Home Instead Senior Care

Updated 14 January 2021

The inspection

As part of a pilot into virtual inspections of domiciliary and extra-care housing services, the Care Quality Commission conducted an inspection of this provider on 26 October 2020. The inspection was carried out with the consent of the provider and was part of a pilot to gather information to inform CQC whether it might be possible to conduct inspections in a different way in the future. We completed this inspection using virtual methods and online tools such as electronic file sharing, video calls and phone calls to gather the information we rely on to form a judgement on the care and support provided. At no time did we visit the provider’s or location’s office as we usually would when conducting an inspection.

Inspection team

This inspection was carried out by one inspector, a medicines inspector and an 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

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.

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

This inspection was announced. We gave the service 48 hours’ notice of the inspection. This was because it was part of a pilot and we needed to ensure staff were present in the location office to support this new way of working virtually.

Inspection activity started on 2 November 2020 and ended on 10 December 2020.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. The provider was not asked to complete 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. We took this into account when we inspected the service and made the judgements in this report. We used all of this information to plan our inspection.

During the inspection

We communicated with two people who used the service and 14 relatives about their experience of the care provided. Not everyone who used the service, communicated verbally or wished to speak on the telephone, therefore they gave us permission to speak with their relative. We spoke with 11 members of staff including the registered manager, assistant manager and nine care workers.

We reviewed a range of records. This included four people’s care records and multiple medicine records. We looked at three staff files in relation to recruitment. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. We communicated with three professionals who work in partnership with the service.

Updated 14 January 2021

This report was created as part of a pilot which looked at new and innovative ways of fulfilling CQC’s regulatory obligations and responding to risk in light of the Covid-19 pandemic. This was conducted with the consent of the provider. Unless the report says otherwise, we obtained the information in it without visiting the provider.

About the service

Home Instead Senior Care is a domiciliary care service providing personal care to people living in their own homes. Services were provided to adults with a wide range of health and social care needs including physical disabilities, mental health needs and dementia. At the time of our inspection there were 93 people receiving a service.

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.

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

Everyone complimented and highly praised the staff team and gave examples of the outstanding care that was delivered. One relative said, “They [staff] are excellent from the manager all through the organisation, I cannot speak highly enough of them.”

The service was very flexible and adapted to people's changing needs and wishes, enabling positive outcomes for all people. People’s care records were personalised and up-to-date. The service had forged successful partnerships with other stakeholders, was actively involved in research and aimed to provide an excellent care experience for people.

Very strong systems were in place to ensure care was individualised and to make sure people were at the heart of the service. This vision was driven by the exceptional leadership of the registered manager. One relative commented, “We chose Home Instead because of their reputation. We haven’t been disappointed. I’d say their leadership is one of their strongest assets."

The service consistently strived to ensure that people had the best possible care, and that they were supported in a compassionate, dignified and safe way. One relative told us, “The quality of care, their compassion is outstanding.”

Staff were highly-trained, knowledgeable and passionate about the service giving people the very best experience they could. They were enthusiastic and believed passionately in the ethos of the service. Staff consistently told us, “It’s the best care organisation I’ve worked for.”

Communication was very effective and staff and people were listened to. One person told us, “The staff are very good at ringing about any changes, they never send in anyone we don’t know, we always have an introduction." Staff were well-supported and were aware of their responsibility to share any concerns about the care provided.

Staffing capacity was sufficient and staff deployment was effective to ensure people's needs were met in a safe, timely and consistent way. Robust vetting procedures were in place when recruiting new staff.

Medicines management procedures were in place. People did not report any concerns with their medicines. We have made a recommendation to further review some medicines management procedures.

Infection control procedures were being followed. There were enough masks, aprons and gloves available for staff to use. One relative told us, “Staff are very thorough about using personal protective equipment [PPE]. They have been ultra-careful when it comes to covid-19 and I’ve seen them always wearing their masks and washing hands.”

People were involved in decisions about their care. 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.

People, relatives and staff were very confident about approaching the registered manager if they needed to. They recognised that their views and feedback were valued and respected and consistently used to support quality service development.

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 outstanding (published 24 March 2018).

Why we inspected

This was a planned pilot virtual inspection. The report was created as part of a pilot which looked at new and innovative ways of fulfilling CQC’s regulatory obligations and responding to risk in light of the Covid-19 pandemic. This was conducted with the consent of the provider. Unless the report says otherwise, we obtained the information in it without visiting the Provider.

The pilot inspection considered the key questions of safe and well-led and provide a rating for those key questions. Only parts of the effective, caring and responsive key questions were considered, and therefore the ratings for these key questions are those awarded at the last inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Home Instead Senior Care on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.