Home Instead Also known as West Norfolk

Updated 1 November 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. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

An inspector and an Expert by Experience carried out the inspection. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service. The inspection was carried out over two days. The first day was announced and used to visit the office. The second day was to visit people who used the service and their extended families.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.

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 a short period notice of the inspection because this is a small service and we wanted to ensure staff were in the office and could arrange for us to visit people who used the service.

What we did before the inspection

We reviewed information we already held about the service including previous inspection visit reports, share your experience which gives you feedback about the service and notifications which are important events the service is required to tell us about.

We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all this information to plan our inspection.

During the inspection.

We spoke with the registered manager, the operations director of west Norfolk, the call scheduler, four caregivers, and the caregiver coordinator. We also visited four people, three were supported by relatives who were spoken with and we met several caregivers and were able to observe their interactions. Whilst in the office we looked at records, training, recruitment, care plans and assessments.

After the inspection.

We continued to review information received and spoke with a further two people.

Updated 1 November 2019

About the service

Home Instead Senior Care provides personal care and, or a companionship service to mainly but not exclusively older people over the age of 65 in their own homes. At the time of our inspection they were providing support to over 100 people but only 27 people were receiving the regulated activity of personal care.

People’s experience of using this service and what we found.

The service provided a bespoke service around people’s individual needs and their extended families. Everyone we spoke with used the agency following personal recommendation. People told us service was exceptional and should be commended for its responsiveness and caring attitude. People received a minimum of an hours visit which was planned ahead and people given rotas, so they knew who to expect and the time of the visit.

Staff were referred to as caregivers, so we have used this term throughout our report. They had time to spend with people, establish a rapport and provide people with the support that had been identified as well as little ‘extras’ for people. Extended families had come to rely on the caregivers who were ‘regulars.’ Relatives saw them as part of their extended family.

Caregivers were well supported and had time to do their jobs properly without rushing because calls were spaced out and caregivers paid for travel time. The service clearly respected, rewarded and invested in its staff which helped them feel valued and encouraged good staff retention and commitment. Staff recruitment was extremely robust which helped ensure only people suited to this role were recruited and well supported through regular training and updates.

The service was extremely well organised with management staff in key positions ensuring every part of the business was well managed and oversight was in place. The service operated 365 days a year. Call scheduling was effective, and caregivers used apps on their phone to log in and out of calls. This helped ensure calls were delivered on time and for the right amount of time. Calls were electronically monitored and meant the service could respond quickly and reschedule calls if a call was running late. They had not had any missed calls and knew where their caregivers were which helped to promote their safety and the safety of people they were supporting. People told us the service was 100 percent reliable.

Care was always delivered to a high standard because staff were well recruited, well trained and there were robust observations of staff practice in place. Staff had regular opportunity to reflect on their practices. People were aware of the direct observations and were assured that staff practices were sufficiently monitored. The service sought and acted on feedback. Staff could be given ‘carer of the month’, or ‘carer of the year’ which was awarded based on feedback and in recognition of staff who went the ‘extra mile.’

Care reviews were held as a minimum every six months, and communication was ongoing. Care records were robust and completed contemporaneously and considered people’s needs and preferences. They demonstrated the involvement and consultation of people supported and where appropriate family members. Caregivers had time to read care plans ahead of the visit which meant they knew how the person had been and made aware of any risk, changes in need.

The service was proactive in the community and acted as educators raising awareness of important issues affecting people. They linked to businesses and health care providers to raise awareness of dementia and its impact. They also advised and increased the uptake of benefits to ensure people were receiving what they were entitled to and could access services they needed. They worked with GP practices and had started to go into schools to help inform people about dementia and its impact.

Their aim was for Kings Lynn to be an accessible town. They were working with the major and the clinical commissioning group to create a dementia friendly town. They had won a series of awards for the best small business and held events and training across the town. They signposted other professionals to the resources and training they might need to best meet the needs of its customer. For example, they provided training on The Mental Capacity Act 2005 and the implications for people living with dementia.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. Consent was sought before providing a service and every time staff provided supported. We observed some of the caregiving and staff were polite and courteous. Rating at last inspection

The last rating for this service was good (report published 28/10/2016)

Why we inspected

This was a planned inspection based on the previous rating.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk