Home Instead

Updated 21 November 2018

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 is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 17 September 2018 and 04 October 2018. We gave the service 48 hours’ notice of the inspection visit because we needed to be sure that they would be in. We visited the office location to see the registered manager and office staff; and to review care records and policies and procedures. We telephoned people who received support, their relatives and staff to gain their views on the service provided as part of our inspection.

One adult social care inspector and one Inspection Manager visited the office and met with the management team. The Inspector then telephoned randomly selected people, relatives and staff for their views on the service.

Before our inspection, we checked the information we held about Home Instead Senior Care. This included notifications the registered provider sent us about incidents that affect the health, safety and welfare of people who received support.

We also contacted the commissioning, safeguarding and contracts departments at Lancashire County Council. This helped us to gain a balanced overview of what people experienced when they received support from Home Instead Senior Care.

We looked at information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. All the information gathered before our inspection went into completing a planning document that guides the inspection. The planning document allows key lines of enquiry to be investigated focusing on any current concerns, areas of risk and good or outstanding practice.

During this inspection, we spoke with three people who used the service and two relatives. We also spoke with the registered manager, owner, care manager, trainer, two office staff and seven members of staff. We looked at the care records of eight people, training and recruitment records of three staff members, records relating to the administration of medicines and the management of the service. We looked at what quality audit tools and data management systems the provider had. We reviewed past and present staff rotas, focusing on how staff provided care within a geographical area. We looked at how many visits a staff member had completed per day and if the registered provider ensured staff had enough time to travel between visits. We looked at the continuity of support people received and how long staff stayed on each visit.

We used all the information gathered to inform our judgements about the fundamental standards of quality and safety of the service delivered by Home Instead Senior Care.

Updated 21 November 2018

Home Instead is a domiciliary care agency providing a service to older adults. It delivers personal care to 79 people living in their own homes. Only 50 people Home Instead supported received the regulated activity; CQC only inspects the service being received by people provided with 'personal care;' and help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

At our last inspection we rated the service outstanding overall. At this inspection we found the evidence continued to support the rating of outstanding and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Why the service is rated Outstanding.

We found staff had received training to safeguard people from abuse. They understood their responsibilities to report any unsafe care or abusive practices related to the safeguarding of adults who may be vulnerable. Staff we spoke with told us they were aware of the safeguarding procedure.

Staff members received training related to their role and were knowledgeable about their responsibilities. They had the skills, knowledge and experience required to support people with their care and support needs.

The registered provider planned visits to allow carers enough time to reach people and complete all tasks required. People told us staff respected their privacy and dignity during their visits.

Care plans were organised and had identified the care and support people required. We found they were personalised and informative about the care people received. They had been kept under review and updated when necessary with the support and consent of people and their relatives. They reflected any risks and people's changing needs.

Staff responsible for assisting people with their medicines had received training to ensure they were competent and had the skills required. The registered provider completed spot checks on staff to observe their work practices were appropriate and people were safe.

Staff were provided with personal protective equipment to protect people and themselves from the spread of infection.

The registered provider had procedures around recruitment and selection to minimise the risk of unsuitable employees working with people who may be vulnerable. Required checks had been completed before any staff started work at the service. This was confirmed during discussions with staff.

Positive links had been built with the local community. The registered provider delivered training and support within the health and social care field. They shared their skills and experience to impart knowledge to people who support and interact with people living with dementia within the local area.

They worked collaboratively with the local authority, sharing knowledge and their expertise to shape policies and procedures around safeguarding to improve people’s experience when using other services.

The registered provider invested their time and experience to support people within the service and within their local community with their personal development to enhance their wellbeing and quality of life.

When talking about the registered provider and management team people, relatives and staff spoke extremely positively about the person centred culture within the service.

The registered manager demonstrated their understanding of the Mental Capacity Act 2005. People told us they were enabled to make decisions and staff told us they would help people with decision making if this was required. People are supported to have maximum choice and control in their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice.

Audits had been completed and were linked to CQC’s regulatory standards. They effectively captured the level of detail sufficient to provide reliable data and lead to positive change.

Staff promoted compassionate, kind and caring values and have developed good relationships with people using the service. People were exceedingly positive about staff and praised the respectful support they received. Relatives confirmed the staff were caring and looked after people very well.

Staff understood the importance of supporting people to have a good end of life as well as living life to full whist they are fit and able to do so. They shared evidence that they had supported people to have the death they had wished by offering caring personalised support.

When appropriate, meals and drinks were prepared for people. Staff could share the importance of people receiving appropriate support and took time to ensure the support was personalised and effective. This ensured people received adequate nutrition and hydration.

Further information is in the detailed findings below