Archived: Home Instead Senior Care

Updated 31 October 2017

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 was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, and to provide a rating for the service under the Care Act 2014.

This announced inspection was carried out on Tuesday 05 September 2017. The inspection was announced (on Friday 1st September) to ensure our inspection could be facilitated on that day by the registered manager. The inspection team consisted of an adult social care inspector from the Care Quality Commission (CQC) and an expert by experience who spoke with people who used the service and relatives by telephone. An expert by experience is someone who has personal experience of caring for older people who may be living with dementia, similar to the needs of people in this type of service.

Before the inspection we reviewed any information we held about the service in the form of notifications received from the service. We also reviewed any safeguarding or whistleblowing information we had received, previous inspection reports and any complaints about the service. We also liaised with stakeholders who had involvement with the service. This included commissioners based within Salford City Council. This helped us determine if there might be any specific areas to focus on during the inspection.

At the time of the inspection the service provided care and support to approximately 32 people in the Salford area. As part of the inspection we spoke with the registered manager, both directors of the service, 12 people who used the service, three relatives and five caregivers. This was to seek feedback about the service provided from a range of different people and help inform our inspection judgements.

We also viewed three plans, three caregiver personnel files, policies and procedures and other documentation relating to the running of the service, such as satisfaction surveys, complaints, spot checks/observations and audits. We also visited two people at their home to look at how their medication was handled and reviewed their care plan and communication log. We reviewed an additional three MARs whilst at the office, which meant we had looked at five in total.

Updated 31 October 2017

This announced inspection was undertaken on Tuesday 05 September 2017.

Home Instead Senior Care is a domiciliary care agency based in Salford and provides personal care and support to people in their own homes. At the time of our inspection, there were 32 people using the service. Additional services available include home and dementia care support.

Employees within the service are referred to as ‘Caregivers’, as opposed to staff and we have referred to them in this way throughout the report.

There was a registered manager in post. 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.

We found there was an exceptional culture within the service. Staff were passionate about ensuring people received a high level of care and support, creating a caring and personalised service. The company had been co-founded by two directors, one of whom wanted to set up the service due to having previous difficulty finding a high quality service for a family member. Both the directors and registered manager had been involved in fund raising events to raise funds for people who had previously used the service and had now passed away. This was being done in memory of the person which demonstrated the caring nature of the service. This included events such as a sponsored walk and a sky dive. In honour of the person and to keep their memory alive, the service had devised ‘The Marshall award’ which would be awarded to caregivers for their continuous hard work and to help them remember the person specifically.

People who used the service and their relatives told us the level of care provided was excellent. We saw numerous examples of where both caregivers and the management team had gone ‘above and beyond’ to meet people’s care needs, requests and personal preferences. A ‘Matching process’ was used and this enabled people who used the service to receive care and support from caregivers who had similar personalities, hobbies and things in common. The service provided a minimum call time of one hour, with some lasting up to four hours and this allowed for genuine, friendly and caring relationships to develop.

The service excelled in areas such as community engagement and partnership working to ensure people were not placed at risk of social isolation and could enjoy their favorite pastimes with support from their caregivers. One of the directors had personally visited numerous facilities within the local area in order to create the WOW (What’s on where guide) so that people had access details and information about any activities and social events they may want to participate in. Other strong links within the community included Trading Standards and Marks and Spencer’s.

The registered manager had also been extremely proactive in raising awareness and sourcing training relating to specific conditions affecting people who used the service such as bowel cancel and Parkinson’s disease. The registered manager had also made arrangements for people to be interviewed via television and radio to share their views and experiences of care in Salford on the back of recent media interest. People had felt valued in having their say and wanted to share a ‘Good news story’ about their positive experience of using Home Instead.

The people we spoke with told us they felt safe. The caregivers we spoke with had a good understanding about safeguarding and whistleblowing procedures and told us they wouldn’t hesitate to report concerns if it may impact on people’s safety.

We looked at how medication was handled at two of the houses we visited and also reviewed MAR charts in the office. We found Medication Administration Records (MARs) were signed by caregivers when medication had been administered. People who used the service also told us they received their medication as part of their care package and told us they always received it on time.

We found staffing levels were sufficient to care for people safely. The caregivers spoken with didn’t raise any concerns about staffing numbers within the service and said their rotas were well managed, with sufficient time between calls for travel and breaks.

Caregivers were recruited safely, with appropriate checks undertaken before they began working with vulnerable adults.

The caregivers we spoke with told us they had access to sufficient training and received supervision as part of their ongoing development.

Caregivers provided support to people to eat and drink as necessary. This included assistance with food preparation and ensuring people were left with something to drink when their call had finished. People’s dietary requirements were also captured within their care plan information.

Each person who used the service had a care plan in place and we saw a copy was kept in the person’s home and at the office. The care plans provided an overview of each person’s care needs and were updated when things changed. The people we spoke with also said an initial assessment was undertaken, when they first started using the service. This enabled caregivers and management to understand the level of care people needed.

Management sent satisfaction questionnaires to people, asking for their comments about the service. This enabled the service to continually improve based on feedback from people and anything that could be changed.

There was a complaint procedure in place, enabling people to state if they were unhappy with the service. The people we spoke with were aware of how to make a complaint where necessary. The service also collated compliments that had been made based on people’s experiences.

People who used the service and caregivers told us they felt the service was well managed. Care givers told us they felt well supported and would feel comfortable raising and discussing concerns.

We saw there were systems in place to monitor the quality of service provided. This was done in the form of audits, spot checks and observations of care givers undertaking their work. Caregivers also had access to policies and procedures if they needed to seek guidance and advice in a particular area.