Background to this inspection
Updated
6 September 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 membership of the inspection team consisted of two inspectors and one 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 and specialist housing.
The service had a manager who was going through the process of registering with the Care Quality Commission. A registered manager 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 short notice of the inspection. This was because it is a small service and we needed to be sure that the provider or manager would be in the office to support the inspection.
Inspection activity started on 28 June 2019 and ended on 15 July 2019. We visited the office location on 15 July 2019.
What we did before the inspection
Before the inspection, we reviewed information we had received about the service since the last inspection. This included details about incidents the provider must notify us about. We requested feedback about the service from the local authority safeguarding and commissioning teams and Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. 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
On 27 June 2019, we interviewed six staff members on the telephone. Between 28 June 2019 and 1 July 2019, we spoke with four people and eight relatives on the telephone. During the office visit on 15 July 2019, we spoke with the two providers, the manager, the community representative, field support and care co-ordinator. We also reviewed elements of three people’s care records, three staff members’ personnel files and other records relating to the management of the service, including policies and procedures.
Updated
6 September 2019
About the service
Home Instead is a Domiciliary Care Agency providing personal care to 15 people aged 65 and over at the time of the inspection.
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
Staff provided exceptionally kind and compassionate care to people. There was a clear person centred culture in place revolving around the needs of people who used the service. Without exception people provided positive feedback about the nature and personalities of the staff who supported them. Staff were dedicated in their approach and we saw instances of them going the extra mile to ensure people were safe and/or comfortable.
People had strong influence in who supported them. For example, people were matched with staff based on their shared interests and how they got along. People regularly provided feedback on individual staff members to ensure they continued to be a good match for them.
People said they felt safe using the service. Risks to people’s health and safety were assessed and mitigated. Medicines were managed in a safe and proper way and people received their medicines as prescribed.
There were enough staff to ensure people received prompt care and support. Safe recruitment procedures were operated. Staff received a range of training and support relevant to their role. This included a strong focus on dementia care to equip staff with the skills to care with people living with dementia.
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’s needs were assessed and clear and very detailed plans of care put in place for staff to follow. These were exceptionally person centred and demonstrated the service had taken the time to understand all aspects of people’s care and support needs. The service liaised with professionals where required such as over people’s nutritional and health needs.
There was a strong focus on ensuring people’s social care needs were met. This was achieved through good care planning, providing companionship and working with the local community to provide social opportunities for people.
A system was in place to log, investigate and respond to complaints and concerns in a prompt manner. People were encouraged to provide feedback about the service.
There was an open and person centred culture within the service with the management team dedicated to ensuring people received high quality care and support. The service was committed to continuous improvement and had a plan in place to ensure they continued to improve.
A range of audits and checks were undertaken to assess, monitor and improve the service. People’s feedback was regularly sought , listened to and used to improve the service.
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 23 December 2016).
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.