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.
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
The service did not have a registered manager in place at the time of our inspection and has not had one since July 2013. However a manager had been recruited who had made an application to become the 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 were supported by staff who understood the risks people could face and knew how to make people feel safe. People were encouraged to be independent and risks were mitigated in the least restrictive way possible.
People were supported by a regular staff member or group of staff who they knew. People who required support to take their medicines received assistance to do so when this was needed.
People were provided with the care and support they wanted by staff who were trained and supported to do so. People’s human right to make decisions for themselves was respected and there were systems for people to show their involvement in planning and agreement with their care.
People were supported by staff who understood their health conditions and ensured they had sufficient to eat and drink to maintain their wellbeing.
People were treated with respect by staff who demonstrated compassion and understanding. People were involved in determining their care and support and were treated in the way they wished to be.
People could not rely on their plan of care containing all the required information to ensure their care and support was delivered as needed. People felt able to express any issues of concern and these were responded to.
People who used the service and care workers were able to express their views about the service which were acted upon. Changes to the management team were enabling a better allocation of work and fulfilment of management duties.
' Is the service safe?
' Is the service effective?
' Is the service caring?
' Is the service responsive?
' Is the service well led?
This is a summary of what we found:-
Is the service safe?
In the care records we reviewed we saw that risk assessments regarding people's individual needs were carried out and measures were in place to minimise or eliminate any risk.
Lawful requirements under the Mental Health Act (2005) were recognised and staff expressed a full knowledge of matters relating to the Deprivation of Liberty Safeguards (DoLs). Staff had regular training in these areas to ensure their knowledge remained up to date and appropriate.
Staff were trained to recognise abuse and knew what actions to take if any incidents of abuse were suspected. People using the service told us that they felt safe and cared for. Two family members told us that if they had any concerns they felt certain that Home Instead would deal with these appropriately.
Is the service effective?
Staff expressed a thorough understanding about the needs of people they supported. We saw that care plans reflected the choices that each person had made. Care plans had been updated regularly and people using the service told us that they had discussed their wishes and preferences with staff.
People who used the service told us that staff always knew what support and care was needed and asked before they undertook any care. This ensured that each individual was able to make decisions on a daily basis and be in control of their care at all times.
Is the service caring?
When we spoke with people who used the service they told us that staff were caring. Everyone we spoke with said they felt their dignity was promoted by staff.
One family member told us that staff always treated their relative appropriately and were, "Always very kind and good at their job."
People using the service told us that they could talk with staff about any matters relating to their care and support. They were confident that any issues would be dealt with quickly and efficiently.
Is the service responsive?
Regular spot checks and audits were undertaken to ensure the quality and efficiency of the service was monitored and improved where needed. People using the service and their family members confirmed this did happen regularly.
Two people using the service and one family member explained to us that when some adjustments or changes were needed, Home Instead had taken action to address issues to their satisfaction.
Is the service well led?
Staff explained that they undertook regular training and we saw a list of dates that showed when training was due to be updated. This meant that people were supported by a staff team who knew how to provide people's support in a safe and appropriate way.
Quality assurance systems were in place and regular monitoring of records and staff practices was carried out and recorded. Staff and people who used the service told us that they felt supported and able to discuss any matters with the manager.