerships, dementia programmes, and community initiatives. Learning from these activities was used to inform staff development, service improvements, and innovation in care delivery, demonstrating a proactive approach to continuous improvement.

Evidence provided a positive and learning-focused culture where staff were empowered to deliver high-quality care and achieve positive outcomes for people. Through personalised care and effective partnership working, people were supported to regain independence following hospital admission, reduce reliance on intensive care packages, avoid unnecessary hospital admissions, and remain living in their own homes and communities. People also reported improved wellbeing, increased confidence, and reduced social isolation. These examples demonstrated a culture where learning was embedded in practice and staff were supported to build meaningful relationships and achieve outcomes that mattered to people.

Incidents were reviewed and used as opportunities to reflect and make improvements, ensuring staff continued to deliver safe and consistent care. People and relatives were involved in discussions about concerns, accidents and incidents, and contributed to planning actions to help prevent future occurrences. Feedback from people and families highlighted that the provider was open, honest and willing to share learning, which helped individuals feel informed and more in control of their safety. Staff described a culture that was respectful and focused on people’s wellbeing, and there was a consistent approach to delivering care in line with the provider’s aims. This helped staff understand their role in supporting people and contributed to a stable and inclusive service. One staff member told us, “This is a great place to work, I feel valued here and there is a positive culture.”

Theproviderhad exceptionally inclusive leaders at all levels who understood the context in which they delivered care, treatment and support and embodied the culture and values of their workforce and organisation. Leaders had the skills, knowledge, experience and credibility to lead effectively. They always did so with integrity, openness and honesty.

Staff described leaders as supportive and compassionate, and told us they felt listened to and treated fairly. Leaders considered different needs and perspectives when making decisions, which helped to build trust and confidence across the team.

The provider demonstrated a strong commitment to staff development and progression. Opportunities for career development were promoted across the organisation, contributing to workforce stability, staff retention, and continuity of care for people using the service. For example, leaders supported a care professional with literacy and digital skills needs to undertake a Level 2 NVQ. Working with the training provider, they ensured appropriate adjustments and tailored support were in place to enable the individual to successfully engage with the programme. As a result, the care professional developed their skills and confidence, remained in post, and continued to provide consistent care and support. This demonstrated the provider's commitment to supporting staff development, removing barriers to learning and maintaining continuity of care for people using the service.

Leaders played an active role in coordinating care during periods of increased need, ensuring support arrangements were reviewed and adapted promptly. This enabled people to remain safe, maintain their independence, and continue living in their own homes wherever possible.

This approach resulted in a stable and experienced workforce, strong continuity of care and positive outcomes for people. Staff were supported to develop their skills and overcome barriers to learning, which improved confidence and competence and helped ensure people received consistent, person-centred care from staff who knew them well.

Staff reported feeling valued, supported, and treated fairly by the management team. They described the management team as both visible and readily approachable. The registered manager explained that they operated an open-door policy, encouraging staff whenever they needed guidance or support. One staff member told us, “The management is very supportive and they listen. We have regular round table meetings, where we share our views and this has led to changes in the way we work.”

Leaders demonstrated inclusive leadership by supporting staff wellbeing and development. Staff described being supported during personal crises, offered flexible rotas and opportunities for progression. Several staff had progressed into senior roles, which showed leaders invested in developing people. External professionals also described leadership as accessible and reliable, noting timely communication and effective coordination of care.

The provider encouraged an open and honest culture where staff felt able to raise concerns, share ideas and challenge practice where needed. Staff told us they felt safe to speak up and were confident issues would be taken seriously. There were clear processes for raising concerns, and leaders responded constructively to feedback. This helped the provider identify issues early and make improvements.

The provider strongly valued diversity in their workforce. They had an inclusive and fair culture which had improved equality and equity for people who worked for them. Leaders recognised the importance of a diverse workforce and worked to ensure staff felt valued and respected. This contributed to positive staff morale and consistency of care for people using the service. Staff had undertaken equality and diversity training as part of their annual training.

The service demonstrated an inclusive approach to both workforce practices and care delivery. Leaders made reasonable adjustments to support staff with individual needs and circumstances, helping them to access employment, develop their skills and remain in their roles. Cultural and religious needs were recognised and respected, contributing to a positive and inclusive workplace culture where staff felt valued and supported.

The service also adapted care delivery to meet people's communication and individual needs. Information was provided in accessible formats where required, helping people and their families to participate fully in decisions about their care and maintain choice and control. Feedback from staff and relatives reflected the positive impact of this approach, highlighting the service's responsiveness, personalised support, and commitment to treating people with dignity and respect.

These examples demonstrated how equality, diversity and inclusion were embedded in the service's culture and day-to-day practice. Leaders actively identified and removed barriers, ensuring staff and people using the service were not disadvantaged by their individual circumstances, protected characteristics, or communication needs. This resulted in improved staff wellbeing and retention, and more personalised, accessible, and responsive care for people using the service.

Theproviderhad clear responsibilities, roles, systems of accountability and good governance. They used these to manage and deliver good quality, sustainable care, treatment and support. They actedon the best information about risk, performance and outcomes, and sharedthis securely with others when appropriate.

Leaders demonstrated effective governance through strong systems and consistent oversight. Risks were identified early, managed promptly and monitored regularly, helping people remain safely supported at home by a competent and responsive workforce. The registered manager had a solid understanding of their regulatory duties, including timely notifications to the Care Quality Commission. They demonstrated good oversight of safeguarding, health and safety, quality assurance and risk management, ensuring compliance with best practice and legislation.

Communication across the service was strong. Effective systems ensured clear information flow between managers, staff, people using the service and relatives. Feedback from staff and people described communication as reliable, timely and reassuring.Well established oversight processes supported continuous improvement. Structured induction, competency assessments and observed practice ensured new staff met expectations before working independently, helping maintain consistent standards of care.

However, some governance processes had not always been followed. We found that supervisions and appraisals were inconsistent and not carried out in line with policy. The management team had recognised this oversight in their audits and had developed an action plan to address this.

The provider clearly understood and carried out their duty to collaborate and worked in partnership, and services worked seamlessly for people. They always shared information and learning with partners and collaborated for improvement.

The service worked collaboratively with healthcare professionals, local authorities, community organisations, and families to ensure coordinated, person-centred care. These partnerships supported timely intervention, continuity of care and positive outcomes for people, helping them to remain safe and independent in their own homes.

The provider was actively involved in local dementia and later-life networks, working with partner organisations to improve access to information, support, and community resources. Effective joint working, shared learning and signposting enabled people and their families to access wider support and maintain connections within their local communities.

Partnership working contributed to positive outcomes, including supporting people to regain independence following hospital admission, reduce reliance on more intensive care packages, avoid unnecessary hospital admissions, and improve their overall wellbeing. People were supported to maintain important relationships and remain engaged in activities that mattered to them.

The service also demonstrated a commitment to reducing social isolation and promoting community inclusion through a range of community-based initiatives and dementia-friendly activities. These provided opportunities for people to build relationships, maintain social connections, and support their emotional wellbeing.

In addition, the provider participated in initiatives such as the Technology for Better Care Project, working alongside NHS partners to explore innovative ways of supporting people to manage their medicines and maintain independence at home.These examples demonstrated the provider's commitment to partnership working, community engagement and continuous improvement, contributing to positive outcomes and an improved quality of life for people using the service.

One professional told us “They are reliable, thoughtful and empathetic. They provide expert care, that is matched to their client. They are incredibly supportive of the Voluntary, Community and Social Enterprise (VCSE) sector and keen to work with other organisations and support the people of Bristol. They are keen to work together, put on joint events, and show what outstanding care really does look like.”

The provider had a strong focus on continuous learning, innovation and improvement across the organisation. They promoted creative approaches to ensuring equality of experience, outcomes and quality of life, and actively contributed to safe practice and sector-wide learning.

Leaders reflected on feedback, incidents and day‑to‑day experiences to identify learning and make changes to practice. Staff were encouraged to develop their skills and share learning, which helped improve the quality of care. Improvements were generally implemented and supported a culture of ongoing development.

Leaders and staff actively sought out learning opportunities, regularly attending webinars and sector‑learning events to strengthen person‑centred practice. Insights from these sessions such as those focused on ‘Outstanding Care’, were shared across the team and used to inform future practice.The provider was involved in research including a medication compliance study and a recruitment initiative to identify individuals with the right attributes for a career in care. They had also undertaken a research study with Bristol University on wellbeing and burnout in the social care sector. This emphasised a proactive culture of learning, improvement and innovation across the service.