Home Instead Senior Care

Home Instead Senior Care is a service providing personal care to people living in their own homes. It provides long term, short term, and respite care to people within the community. At the time of our inspection, the service supported 105 people.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided. At the time of inspection there was 63 people in receipt of personal care.

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

People received safe care and were protected from the risk of avoidable harm and abuse. People told us they were supported by a consistent team of staff who knew them well and were always informed of changes and if staff were running late.

Staff were recruited safely and received induction and training for their roles. Staff told us they were supported by the registered manager and received regular supervisions and feedback.

Processes were in place to support people with their medicines if required. Infection control measures were in place including staff use of personal protective equipment (PPE).

Where people required support with their eating and drinking needs, staff had receiving relevant training to enable them to do this safely and in line with people’s wishes.

People told us they had access to their care plan, and these were regularly updated to ensure appropriate care was being delivered. Care plans were person centred and identified risk. There was clear guidance for staff on how to support people whilst mitigating risks to keep people safe.

People, relatives and staff felt the management team were approachable, open and transparent. Relatives said they had confidence in staff to perform the health task associated with the complex needs of people and knew when to seek advice and support from other medical professionals.

People were supported to have maximum choice and control of their lives and staff supported support them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

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

Rating at last inspection

The last rating for this service was good (published 4 April 2018).

Why we inspected

This inspection was prompted by a review of the information we held about this service and the time since our last inspection.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

There was a registered manager in post at the time of our inspection. 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.

At the time of the inspection Home Instead Senior Care supported 44 people who received some element of support with their personal care. This is the service’s third inspection under its current registration. At the previous inspection the service was rated as ‘Good’ overall. At this inspection they maintained that rating.

People continued to receive safe care. The risks to people’s safety were assessed and in the majority of cases regularly reviewed. Staff arrived on time for calls and people told us they stayed for the agreed length of time. Staff were recruited safely. People were supported safely with their medicines, although some records were not always regularly reviewed. Processes were in place that ensured accidents and incidents were monitored, reviewed and where needed, measures put in place to reduce the risk of reoccurrence.

People’s care was provided in line with current legislation and best practice guidelines. People were supported by staff that had completed a detailed induction and training programme and had their performance reviewed. Staff felt supported by the registered manager. People were supported effectively with their meals when needed. Information was available to support the involvement of other health and social care agencies where further support was needed for people. 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 support this practice. However, there were a small number of examples where an assessment of a person’s capacity may have been needed.

People praised the staff that supported them. They felt they were kind, compassionate and caring and provided them with care in a dignified and respectful way. The minimum duration of one-hour calls meant staff were able to build positive relationships with people. Staff were knowledgeable about people’s needs. Where able, people or their relatives, were involved with making decisions about their care. People’s diverse needs were respected and independence was encouraged.

Prior to starting with the service, people’s needs were assessed to determine whether the service could meet those needs. People and relatives felt involved with the process of agreeing the care that was needed. Care records contained detailed, person centred guidance for staff to provide care in the way people wanted. People were treated equally, without discrimination and systems were in place to support people who had communication needs. People felt able to make a complaint and were confident it would be dealt with appropriately.

The service was well led by a registered manager who was well liked by relatives, staff and the people they supported. Staff felt valued and enjoyed their job. Exceptional staff performance was rewarded. People and staff were encouraged to contribute to the development of the service. Effective auditing processes were in place to monitor the quality of the service. The registered manager carried out their role in line with their registration with the CQC.

The service had a 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 told us they felt safe and staff understood their responsibilities to protect people from the risk of abuse. Risks to people’s health and safety were assessed and appropriately managed.

There was a sufficient number of suitable staff available to meet people’s needs and people received the support required to safely manage their medicines.

Staff were provided with the knowledge and skills to care for people effectively. People received the support they required to have enough to eat and drink. Staff acted appropriately in contacting healthcare professionals and supported people to attend appointments.

The Care Quality Commission (CQC) monitors the use of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). Procedures were in place to act upon any concerns about people’s capacity to make their own decisions. People were asked for their consent before receiving any care.

There were positive and caring relationships between people and staff and people told us staff were genuinely caring. People and their relatives were fully involved in the planning and reviewing of their care and staff supported people to make day to day decisions. People were treated with dignity and respect by staff who understood the importance of this.

People were provided with care that was responsive to their changing needs and staff punctuality was good. There was a system in place to monitor staff punctuality and ensure that people always received the care required. There was a clear complaints procedure in place which was provided to people and complaints had been appropriately responded to.

People were asked for their opinions about the quality of the service they received and action was taken in response to any issues raised. There were effective systems in place to monitor the quality of the service and these resulted in improvements to the service where required.

People who used the service, and their relatives or representatives, felt that they had been involved in making decisions about the arrangements for delivering care and support. Each person's needs had been assessed and this information had been updated on a regular basis.

There were policies and procedures in place to help protect people who used the service from harm. If there were any concerns about a person's welfare or safety action was taken.

Staff had been supported to enable them to deliver safe and effective care. They had received appropriate induction training at the beginning of their employment. The manager of the service carried out regular checks to make sure that staff carried out their roles effectively.

The provider had systems in place to monitor the overall quality of the service. This included speaking to people who used the service to ask them for their views and checking written records to ensure they were properly completed.