Dixon Dunn Care Solihull Limited Also known as Home Instead - Solihull

Dixon Dunn Care Solihull Limited is part of the Home Instead Senior Care national franchise. A franchise is when a franchisee (the provider) has bought the right to sell a specific company's (the franchisor's) products in a particular area using the company's name.

This announced inspection took place on 28 June 2018. We told the provider 48 hours before the visit we would be coming so they could make sure they would be available to speak with us and arrange for us to speak with care workers.

The service is required to have 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 and associated Regulations about how the service is run. A registered manager was in post.

The service was last inspected on 11 May 2017 when we rated the service as ‘requires improvement’. The provider had learnt lessons since that inspection and had taken action to make improvements.

People felt safe with the staff that provided their care and support. Risk assessments contained up to date information to support staff to provide safe care. Staff understood the risks associated with people's care and knew how to manage risks.

Procedures were in place to protect people from harm. The registered manager was aware of their responsibilities to keep people safe. All staff had received ‘safeguarding adults’ training to support them to understand what constituted abuse.

The provider's recruitment procedures minimised the risks to people's safety. Enough care workers were available to support people at the times they preferred and people confirmed care workers arrived at the times they expected them. An electronic system was used by the provider to check people had received their care. The provider had systems to record and review any accidents and incidents that occurred.

The management of people’s medicines had improved since our last inspection. We checked and found people had received their medicines as prescribed. The system for recording medication errors meant action could be taken in a timely way to keep people safe if errors occurred.

People told us staff had the right skills and knowledge to meet their needs. New staff received the support and the training they needed to be effective in their roles. Staff spoke positively about their training and a programme of regular updates supported them to keep their skills and knowledge up to date.

Staff knew how to manage people's nutrition and hydration which included encouraging them to eat to maintain their health. People felt confident care workers would support them if they needed to attend any health appointments. Staff followed good practice and understood their responsibilities in relation to infection control.

People told us all of the staff were kind and caring. Relatives supported this viewpoint and told us they would recommend the service to others. Staff thought the service was caring because they provided consistent care to the same people which meant meaningful relationships had developed. People were supported to develop friendships which had a positive effect on their wellbeing.

People received care and support that was responsive to their needs. People and their families were involved in the planning and review of their care. People's care plans were written in a personalised way and included a brief life history and information about their preferred routines and lifestyle choices from their perspective.

People chose how they spent their time and staff knew the importance of people being involved in making decisions. 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.

Staff supported people to maintain their independence. People confirmed care workers treated them with respect and maintained their dignity. Staff understood the importance of maintaining people's confidentiality.

People and staff spoke positively about the way the service was managed. Staff felt cared for and supported by their manager because they received regular supervision and observations of their work performance. They also attended team meetings where they discussed ideas for improvements.

Audits and checks to assess and monitor the quality of the service were effective which assured us improvements had been made since our last inspection.

People felt assured that complaints would be taken seriously and acted upon. People were encouraged to share their views on the service they received. The feedback gathered was used to drive forward improvement.

Since our last inspection the provider had increased their community links and the service was an active part of the local community.

The registered manager understood their responsibilities and the requirements of their registration.

This was the first inspection of Home Instead Senior Care, Solihull since registering with the Care Quality Commission in June 2016.

A new manager was appointed in January 2017. The manager has submitted an application to us so they can be ‘registered’. A requirement of the provider’s registration is that they have a registered manager. 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.

Known risks, related to the delivery of care and support for people who used the service, had not been assessed and some risk assessments did not reflect people’s current needs. This meant staff did not always have the information they needed to support people safely and to keep themselves safe. The manager was taking action to address this.

People who used the service told us they felt safe with care workers who were caring, kind, friendly and patient. Staff had been trained to understand how to protect people from abuse.

Staff had been recruited safely and received a comprehensive induction when they began working at the service to prepare them for their role. The quality of training care workers received equipped them with the skills and knowledge needed to support people effectively. Care workers practice was regularly checked to make sure they worked in line with the provider’s policies and procedures.

The provider had not established effective procedures to check and monitor the quality and safety of the service people received. This meant the provider was not always aware of potential poor practice and areas where improvement was necessary. Systems to ensure medicines were managed safely were not always effective and required improvement.

People were involved in how their care and support was planned and delivered. Care records provided staff with information about people’s backgrounds, preferences and needs to enable care workers to provide personalised care and build relationships with people.

Care workers had a good understanding of the people’s needs and provided care in a respectful and dignified way. Care workers promoted people’s privacy and encouraged independence. However, care records were not always reflective of people’s current needs. This was being addressed by the management team.

The provider had developed systems to gather feedback from people, relatives and others so they could use the information to improve the quality of the service provided. People saw health professionals when needed. Support was given to people who required help with eating and drinking.

There were enough care workers to meet people’s needs effectively. All people using the service received their care visit from care workers they knew and with whom they shared a common interest or pastime. Care calls were consistently made at, and for the length of the time agreed. People were very satisfied with the service they received.

The registered manager understood the principles of the Mental Capacity Act 2005 and their responsibilities under the act. People’s capacity to make decisions had been assessed and care workers had the information needed to understand which decisions people could make and those they needed support with. Care workers sought people’s consent before care was provided.

People and relatives were confident the service was well run and well managed. Complaints were managed in line with the provider’s policy. Staff felt supported and valued by the management team who were accessible and responsive.