About the service: Home Instead Senior Care is a domiciliary care agency that provides personal care and support to people living in their own homes. Not everyone using the service received the regulated activity. 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. When we inspected the service 15 people were receiving the regulated activity.
People’s experience of using this service:
Audits checks were in place to monitor the quality of service provision and systems. However, some issues about recording changing needs and risk assessment had not been picked up. All these things were dealt with immediately and had not resulted in a negative impact for people but should have been identified by the systems in use.
Some staff supervision records retained personal client information after being used at supervision. We have made a recommendation the provider and manager consult and take advice from a reputable source to make sure any confidential details are managed in line with current legislation and best practice.
The service had a strong person centred and community based ethos. Everyone we spoke with who used the service was overwhelmingly positive about the compassionate and highly individualised care and support they received. People told us they felt “very safe” with the carers who visited. People told us, “I look forward to them coming in every day” and “Always on time, I can set my clock by them.”
The provider had safeguarding systems to protect people from the risk of abuse or unsafe care. Staff were aware of the procedures, had received training on it and knew what action to take. The service was very involved in the local communities and provided 'scam awareness' talks in the communities they served to help inform and protect vulnerable people.
We saw, and people confirmed that staff treated them with kindness, compassion and respect and made sure their dignity was maintained. People spoke highly of the care and support they received from regular staff who knew them well and often "went the extra mile". There were many examples of staff going "over and above" to help and support the people they cared for.
Staff assessed and reviewed people's physical, mental health and social needs. Holistic are plans had been developed with the close involvement of the person and where appropriate their families and representatives to give a vivid picture of the person and their needs. People's communication needs were thoroughly assessed and understood by staff. This helped to support people's communication needs and the Accessible Information Standard (AIS). A relative noted, "A small team of wonderful carers gained [relatives] trust and built up fantastic relationships in a very short time."
There was a high staff to client ratio of suitably qualified and skilled staff to meet people’s individual needs. Staff had received a range of training and developmental support to help them to carry out their role safely. People told us they received care and support from staff who were well trained and knowledgeable about them and what they needed. Only staff who had received training in safe medicine administration were able to give medicines.
People told us staff were often more likes friends coming to visit were very reliable and had always responded very quickly if they needed any help, additional support or if they were feeling unwell. The service had a recruitment process to help make sure new staff were suitable to work with the people in their homes.
People received support to maintain good nutrition and hydration in line with their personal choice and preferences and their healthcare needs were well understood and met promptly The service worked collaboratively with other agencies and professionals to support people’s health and well-being.
Staff were supplied with personal protective equipment for use to prevent the spread of infections. Staff had received training in infection control.
The registered provider had procedures in place for assessing a person's mental capacity in line with the Mental Capacity Act 2005. 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 supported this practice.
People and their relatives were aware of how to raise concerns or complaints and told us they would feel comfortable raising any matter. They and staff expressed confidence in the management to address any complaints or concerns raised quickly.
People's social and emotional needs were considered as part of the overall service and the risk of social isolation was recognised as an issue for some people. Staff actively promoted people's independence and social participation and respected their privacy.
The leadership of the service promoted a positive, open culture. People, family members and staff all described the provider and manager as supportive and approachable. People and their relatives were happy with how the service was managed and several said they would happily recommend it.
The registered manager and provider showed a clear desire to continue to develop and improve the service in a planned and managed way as it grew. They displayed knowledge and understanding around the importance of openness and working closely with other agencies and healthcare professionals to make sure people had good care.
Rating at last inspection: This is the first inspection of the service since their registration with us.
Why we inspected:
This inspection was part of our routine scheduled plan of visiting services to check the safety and quality of care people received.
Follow up:
We will continue to monitor intelligence we receive about the service and plan to inspect in line with our inspection schedule for those services rated good. If any concerning information is received we may inspect sooner.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk