Archived: Home Instead Poole

Home Instead Senior Care provides personal care and support to people in their own homes. Home Instead Senior Care is a national franchise. A franchise is when a franchisee (the provider) has bought the right to sell a specific company's (the franchisor's) products in a particular area using the company's name.

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

People were protected from abuse and avoidable harm. People said they felt safe with staff, who had the training and skills they needed to provide care safely and effectively.

Care plans were detailed and explained how people liked personal care provided and what activities they enjoyed. Risk assessments were in place to ensure people's safety. Staff knew how to recognise and report abuse and were confident their manager would respond to any concerns raised.

Medicines were managed and administered safely and recruitment practices continued to be followed. A range of checks remained in place to ensure people’s and staffs’ safety. Staff were well supported through training and supervision.

The registered manager was readily available to people, relatives and staff. They had an open and honest approach to complaints.

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 28 February 2017).

The overall rating for the service has remained good. This is based on the findings at this inspection.

Why we inspected

This was a planned inspection based on the previous rating.

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.

At the last inspection completed in June 2014 the provider was compliant in the regulations.

Home Instead Senior Care is a national franchise. A franchise is when a franchisee (the provider) has bought the right to sell a specific company's (the franchisor's) products in a particular area using the company's name. At the time of the inspection visit Home Instead Senior Care provided care and support for up to 110 people living in their own homes.

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.

Relatives and people we spoke with were very satisfied with the service provided by Home Instead Senior Care. People felt safe with the care staff and staff knew the correct procedures on how to respond and report potential abuse.

Feedback from health professionals who had dealings with the service was very positive with comments including, “I have nothing but praise for the work that they have done” and “Their communication has been excellent and the care that they have provided has been very patient centered”.

Staff were given enough time to provide effective care and support to people and told us they felt very well supported by the manager and the management team. There was a robust recruitment process for staff which ensured people were cared and supported by staff who had been safely recruited.

Staff received regular training and supervision which ensured they were provided with the relevant skills and support to develop their role and provide effective care and support for people in their own homes.

Medicines were managed safely.

People's rights were protected because staff and management had a working knowledge of the Mental Capacity Act 2005.

Staff understood people’s care plans and provided individual support and care. People and staff told us communication within the company was good. Staff said there was always someone to speak to if they needed further advice and guidance.

Environmental risk assessments on people’s homes had been completed. These were completed before care commenced to ensure any risks to staff and people were minimised.

There were robust quality assurance systems and a range of policies and procedures to enable people to receive safe, effective care and support in their own homes.

The summary describes what people using the service, their relatives and the staff told us, what we observed and the records we looked at. If you want to see the evidence that supports our summary please read the full report.

We considered our inspection findings to answer questions we always ask:

' Is the service safe?

' Is the service effective?

' Is the service caring?

' Is the service responsive?

' Is the service well-led?

This is a summary of what we found.

Is the service safe?

The care records we looked at showed that people's needs had been assessed before they received a service. The registered manager showed us that, following an allegation that someone's needs had not been fully assessed, they had introduced initial assessment documentation that prompted staff to obtain key information, such as safe swallow plans, from people's health and social care professionals.

Care plans addressed risks to people's health, safety and welfare. For example, we saw that they covered people's physical health needs, including any swallowing difficulties and assistance needed to eat and drink safely, and any support they needed to take their prescribed medicines. They also specified the moving and handling assistance and equipment people needed to transfer safely from one position to another.

People who use the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening. The people we spoke with all indicated they felt safe with staff and that staff treated their property with care. The five care workers we spoke with were aware of signs or issues that could indicate a concern, and of the correct procedures to follow if someone offered them a gift. They knew how to report safeguarding concerns to their managers and to statutory agencies.

There were enough qualified, skilled and experienced staff to meet people's needs. The people we spoke with told us they mostly had a regular team of care workers. For example, one person said, 'I keep the same ones' and someone else's relative told us, '[Person] has had a reasonable and fairly consistent group of people.' The people and relatives we talked with told us they were happy with their regular care workers and that care workers knew what they were doing. The care workers we spoke with all confirmed they received sufficient training to enable them to perform their roles.

Is the service effective?

People and their relatives were positive about the care provided and confirmed that the support people received was generally in line with their care plan. For example, one person told us, 'They do what they're being paid for and do it very well.'

People said that care workers were usually punctual; one person told us, 'They always come on time.' The care workers we spoke with all told us they were allocated travel time between appointments.

Is the service caring?

People spoke highly of their regular staff and told us they were caring. A relative said, 'I find them professional and thorough.'

Is the service responsive?

Before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes. Where people did not have the capacity to consent, the provider acted in accordance with legal requirements. People and their relatives told us that care workers provided the support they wanted. For example, one person said, 'They [care workers] do exactly what you want' and someone else's relative stated, 'They have provided what we asked.' During our visit to one person, we observed that their care worker checked they wanted assistance before helping them to move.

The care plans we looked at reflected people's assessed needs and contained clear instructions for care workers so that people received the help and support they needed. This support included help with washing and dressing, using the toilet and attending to continence needs, and preparing food. Care plans were regularly reviewed and updated.

Is the service well-led?

The provider had an effective system to regularly assess and monitor the quality of service that people receive, and to identify, assess and manage risks to the health, safety and welfare of people who use the service and others. The registered manager informed us that the national Home Instead Senior Care quality assurance survey was under way. There was also a local system of quality assurance checks and spot checks in place.

The provider took account of comments to improve the service. There had been no written complaints. Everyone we spoke with, except for one person, told us that care workers and managers acted on their requests. For example, a relative told us that their family member preferred to receive assistance from more mature staff and said that Home Instead Senior Care 'paid attention to my request to send older people.'

There was evidence that learning from accidents and incidents took place and appropriate changes were implemented. The registered manager showed us their log of missed visits, which showed that 11 missed visits had been reported during 2014. The nominated individual informed us that this represented a very small fraction, 0.04%, of the total visits provided during the period. Managers had ensured the person's wellbeing as soon as possible after each omission had been identified, for example by office staff visiting the person. They had also followed up each incident and had changed procedures to reduce the likelihood of this happening in future.

In this report two registered managers appear who were not in post and not managing the regulatory activities at this location at the time of the inspection. Their names appear because they were still on our register at the time.

We talked with a relative of one person using the service who said the agency was 'Really good. I can't think of anything I would change.'

We spoke with a director, the care manager, the recruitment and HR manager and six caregivers, the title by which support staff were known. One caregiver told us 'This is a good company to work for. We encourage people to do as much as they can for themselves to stay independent'.

People were informed about the service provided, and were involved in their care.

We looked at care files for four people with varying support needs. We found that the planning and delivery of care promoted peoples' choices, dignity and independence, and was flexible to meet their needs.

There were effective systems in place to ensure people were safe because staff were subject to rigorous recruitment procedures and a thorough induction.

People benefited from safe care and support because the provider monitored the quality of service that people received.