Archived: Home Instead

Updated 3 March 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 was a comprehensive inspection.

The inspection took place on 29 January 2018 and was unannounced.

The inspection was conducted by an adult social care inspector.

Before the inspection the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and any improvements they plan to make. We checked the information that we held about the service and the service provider. This included statutory notifications sent to us by the registered manager about incidents and events that had occurred at the service. A notification is information about important events which the service is required to send to us by law.

As part of our planning for this inspection we sent out questionnaires to people connected with the service. We received 12 out of 21 questionnaires back from people using the service, 12 out of 41 from staff, four out of 21 from relatives and one from a community professional. We used all of the information available to us to plan how the inspection should be conducted.

During the inspection we spoke with two people using the service, eight relatives of people supported, four care staff, the nominated individual, the registered manager and senior staff responsible for oversight of the service. We also spent time looking at records, including six care records, four staff files, medication administration record (MAR) sheets, staff training plans, complaints and other records relating to the management of the service.

Updated 3 March 2018

Home Instead Senior Care (Warrington) is a registered domiciliary care agency based in Cheshire that provides personal care to people in their own homes. The service is part of a network of Home Instead Senior Care franchises. At the time of the inspection 41 people were receiving a regulated activity from the service.

At the last inspection, the service was rated Good.

At this inspection we found the service remained Good.

Why the service is rated Good.

The service met all relevant fundamental standards.

A registered manager was 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.

The majority of people spoke positively about the management of the service and the approachability of senior staff. However, there were a small number of concerns raised about the quality and timeliness of communication by some people using the service.

The service had a clear structure and performance framework which helped to define roles and responsibilities. A substantial and regularly updated set of policies and procedures provided guidance to staff regarding expectations and performance. We saw evidence that staff had been challenged when their performance did not meet the required standards.

Staff and managers spoke with clarity and enthusiasm about their roles and demonstrated a mature and transparent approach when questions were raised during the inspection.

The service had used safety and quality audits to identify and address issues relating to; staff conduct, medication errors and late calls. Information had been used effectively to improve practice and to inform further development.

People and their relatives told us that the service was safe, and the service maintained effective systems to safeguard people from abuse. Staff were aware of what to look out for and how to report any concerns.

Individual risk was fully assessed and reviewed. Positive risk taking was encouraged to improve people’s skills and promote their independence.

Staff were safely recruited and deployed in sufficient numbers to provide safe, consistent care and support. The employment records for staff were maintained to a high level and showed clear evidence of employment histories, photographic identification, references and checks.

Staff were trained in the administration of medicines and had their competency checked. Medicines were stored and administered in accordance with best-practice guidelines. Where an error had been identified, the service had taken immediate action to improve practice.

The service trained staff to a high standard in appropriate subjects and supported with regular supervision and appraisal. Training was subject to regular review to ensure that staff were equipped to provide care and support. Staff had been provided with additional, specialist training where necessary. New staff completed the Care Certificate to ensure that they were competent to deliver care before they were offered a permanent contract.

We saw evidence of staff working effectively in partnership with healthcare services to deliver positive outcomes for people. People were also supported by staff to maintain their health and wellbeing through access to a wide range of community healthcare services and specialists as required. For example, local dementia services and the stroke association.

The service operated in accordance with the principles of the Mental Capacity Act 2005 (MCA). It was clear from care records and discussions with people that their consent was always sought in relation to care and treatment.

People told us that staff treated them with kindness and respect, and it was clear from our discussions that staff knew people, their needs and preferences well and provided care accordingly. People and their relatives told us they were actively involved in decisions about care. They gave us examples of how staff took time to explain important information and offer choices.

Through discussions people described that their care needs were met in a personalised way and were subject to regular review. People gave positive feedback when asked about this aspect of their care.

The majority of people that used the service had specific needs in relation to equality and diversity. We saw that people’s needs were considered as part of the planning process in relation to; disability, age and religion as well as other protected characteristics.

We checked the records in relation to concerns and complaints. There were six complaints recorded in the previous 12 months. Each had been addressed in accordance with the provider’s policy and included a written response.

Further information is in the detailed findings below.