Background to this inspection
Updated
20 August 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. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
Inspection team
The inspection was completed by one 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. The Expert by Experience had experience of caring for older people and those living with dementia.
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 provider 48 hours’ notice of our site visit as it was a domiciliary care service and we needed to be sure key staff members would be available.
Inspection activity started on 28 June 2019 with telephone calls to people and ended on 02 July 2019. We visited the office location on 01 and 02 July 2019.
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. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.
During the inspection
We spoke with or received email feedback from nine people who used the service and six relatives about their experience of the care provided. We spoke with eight members of staff including care staff, office staff, the recruitment/training manager, the general manager, the registered manager and the provider.
We reviewed a range of records. This included four people’s care records and their medication records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
Updated
20 August 2019
About the service
Home Instead Senior Care Farnborough was a privately-run domiciliary care agency, which was part of the national Home Instead franchise. It provided companionship and personal care to adults over twenty-five years of age, including people living with dementia or a cognitive impairment. At the time of the inspection it was providing the regulated activity of personal care to 55 people.
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
There was a very strong and visible person-centred culture. The registered manager and provider valued their staff. Staff were carefully matched to people’s needs and preferences, to maximise the chance of them forming a strong bond. Staff were highly motivated to provide exceptionally caring and compassionate care. People unanimously told us of how important the staff were to them and how much they enjoyed their relationships with them. A relative said, "All staff, including the office staff, are extremely caring and I am left feeling that they really understand and wish to support my [loved one’s] needs fully." Staff were skilled at involving people in decisions about their care and ensured their views were heard. People felt staff fully respected them and their personal care was provided with great sensitivity. Staff supported people to maximise and retain their independence, which enabled them to remain at home as per their wishes.
People told us the service was exceptionally well managed. There was a culture of one staff team committed to person centred care. Staff were developed and nurtured, to ensure the service was provided by motivated and skilled staff. There were rigorous governance processes and staff understood their responsibilities. There was a strong focus on innovation and development which had led to service improvements for people. There were strong and extensive relationships with the community which enabled people to access varied opportunities for social inclusion.
The provider ensured staff implemented and applied best practice guidance to improve outcomes for people. Staff’s knowledge and skills had been nurtured to enable them to train their peers. Staff were provided with a range of learning opportunities which equipped them with the skills required to provide good care. There was a focus on encouraging people to eat and drink well. Staff were committed to working collaboratively and providing people with joined-up care, so their health needs were met. 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 were fully consulted and involved in planning their care. People’s needs, history, preferences and planned outcomes were well understood by staff to enable them to deliver personalised care to people. People told us the service was highly responsive to any changes in their care needs. People were well supported to attend activities of their preference. Staff ensured any issues people raised were responded to and investigated promptly. People were appropriately supported with end of life care.
People were protected from the risk of experiencing abuse as staff completed regular training and understood their responsibilities. Potential risks to people had been assessed and measures put in place to ensure their safe management. Any incidents were investigated and required changes or staff training took place. People received continuity of care from regular staff who had been recruited through rigorous recruitment procedures. People received their medicines safely from trained and competent staff. Staff ensured people were protected from the risk of acquiring an infection as they followed the provider’s policies and procedures.
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 22 February 2017).
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.