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 providing personal care to 46 people at the time of the inspection. 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. The service was supporting 20 people with these activities.
People’s experience of using this service and what we found
People and their relatives told us that the service was safe. Staff attended calls on time and people told us that they stayed for the correct amount of time. One person told us, “They are absolutely good on time, never missed coming at all and never leave early.” Staff were trained to give medicines and staff told us they were confident giving people medicines. Staff were aware of how to identify and report safeguarding concerns. Staff followed infection control procedures and told us they had access to appropriate levels of personal protective equipment (PPE). Staff were able to tell us about the risks to people and knew how to support people to minimise the risks.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible in their best interest; the policies and systems in the service supported this practice. People were involved in their care planning. Staff told us that they received training and felt supported in their role. One staff member said, "The company are really good and really supportive." Staff supported people to live healthier lives.
The service was caring. People told us that the staff treated them with kindness and respect. One person said, "Very pleased with them. My carers are cautious, caring and so friendly and always listen to me. I would not change them." Staff were aware of how to protect people's privacy and dignity and people told us that the staff did this well. People felt supported to make decisions about their daily lives.
People told us they knew how to complain and there was a policy and procedure in place. We saw that this was followed. Staff had received training in end of life care. Staff supported people to go out shopping and attend appointments when they needed to. Staff were aware of people's communication needs and how best to support them. People told us the service is flexible and responsive to their needs. One person said, “I am lucky enough and reduced my number of calls as got better and didn’t need as many.”
People told us the service was well managed. Staff told us they received staff newsletters and information was shared with them. There was a positive staff culture. We found the management team receptive to feedback and keen to improve the service. The registered manager worked with us in a positive manner and provided all the information we requested.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was requires improvement (13 July 2019) we found breaches at the last inspection in regulation 9 (person centred care) and regulation 17 (good governance). The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
This was a planned inspection based on the previous rating.
Home Instead Preston is a domiciliary care service, which provides support for adults in the community, who require assistance with personal care, including those living with dementia, physical and learning disabilities, mental health needs and sensory impairments. The agency office is on the outskirts of the city of Preston, adjacent to the railway station and accessible by the local bus services. People live in their own houses within the local community. At the time of our inspection there were 53 people who used the service, 22 caregivers, 2 administrators, a training officer and a care-co-ordinator, as well as the registered manager.
People’s experience of using this service:
Everyone we spoke with provided us with positive comments about the quality of service provided and the ability of the staff team. The provider had systems to act on allegations of abuse. Environmental risk assessments contained good detail. However, health and social care risk assessments were basic and lacked important information. The provider had a system for the reporting and recording of accidents and incidents. Staff had received training in medicines awareness and guidance for staff was available. We have made a recommendation about the process for auditing medicines. Staff were recruited safely, although on one occasion the provider could have further explored the employment history of one staff member. We have made a recommendation about this.
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. People's needs and choices were assessed before a package of care was arranged and before a client returned from hospital. These assessments were sometimes very brief and would have benefitted from more detailed information being obtained. We have made a recommendation about assessing people’s needs. However, positive feedback was provided by people we spoke with, who told us they received effective outcomes from their caregivers, who were kind and caring.
New staff received an induction programme and a broad range of training had been completed by all staff, who were regularly supervised and observed at work. However, training for staff in relation to end of life care had not been provided. We have made a recommendation about this. Appraisal systems were not up to date and therefore, staff members were not formally offered the opportunity to discuss their work performance at regular intervals. We have made a recommendation about this.
Support plans did not contain detailed and person-centred information and therefore these did not always accurately reflect the needs of those who used the service. The needs assessment, risk assessment and support plan for one person failed to refer to a medical condition which impacted on their specific dietary requirements. This could have had a detrimental effect on their daily life should inappropriate foods be served. A mental capacity assessment had not been conducted for one person, who had a mental health diagnosis. We have made a recommendation about mental capacity assessments. Community health and social care professionals were involved in the care and treatment of those who used the service.
The provider had systems for the management of complaints. However, none had been recorded since the last inspection, but people told us they would know how to make a complain, should the need arise. Everyone we spoke with provided us with very positive comments about the quality of service provided and the staff team.
There was little oversight of the management of the service and effective audits were not taking place. Therefore, a robust system for assessing and monitoring the quality of service provided had not been established. However, feedback was periodically obtained from those who used the service, their relatives and the staff team. Regular team meetings had been conducted and staff members felt able to approach the managers with any concerns, should they need to do so.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection:
The service was rated good at the last inspection (Published 10 December 2016).
Why we inspected:
This was a scheduled inspection based on the previous ratings.
Enforcement:
At this inspection we rated the service as requires improvement. We identified two breaches of regulations, in relation to person-centred care and good governance. Please refer to the end of the report for action we have told the provider to take.
Follow up:
The service will be re-inspected as per our inspection programme. We will continue to monitor any information we receive about the service. We may bring the next inspection forward if we receive any concerning information.
Provide a brief overview of the service (e.g. Type of care provided, size, facilities, number of people using it, whether there is or should be a registered manager etc).
N.B. If there is or should be a registered manager include this statement to describe what a registered manager is:
‘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.’
Give a summary of your findings for the service, highlighting what the service does well and drawing attention to areas where improvements could be made. Where a breach of regulation has been identified, summarise, in plain English, how the provider was not meeting the requirements of the law and state ‘You can see what action we told the provider to take at the back of the full version of the report.’ Please note that the summary section will be used to populate the CQC website. Providers will be asked to share this section with the people who use their service and the staff that work at there.
People who use the service told us they were very happy with the support they received. People told us they had received a visit from the manager before the service commenced and had frequent contact since then. They told us that they had been involved in planning care and support they wanted and how and when this was to be carried out.
People said that staff always provided the best possible service to them. One person said, 'They are always willing to change days or times to fit in with us.'
According to the people we spoke with, the same staff provided their care almost all the time. They said staff were competent, arrived on time, stayed for their allotted time and were pleasant and helpful.
People knew how to complain and were confident they would be listened to. They and the staff team told us they felt well supported.
Comments received from those we spoke with included:
"They (the staff) have been really good up to now."
"She's (the care worker) very polite, you know. Yesterday she wanted to come a bit early, so she rang me to see if it was alright. I had no objection as I am always up early anyway."
"They just do a bit of cleaning for me in the bathroom and kitchen."