We carried out a review of the data available to us about Home Instead 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, you can give feedback on this service.
At our last inspection we rated the service outstanding overall. At this inspection we found the evidence continued to support the rating of outstanding and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.
Why the service is rated Outstanding.
We found staff had received training to safeguard people from abuse. They understood their responsibilities to report any unsafe care or abusive practices related to the safeguarding of adults who may be vulnerable. Staff we spoke with told us they were aware of the safeguarding procedure.
Staff members received training related to their role and were knowledgeable about their responsibilities. They had the skills, knowledge and experience required to support people with their care and support needs.
The registered provider planned visits to allow carers enough time to reach people and complete all tasks required. People told us staff respected their privacy and dignity during their visits.
Care plans were organised and had identified the care and support people required. We found they were personalised and informative about the care people received. They had been kept under review and updated when necessary with the support and consent of people and their relatives. They reflected any risks and people's changing needs.
Staff responsible for assisting people with their medicines had received training to ensure they were competent and had the skills required. The registered provider completed spot checks on staff to observe their work practices were appropriate and people were safe.
Staff were provided with personal protective equipment to protect people and themselves from the spread of infection.
The registered provider had procedures around recruitment and selection to minimise the risk of unsuitable employees working with people who may be vulnerable. Required checks had been completed before any staff started work at the service. This was confirmed during discussions with staff.
Positive links had been built with the local community. The registered provider delivered training and support within the health and social care field. They shared their skills and experience to impart knowledge to people who support and interact with people living with dementia within the local area.
They worked collaboratively with the local authority, sharing knowledge and their expertise to shape policies and procedures around safeguarding to improve people’s experience when using other services.
The registered provider invested their time and experience to support people within the service and within their local community with their personal development to enhance their wellbeing and quality of life.
When talking about the registered provider and management team people, relatives and staff spoke extremely positively about the person centred culture within the service.
The registered manager demonstrated their understanding of the Mental Capacity Act 2005. People told us they were enabled to make decisions and staff told us they would help people with decision making if this was required. People are supported to have maximum choice and control in their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice.
Audits had been completed and were linked to CQC’s regulatory standards. They effectively captured the level of detail sufficient to provide reliable data and lead to positive change.
Staff promoted compassionate, kind and caring values and have developed good relationships with people using the service. People were exceedingly positive about staff and praised the respectful support they received. Relatives confirmed the staff were caring and looked after people very well.
Staff understood the importance of supporting people to have a good end of life as well as living life to full whist they are fit and able to do so. They shared evidence that they had supported people to have the death they had wished by offering caring personalised support.
When appropriate, meals and drinks were prepared for people. Staff could share the importance of people receiving appropriate support and took time to ensure the support was personalised and effective. This ensured people received adequate nutrition and hydration.
Further information is in the detailed findings below
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008 and to pilot a new inspection process being introduced by CQC which looks at the overall quality of the service.
The provider was given 48 hours notice of our intention to inspect the service. This is in line with our current methodology for inspecting domiciliary care agencies.
Home Instead Senior Care provide some domiciliary care services to people who live in their own home. At the time of our inspection there were 31 people with a variety of care needs, including people with physical disabilities or mental health needs, who used the service. The agency is managed from a centrally located office base in Ormskirk.
There has been a registered manager in place at the service since it began operating in May 2012. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.
Throughout the inspection we consulted people who used the service and where appropriate, their representatives. We also spoke with staff from the service and obtained the views of a number of community health and social care professionals, who had contact with the service on a regular basis.
The feedback we received from people was excellent. Those people who used the service expressed great satisfaction and spoke very highly of managers and staff. Community professionals were without exception, very complimentary about the service and reported very positive experiences when dealing with Home Instead Senior Care.
The safety of people who used the service was taken very seriously and managers and staff were well aware of their responsibility to protect people’s health and wellbeing. There were systems in place to ensure that risks to people’s safety and wellbeing were identified and addressed.
The registered manager ensured that staff had a full understanding of people’s care needs and the skills and knowledge to meet them. People received consistent support from care workers who knew them well. People felt safe and secure when receiving care.
People had positive relationships with their care workers and were confident in the service. There was a strong emphasis on key principles of care such as compassion, respect and dignity. People who used the service felt they were treated with kindness and said their privacy and dignity was always respected.
People received a service that was based on their personal needs and wishes. Changes in people’s needs were quickly identified and their care package amended to meet their changing needs.
The service was flexible and responded positively to people’s requests. People who used the service felt able to make requests and express their opinions and views. Managers were committed to continuous improvement and feedback from people, whether positive or negative, was used as an opportunity for improvement.
Managers demonstrated a good understanding of the importance of effective quality assurance systems. There were processes in place to monitor quality and understand the experiences of people who used the service. Where areas for development were identified, managers responded positively by developing action plans to address them.
The service developed and maintained strong links with external organisations and within the local community. Managers demonstrated strong values and a desire to learn about and implement best practice throughout the service.
Staff were highly motivated and proud of the service. They described a ‘supportive’ and ‘open’ working environment within which they were encouraged to challenge, express concerns and share their views and opinions.
People we spoke to told us they received the service they wanted and had discussed the type of help they needed with the owners or manager from the agency when arranging the care package. They said they were happy with the service they received.
People told us the managers and staff were very good and provided flexible and responsive support. One person told us about the level of support they had and said, 'I get a very personal service. I was brought home from hospital by' the owner and the carer was waiting for me on the door step. They go beyond the call of duty. Every detail of what I needed was discussed with me and the care I get thought through'.
We saw that staff were recruited appropriately and as a result people were protected from unsafe care.
We saw that where people were supported with their personal care, mobility or to prepare meals that the use of equipment was risk assessed
People told us that they had regular contact with the same staff and that the managers of the agency kept in regular contacted with them to seek their views about the service they received. They told us that managers from the agency visited caregivers unexpectedly to check on their performance. People told us they were aware of the complaints procedure and how to use it.
Relatives told us they had no concerns about the staff that visited their family members. We were told that the agency asked relatives for information about their family members. This was transferred into care plans so staff had information about how their family members wanted their care and support to be provided. Relatives said that they attended reviews of care and supported family members to make decisions. One relative said, 'From meeting the owners things were right. They keep in touch and we have regular telephone chats and meetings. The most important thing to me is that they listened to me and accepted my worry as a carer'. Another said, 'They have simply transformed mum's life".
People told us they felt safe in their home. They had arrangements in place for staff to gain entry and to keep their home secure.