Background to this inspection
Updated
17 October 2018
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
This comprehensive inspection took place on 20 August 2018, 22 August 2018 and the 31 August 2018 and was announced. The inspection team consisted of one inspector. We gave the service 48 hours’ notice of the inspection visit because the registered manager may have been out of the office supporting staff. We needed to be sure that they would be in.
Before the inspection we reviewed information available to us about this service. The registered provider had completed a Provider Information Return (PIR). The PIR is a form that asks the registered provider to give some key information about the service, what the service does well and improvements they plan to make. We also reviewed safeguarding alerts; share your experience forms and notifications that had been sent to us. A notification is information about important events which the provider is required to send us by law.
We spoke with five people and three relatives. We spoke with the director of the company, the registered manager, the deputy manager and six care staff. We reviewed four people's care records, looked at four staff files and reviewed records relating to the management of medicines, complaints, training and how the registered persons monitored the quality of the service.
Updated
17 October 2018
Home Instead is a domiciliary care agency. It gives personal care to people living in their own houses for 80 people. It provides a service to older adults. Not everyone using Home Instead received the regulated activity; CQC only inspects the service being received by people provided with ‘personal care;’ and help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.
At the last inspection the service was rated Good. At this inspection we found the service was now outstanding.
Typical feedback included. “This is an excellent company you won’t have any problems. If you ring them they will send someone to you to find out your requirements.” And, “I know the person who is on the premises. If they do not come they will send a replacement. You will not get let down. My staff member very often gives me an extra 10 minutes. They do the work thoroughly.” And, “Every now and again they send someone to see you, to ask if you are happy with their service. They will ask if there is anything they can do to improve. With regards to medicines, the manager will watch the staff member, while I take the tablets. They will explain everything to you. I have no complaints.” And, “It is very well organised one of the best around. I cannot fault them at all.”
A registered manager was 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 directors of the company, management team and staff continued to find ways to improve the service and remain driven by their passion for caring for people, by ‘making it personal.’ The service had built on their earlier rating and since the last inspection, had implemented a strategy which had been focused on how they were going to achieve an outstanding model of care. The pathway used to do this was referred to as 'going the extra mile team' approach. The vision and the value of the service was to become the most admired home care provider across Brentwood, Billericay, and Upminster.
Staff had an excellent understanding of people's needs and were imaginative in the way they gave person centred care. The provider put people at the heart of the service and looked to find creative ways of supporting people to have an exceptional quality of life.
People and their relatives felt confident that people were safe and secure when receiving care in their own homes. There were clear systems in place to ensure the safety of people who used the service. Staff had received training to identify if people were at risk from abuse or harm. Enough staff was deployed to ensure that people had a consistently reliable service. Recruitment procedures to appoint new staff were thorough. People were supported to take their medicines safely.
Staff spoke consistently about the service being a good place to work. The registered provider worked in partnership with other organisations and took part in several good practice initiatives, designed to further develop the service.
People received their care and support from a staff team, that had a full understanding of people's care needs and the skills and knowledge to meet them. Staff were given an induction when they started and had access to a range of training to provide them with the level of skills and knowledge to deliver care efficiently. Staff were regularly supervised and supported. People’s needs were assessed before their care and support package began. People were provided with person-centred care which considered their needs, wishes, preferences, and any cultural or religious needs. Staff supported people to meet their nutritional and health care needs.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.
People’s dignity and privacy was respected. People told us staff were reliable, friendly, and caring. Staff developed positive and caring relationships with the people they supported and used creative ways to enable people to remain independent.
The registered provider had a number of schemes in place to drive improvement and reward staff that used their initiative and for their outstanding contribution. The service had been highly commended and had recently won an award after being rated one of the top 20 recommended home care providers in the East of England.
Further information is in the detailed findings below.