Home Instead Horsham, Haywards Heath & Burgess Hill

Not everyone using this service receives a regulated activity. The Care Quality Commission (CQC) only inspects the service being received by people provided with personal care, which means help with tasks related to personal hygiene and eating. Where people receive personal care we also take into account consider any wider social care provided. At the time of our inspection the service supported 23 people with their personal care needs.

This comprehensive inspection took place on 14 December 2018 and 08 January 2019 and was announced.

At our last inspection we rated the service Good. At this inspection we found the evidence continued to support the rating of Good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns.

At this inspection we found the service remained Good.

Home Instead Senior Care Horsham had a registered manager who had been in post with since 2015. A registered manager is a person who has registered with the Care Quality Commission (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 2008 and associated regulations about how the service is run.

People continued to be protected from avoidable harm. There was a safeguarding policy and staff received training. Staff knew how to recognise the potential signs of abuse and knew what action to take to keep people safe.

People continued to feel safe. One person told us, “They are very careful with me, I trust them.” Risks to people and the environment continued to be assessed and staff understood how to manage risks to help ensure people were safe. People continued to be supported to receive their medicines safely by staff that were trained in administering medicines.

People continued to be supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice. Staff understood best interest decision making where people lacked capacity in line with the principles of the Mental Capacity Act 2005. Staff sought people’s consent before giving personal care.

People continued to be supported to maintain their health and had assistance to access health care services when they needed to. One person told us, “On one occasion I was poorly, they called an ambulance … I trust them.”

People continued to be supported to remain engaged in activities and interests. People continued to be supported to maintain relationships with people who were important to them. Staff knew the people they looked after well. One person said, “They know my likes and dislikes.” Concerns and complaints remained well managed and were responded to.

People continued to receive compassionate care from staff who were kind and caring. One person said, “I feel at home with them.” Staff said they enjoyed working for the service and felt supported by the registered manager. A staff member said, “The support is incredible.”

The service continued to be well-led. The registered manager was engaged in the day to day running of the service and proactively looked for ways to improve on a continuous basis. One person said, “It’s a very well managed service.” People, staff and relatives remained engaged and involved in the service provided. A member of staff said, “There’s a positive atmosphere, I can always ask questions.”

Further information is in the detailed findings below.

Home Instead Senior Care Horsham is a domiciliary care service which provides personal care and support services for a range of people living in their own homes. These included older people and people living with dementia. At the time of our inspection 48 people were receiving a service, which of 19 were receiving the regulated activity of personal care.

The service had 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.

The experiences of people and relatives were very positive. People told us they felt safe, that staff were kind and the care they received was good. A relative told us “When I leave the house I’m delighted to know my relative is safe, carers are not only mature they’re caring and have a lovely disposition”.

The provider had arrangements in place for the safe administration of medicines. People were supported to receive their medicine when they needed it. People were supported to maintain good health and supported to access health care services if required.

Assessments of risk had been undertaken and there were instructions for staff on what action to take in order to mitigate them. Staff knew how to recognise the potential signs of abuse and what action to take to keep people safe. The registered manager made sure there was enough staff at all times to meet people’s needs. When the provider employed new staff at the service they followed safe recruitment practices.

The service considered peoples capacity using the Mental Capacity Act 2005 (MCA) as guidance. People’s capacity to make decisions had been assessed. Staff observed the key principles in their day to day work checking with people that they were happy for them to undertake care tasks before they proceeded.

Staff felt fully supported by the registered manager to undertake their roles. They were given training updates, supervision and development opportunities. For example staff were offered to undertake additional training and development courses to increase their understanding of the needs of people using the service. One member of staff told us “The training is so good. I recently completed the induction, which was very informative and interactive so I felt confident when I started. My manager took me out and introduced me to the people I would be supporting and went through so much, it was great”.

People confirmed staff respected their privacy and dignity. Staff had a firm understanding of respecting people within their own home and providing them with choice and control. People were supported at mealtimes to access food and drink of their choice and were supported to undertake activities away from their home.

People and relatives said they were happy with the management of the service. People’s comments included “I met the boss, she was so lovely and friendly” and “I have had contact with the head lady and she is very nice”. There were clear lines of accountability. The service had good leadership and direction from the registered manager. One member of staff told us “My manager and everyone in the office are so approachable and helpful. Any help I need they are there. One time I called up and needed help with a call I was doing and the manager came out to help me straight away”.

The registered manager monitored the quality of the service by the use of regular checks and internal quality audits to drive improvements. Feedback was sought by the registered manager through surveys which were sent to people and their relatives. Survey results were positive and any issues identified acted upon. People and relatives we spoke with were aware of how to make a complaint and felt they would have no problem raising any issues.

We found that the provider had effective recruitment procedures to ensure that care workers were of good character and had the qualifications, skills and experience necessary for the work to be performed. People were protected from the risks of unsafe or inappropriate treatment because accurate and appropriate records were maintained.

We read detailed assessments and care and risk plans that were suitable for people's needs and we saw that these were updated in response to people's requests or changing needs.

We saw that the provider had suitable safeguarding procedures in place and that these had been used when needed. We saw that staff had been trained in safeguarding and this was confirmed to us by staff we spoke to.

We saw that staff had received training appropriate to their roles, including specialist training such as senior care, and that this was updated as necessary.