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Archived: Home Instead Senior Care Good

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Reports


Inspection carried out on 3 November 2015

During a routine inspection

We carried out an inspection of Home Instead Senior Care Limited on 3 November 2015. This was an announced inspection where we gave the provider 48 hours’ notice because the location provides a domiciliary care service and we needed to ensure someone would be available to speak with us.

Home Instead Ltd provides a range of services to people in their own home including personal care, companionship and shopping in Twickenham and the surrounding areas. At the time of inspection there were 17 people receiving personal care.

A registered manager was in place. 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.

People who used the service told us they felt safe. Staff had received training about safeguarding and knew how to respond to any allegation of abuse. Staff were aware of the whistle blowing procedure which was in place to report concerns and poor practice.

There were sufficient staff employed to provide consistent and safe care to people, with people receiving care from the same small team of staff.

People received their medicines in a safe way and staff had received training in the types of medicines people received. Staff recorded medicines taken by people in an appropriate medicines record sheet.

Staff had received training and had a good understanding of the Mental Capacity Act 2005 and Best Interest Decision Making, when people were unable to make decisions themselves. They also received other training to meet people’s care needs.

Staff helped ensure people who used the service had food and drink to meet their needs. Some people were assisted by staff to cook their own food and other people received meals that had been prepared by staff.

Staff knew people’s care and support needs. Care plans were in place detailing how people wished to be supported and people were involved in making decisions about their care. There were regular visits and spot checks carried out by the service to monitor the quality of service and the care practice carried out by staff.

People told us that staff were kind, caring and efficient.

People who received care remained independent and in control of their decision making and choices. People had access to health care professionals to make sure they received appropriate care and treatment. The service maintained accurate and up to date records of people’s healthcare and GP contacts in case they needed to contact them.

A complaints procedure was available and people we spoke with said they knew how to complain, although no one said they had needed to. The service maintained records of compliments and complaints and recorded how these were resolved.

People had the opportunity to give their views about the service. There was regular consultation with staff, people and/or family members and their views were used to improve the service. Regular audits were completed to monitor service provision and to ensure the safety of people who used the service.

Inspection carried out on 16 May 2014

During a routine inspection

We gathered evidence against the outcomes we inspected to help answer our five key questions; Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led? We gathered information from people who used the service by telephoning them and their relatives.

Below is a summary of what we found. The summary is based on evidence we collected from speaking with people who used the service, their representatives, the staff supporting them and from looking at records.

If you want to see the evidence supporting our summary please read our full report.

Is the service safe?

People told us they felt safe. The provider had safeguarding procedures that were robust and staff understood how to safeguard people they supported. People told us that they felt their rights and dignity were respected. One person told us, "The management are always very contactable and give good advice on any issues”. Another said: “The staff are always professional and well-trained”.

Systems were in place to make sure that managers and staff were able to deal with and learn from events such as accidents and incidents, complaints and concerns. The provider's systems reduced the risks to people and helped the service to continually improve.

Staff told us they referred to people's care plans when providing care. People we spoke with confirmed that care workers always carried out the care routines that were detailed in their care plans. This showed that people received the care and support they expected, and they had not been put at unnecessary risk by care workers not delivering appropriate care.

The provider had effective procedures that ensured people were cared for by staff who had the right skills and experience. The provider had effective recruitment procedures and had provided staff with relevant training and support. This helped to ensure that people's needs were met by staff who understood people's needs. People told us that it was important to them that they had consistent care workers. The provider had sought to ensure that people received care and support from the same team of care workers. People we spoke with confirmed that this happened most of the time.

The provider had procedures in place that identified good and poor practice. Staff received refresher or additional training if their care practice had been identified as falling below expected standards. The provider had an effective complaints procedure that ensured complaints were thoroughly investigated. The provider ensured that lessons were learnt from complaints and incidents and risks to people were effectively managed.

CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. While the manager informed us that no applications have needed to be submitted, proper policies and procedures were in place. Relevant staff had been trained to understand when an application should be made, and how to submit one.

Is the service effective?

People's health and care needs were assessed with them or their representatives. People told us that they and anyone else they chose were involved in the development of their plans of care. Where required, specialist input into care plans had been provided by other health and social care professionals. Care plans were regularly reviewed and kept up to date. That meant people's care plans reflected their current needs.

Is the service caring?

We asked five people for their opinions about the service and staff that supported them. People were complimentary about the service. One person told us, "They are fantastic and go above and beyond”. Another person told us, "They are very caring and Mum is very comfortable with them”. People told us that what mattered most to them was that they were supported by care workers they knew; that care workers came at times they expected and completed all care routines. People told us that care workers were usually punctual and that they carried out the care routines they expected. They described care workers as kind and caring.

We spoke with care workers who demonstrated that they genuinely cared for and understood the needs of the people they supported. Care workers knew what their responsibilities were in relation to identifying and reporting abuse.

People who used the service and their representatives provided feed-back through an annual satisfaction survey and regular reviews of care. The provider had responded to what people had said. Where shortfalls or concerns were raised these were taken on board and dealt with.

People's preferences, interests, aspirations and diverse needs had been recorded in their care plans and care and support had been provided in accordance with people's wishes.

Is the service responsive?

People knew how to make a complaint if they were unhappy. No one we spoke with had ever had to make a complaint. The provider had made the complaints procedure available to people and had systems in place to respond to concerns and complaints. This meant people could be assured that the provider took concerns seriously and investigated them and made improvements.

The provider worked closely with other services to make sure people received support with their health.

Is the service well-led?

The provider had a system for monitoring the quality of service that had been provided. This included regular contact with people as well as feedback questionnaires. People and their relatives were welcome to provide their views and suggestions.

Staff we spoke with were clear about their roles and responsibilities. Staff had a good understanding of the aims of the service. Staff were supported through supervision and training and had opportunities to further develop their knowledge and skills. This helped to ensure that people received a good quality service at all times.

Inspection carried out on 31 May 2013

During a routine inspection

During out inspection we spoke with three people using the service and their relatives who all confirmed they had been consulted before accepting the service. One person said "the staff are very good; they explain everything clearly and I know what care I am receiving".

Staff clearly explained their roles and responsibilities towards people they were allocated to support. People we spoke with told us that staff at Home Instead were dedicated and very caring. One person said "the staff are professional and go beyond the call of duty to make sure that they give an excellent service; it's a huge comfort".

We spoke with office staff and care workers who explained the type of equipment used in people's homes. These included stair lifts, sliding sheets, commodes, bath seats, walking frames, seat risers and wheelchairs. One staff member told us "it's particularly important to check that electronic equipment is properly charged for use and that equipment is safe and has been regularly serviced."

We asked to see records of the staff recruitment process and found application forms to be fully complete and a list of interview questions and responses provided by applicants. We were shown feedback forms returned from people using the service and their relatives. We saw many positive comments about the service and the staff. One care worker told us "team meetings are a platform for learning".

Inspection carried out on 13 September 2012

During a routine inspection

We used a number of different methods to help us understand the experiences of people using the service, because the people using the service had complex needs which meant they were not able to tell us their experiences.

We spoke with the relatives of four people using the service who told us that the staff were kind compassionate and helpful. One person said “I can’t praise them highly enough, they are exemplary”. The people we spoke with were all complimentary of the service and staff, adding that they had confidence in the service provided to their relatives. One person told us that ‘staff couldn’t be better’ while another said, “I can’t believe how much they manage to achieve while they are here”.