Background to this inspection
Updated
27 July 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. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
Inspection team
The inspection was carried out by one inspector and one Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
The service is a domiciliary care agency. It provides personal care to people living in their own home. Not everyone using Home Instead Senior Care receives a regulated activity. The Care Quality Commission (CQC) only inspects the service being received by people provided with 'personal care'; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.
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 the service 48 hours’ notice of the inspection visit. We needed to be sure the registered manager would be at the office.
Inspection site visit activity started and ended on 24 June 2019. We visited the office location on 24 June 2019 to see the registered manager and office staff and to review care records and policies and procedures. We spoke with people and relatives on 24 June 2019.
What we did before the inspection
We reviewed information we held about the service. We contacted the local authority contracts and safeguarding teams for any information they held about the service. We used their feedback to inform the planning of this inspection.
The registered manager completed a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. This information helps support our inspections.
During the inspection
We spoke with seven people, five relatives, the director, registered manager, training manager, recruitment officer, care co-ordinator and three care workers. We looked at three people’s care plans and information relating to staff training, medicines management, rotas, recruitment and the management of the service.
After the inspection
We contacted three external health and social care professionals.
Updated
27 July 2019
About the service
Home Instead Senior Care is a domiciliary care agency. It provides personal care to people living in their own homes in the east Nottinghamshire area. There were 42 people using the service at the time of the inspection. The service supported older people, some of whom were living with dementia.
People’s experience of using this service
At our previous inspection we found staff to be exceptionally caring and committed, and were led extremely well. At this inspection this continued to be the case.
People were provided with an exceptional, caring and consistent service. People described the service they received in outstanding terms and staff displayed dedication and commitment to their work. People decided what care and support they needed which was provided in a manner that valued and respected each person who used the service.
People gave numerous examples of staff going above and beyond their duties to ensure their experience of Home Instead was exceptional. Relatives and external professionals agreed.
Continuity of care remained outstanding and a key strength, with all people confirming they always received a visit from someone they perceived as a friend. Staff turnover was extremely low and use of agency staff never occurred.
The service was led distinctively and with a passion for making a difference in people’s lives. Staff were extremely well supported and empowered to make those differences.
The leadership engaged positively with a wide range of external stakeholders, in order to meet people’s immediate needs but also to broaden understanding in the community about living with dementia.
People told us that they felt safe with the staff who supported them. Staff were knowledgeable about the action they would take if abuse was suspected.
Rota planning was effective and arrangements were in place to prevent delays and missed calls.
People were supported to maintain healthy lifestyles through the provision of information, access to a range of eternal services and help with day to day tasks such as preparing meals.
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.
Care visits were at least an hour long which helped enable staff to provide person-centred care which was responsive to people’s needs.
Staff received training relevant to their roles and ample professional support.
Care planning was comprehensive and peoples likes and dislikes always considered.
A range of audits at local level and by the provider’s national quality assurance team helped ensure quality standards were high and people remained safe. Our findings at this inspection confirmed that an effective quality monitoring system was in place, locally and from the national provider. The service was run extremely well as a franchise of the national organisation. It used that national support in place to good effect and also had its own distinctive approach to building bonds and rapport with people.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
Outstanding (last report published 6 July 2016).
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.