Harrall Care Services Limited t/a Home Instead Senior Care

Updated 25 June 2019

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

One inspector carried out this inspection.

Harrall Care Services Limited t/a Home Instead Senior Care is a domiciliary (home care) care agency. It provides personal care to people living in their own houses and flats. Home Instead provides care and support to older people, younger adults, people living with dementia, people with a physical disability and people with sensory impairments. Not everyone using Home instead receives the regulated activity of personal care. 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 consider any wider social care provided. At the time of the inspection there were 73 people receiving the regulated activity of personal care and overall 113 people were receiving support.

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: We gave the service 48 hours’ notice of the inspection site visit because we needed to make sure that the registered manager would be there.

Inspection started on 02 April 2019 and completed on 9 April 2019. The day before we visited the office we contacted people and relatives by telephone to explore their experiences. We visited the office location on 3 April 2019, we reviewed care records and other documents relating to the service.

Before the inspection: We gathered and reviewed information that we received from the provider on the provider information return (PIR). This is a document that the provider sent us saying how they were meeting the regulations, identified any key achievements and any plans for improvement. We also reviewed all information received from external sources such as the local authority and reviews of the service.

During the inspection: We spoke with the provider’s, the registered manager, training manager, care coordinator and four staff. We gathered information from two care plans which included all aspects of care and risk. We looked at records of accidents, incidents, complaints audits, surveys and minutes of staff meetings.

Following the inspection: We reviewed information we requested such as training documents and we spoke with three more staff, four relatives and nine people who used the service.

Updated 25 June 2019

About the service: Harrall Care Services Limited t/a Home Instead Senior Care is a domiciliary (home care) care agency. It provides personal care to people living in their own houses and flats.

People’s experience of using this service:

People were supported to have maximum choice and control of their lives. People and their relative’s felt this was a fantastic service.

There was a strong ethos of learning, when things went wrong, lessons were learned and shared with staff to support learning and understanding. Changes were implemented effectively ensuring best practice.

The provider had a twelve-week induction and training programme to develop and train staff. There was a support network to ensure staff had the confidence to grow. The training manager was passionate about good quality training. Staff told us they felt the training was excellent and were completely supported by the trainer. One aspect of the provider’s improvement plan included on line access for staff at any time to develop their needs further.

People, relatives and staff were complimentary about the positive outcomes people achieved. The provider’s systems and processes enabled staff to place the person at the centre of the care and support they received. People were supported to be independent.

People were supported to live and develop their skills and confidence in their own home. Staff were matched and introduced to people before they commenced their shift. The provider’s and registered manager ensured that people were supported by the same staff to ensure the development of relationships. This also meant people felt safer knowing what staff were supporting them.

The providers had an established staff structure with clear responsibilities for all staff. This ensured that communication was effective and the decision-making process for any actions identified to improve the service were taken promptly without any delay. Staff felt supported and confirmed that the management teams’ doors were always open.

The provider's governance systems were effective and ensured ongoing compliance. The providers had an improvement plan and was constantly developing the service. They had implemented an electronic monitoring and reporting system that had made a huge change to the way care and support was delivered.

The electronic system was live and gave real time information and allowed for immediate response and updates when required. The system also supported staff in delivering safer care and support, with prompts for staff and daily auditing and confirmation of completed tasks that were monitored by the registered manager and office staff daily.

All relatives were full of praise for Home Instead. They told us that the kind, caring staff who supported their families to grow, nothing was too much trouble and Home Instead had exceeded their expectations. People also confirmed they were delighted with the support they received.

Care plans were personalised, person centred with risk assessments developed for each identified risk to people`s health and wellbeing.

There was an extremely positive culture within the service, the management team provided strong leadership and led by example. The provider and the registered manager had a clear vision and strong values about how people were supported, this was echoed by all the staff we spoke with. Staff were proud to work for Home Instead and felt they were an active part of an organisation where they mattered, and their voice was heard.

The provider was engaged in supporting other organisations to learn and develop and gave talks on varied topics and provided learning to support other health and social care professionals.

The providers have opened a dementia café in the local community that supported people, their relatives and friends with invaluable advice and guidance. The dementia café provided a place for people to go and meet new friends for tea and coffee and take part in numerous activities.

Rating at last inspection: Good (report published 02 August 2016).

Why we inspected: This was a planned inspection based on the rating at the last inspection. The service has improved to Outstanding overall.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.