We carried out a review of the data available to us about Home Instead Senior Care on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Home Instead Senior Care, you can give feedback on this service.
Home Instead Senior Care is a domiciliary care service. It is registered to provide personal care to younger and older people with a physical disability; learning disability or autistic spectrum disorder; dementia; sensory impairment and mental health needs.
Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided. At the time of the inspection 41 people were receiving personal care.
People’s experience of using this service and what we found
The service had two registered managers. A registered manager is a person who has registered with the Care
Quality Commission to manage the service. We could not be assured the registered managers fully understood the regulatory requirements in relation to notifying CQC of police incidents.
Multiple Quality assurance systems and processes enabled the registered managers to identify areas for improvement. However, these had not identified a potential failure to notify CQC of a police incident or a system issue for the recording of as required medicines.
The impact of the COVID-19 pandemic on staffing meant at times some people received care from staff they had not previously met. Some people and staff felt there were not enough staff. However, we found everyone received care at the time they needed it, no care visits were missed and changes to care staff had been agreed in advance with people. The service was actively recruiting new staff.
The registered managers were passionate about providing person-centred care. They knew people well as they were involved in care delivery. The service regularly sought feedback from people about their care experience to ensure any issues were promptly addressed.
People were supported by staff that knew how to keep them safe from harm or abuse. People received medicines on time and were supported by staff that had been safely recruited. Staff had a good knowledge of risks associated with providing people’s care and received training relevant to people’s needs. They were empowered to develop their knowledge and skills.
The service supported people to express their views, preferences, wishes and choices. The service ensured staff supporting people had similar hobbies and interests, this contributed to the success of the care delivery. Staff supported people to engage in their hobbies and interests, while promoting people’s independence. The service was flexible and responsive to people’s individual needs and preferences. People knew how to raise a concern or make a complaint and felt confident this would be addressed.
People and staff gave many examples of the care they received that was kind, caring and compassionate. Staff we spoke with were committed to ensuring people’s health, emotional and social wellbeing needs were fully met. People and staff had built positive relationships together and enjoyed spending time in each other’s company. People’s diversity was respected and embraced. Staff were open to people of all faiths and beliefs and people’s privacy and dignity was respected.
People were supported to have maximum choice and control of their lives and staff supported them in the
least restrictive ways possible; the policies and systems in the service supported this practice.
People were supported to eat and drink enough and to attend healthcare appointments as needed.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was Outstanding (published 05 July 2018).
Why we inspected
We undertook this inspection as part of a random selection of services rated Good and Outstanding to test the reliability of our new monitoring approach.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
Not everyone using Home Instead Senior Care received the regulated activity; personal care. CQC only inspects the service received by people provided with personal care, help with tasks related to personal hygiene and eating. Where they did we also took into account any wider social care provided. Of the 21 people using the service, nine were receiving personal care.
The evidence seen supported the rating of Outstanding.
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.
People using the service and their relatives were extremely positive and complimentary about the service they received and of the support workers, known as care givers and management team who supported them on a daily basis.
People told us they felt extremely safe using Home Instead Senior Care and felt really safe with the care givers who provided their care and support. Relatives we spoke with agreed that their relatives were safe with the care givers who supported them.
Care givers were aware of their responsibilities for keeping people safe from avoidable harm or abuse. They had received training on the safeguarding of adults and knew the process to follow should they be concerned for anyone. The management team were aware of their responsibilities for keeping people safe and knew to refer any concerns on to the local authority and Care Quality Commission (CQC).
People's needs had been comprehensively assessed and the risks associated with their care and support had been assessed, reviewed and managed. The care givers had received training in the prevention and control of infection and the necessary protective personal equipment was available.
People were supported to stay safe at all times and their freedom was respected. They were supported to have maximum choice and control of their lives and care givers supported them in the least restrictive way possible.
A robust recruitment process was followed to make sure only suitable people worked at the service. A comprehensive induction and training programme ensured the care givers were well trained to meet people’s individual and diverse needs and work in line with the provider’s values and beliefs. People told us there were enough care givers to meet their needs. They explained they were extremely punctual, always turned up and never missed a visit. Care givers were matched to the people using the service and meaningful relationships had been built between the care giver and the person using the service and their families.
Care givers had received training in the management of medicines and people were supported with their medicines as prescribed by their doctor and in line with the provider’s medicines policy. The provider’s auditing processes ensured people continued to be supported with their medicines in a safe way.
There were arrangements in place to make sure action was taken and lessons learned when things went wrong to sustain and improve safety across the service.
People told us the care givers were extremely kind and caring and they were treated with the upmost respect. They told us their care and support was provided in a way they preferred and their consent was always obtained. The care givers supported people to make decisions about their day to day care and support. They were aware of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS) ensuring people's human rights were protected.
People were supported in a way they preferred because plans of care had been developed with them and with relatives or staff who knew them well. The care givers knew the needs of the people they were supporting extremely well because appropriate plans of care were in place which included people's personal preferences, preferred hobbies and interests. The care givers worked extremely hard in supporting people to pursue pastimes that were important to them.
People were supported to maintain good health. Care givers supported them to access relevant healthcare services such as doctors and community nurses and they took quick action when they felt someone was unwell, including raising concerns with family members. An assessment of people’s dietary requirements had been carried out and care givers went out of their way to make sure people were supported to partake in meals they enjoyed and to maintain a healthy, balanced diet.
People were provided with exceptional care and support that was responsive to their needs and individually tailored to meet their personal wishes and preferences. The care givers and the management team were thoroughly dedicated and committed to ensuring people’s care and support was the best it could be.
A formal complaints process was in place and people knew who to talk to if they had a concern of any kind. People using the service and their families and friends were confident any issues would be addressed in a timely manner and to their satisfaction.
People were supported by care givers who felt very much supported and valued by the management team. They were supported through formal systems such as supervisions, spot checks and monthly meetings and through the opportunity of speaking with a member of the management team at any time if they required support of any kind. The wellbeing of the care givers working at the service was paramount to the management team.
The service played an active role in the local community and worked with other services to raise the awareness of dementia. The work of the care givers had received recognition from outside bodies with one recently winning an award from a local newspaper publisher.
Robust and effective systems were in place to monitor the service being provided. People’s views of the service were sought and welcomed. This was through visits to people’s homes, telephone conversations and through the use of surveys. People were put at the heart of the service and the provider’s vision for the service was upheld by the care givers and the management team on a daily basis.
The management team were aware of their registration responsibilities including notifying CQC of significant incidents that occurred at the service.
Further information is in the detailed findings below.