Background to this inspection
Updated
7 March 2019
The inspection:
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
Inspection team: This inspection was carried out by one inspector and one expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service. This person had experience with this type of service.
Service and service type:
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.’
Notice of inspection:
We gave the service 24hours’ notice of the inspection site visit because we needed to be sure the registered manager would be in. The inspection site visit activity started on 12 February 2019 and ended on 14 February 2019. We visited the office location on 12 February 2019 to see the registered manager and office staff; and to review care records and policies and procedures.
What we did: Providers are required to send us key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We reviewed this information to help plan our inspection.
Before the inspection we sent out questionnaires to some people, so they could share with us their experiences of the service. We also spoke with three people, eight relatives, three members of staff, the deputy and the registered manager.
We inspected three care plans, and three staff files. We looked at audits and quality assurance procedures relating to the management of the service, which had been developed and implemented by the provider. Some of this information was received, following the inspection visit. Where commissioners or health professionals have given feedback, we have included this within our report.
Updated
7 March 2019
About the service: This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats. It provides a service to 105 older adults. Not everyone using Home Instead received the regulated activity of personal care. CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.
People’s experience of using this service:
People consistently described the service as being exceptionally caring, and able to meet their needs in a personalised and thoughtful way. Consistency with rota's enabled people and staff to develop working relationships which were meaningful. The registered provider looked at creative ways to meet people’s needs.
People felt safe with the staff supporting them. Systems were in place to ensure people’s safety and enough staff had been recruited to ensure people received a reliable service. Recruitment processes were thorough. People were supported to take their medicines safely.
Staff had a thorough understanding of people's needs. An induction was provided and staff could access a range of training which provided them with the level of skills and knowledge needed, to deliver safe care.
The registered manager looked at ways person-centred care could be provided, which met people’s needs, wishes, preferences. Staff supported people to meet their nutritional and health care needs. Risk assessments were in place. These looked at a range of areas, but needed to be more detailed for people who were at risk of choking. We have made a recommendation about supporting people to eat in a safe way.
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.
Some staff had been trained in end of life care and understood the specific requirements to meet the needs of people at the end of their life. We have made a recommendation about end of life care.
People and their relatives told us they were actively encouraged to share their views and provide feedback about the service. A robust audit system was in place. The registered provider worked in partnership with other organisations and took part in several good practice initiatives, designed to further develop the service.
This service met the characteristics of Good; more information is in the full report
Rating at last inspection: This service was last rated Good. (1 September 2016)
Why we inspected: This was a planned inspection based on the previous rating.
Follow up: We will continue to monitor intelligence we receive about the service until we visit again in line with our inspection programme and scheduling. If any concerning information is received we may inspect sooner.