Home Instead

Updated 23 December 2017

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

This inspection was carried out on 20 and 22 September 2017 and was announced. The provider was given up to 48 hours’ notice because the location provides a domiciliary care service and we wanted to be certain the registered manager and key staff would be available on the day of our inspection. We also wanted to give them sufficient time to seek agreements with people that we could visit them in their homes to find out their experience of the service.

The inspection was carried out 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.

Before the inspection, we requested that the provider complete a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. This was received from the provider. We also reviewed information we held about the service including feedback sent to us from other stakeholders, for example the local authority and members of the public. Providers are required to notify the Care Quality Commission about events and incidents that occur including unexpected deaths, injuries to people receiving care and safeguarding matters. We reviewed the notifications the provider had sent us.

We spoke with the provider’s nominated individual and registered manager, two client service managers, training and retention leader, a care coordinator and 13 caregivers. With their permission we met with five people and three relatives in their own homes on 22 September 2017.

Telephone interviews with people who used the service and their relatives were carried out by the inspector and an expert by experience. We spoke with sixteen people who used the service, seven people’s relatives and received electronic feedback from eight relatives. In addition we received comments about the service provided from five community professionals.

We reviewed the care records of ten people to check they were receiving their care as planned. We looked at records relating to the management of the service, staff recruitment and training, and systems for monitoring the quality of the service.

Updated 23 December 2017

Home Instead Senior Care (Ipswich, Woodbridge & Felixstowe) is a large domiciliary care service which provides personal care and support to people living in their own homes. When we inspected on 20 and 22 September 2017 there were 112 people using the service. This was an announced inspection. The provider was given up to 48 hours’ notice because the location provides a domiciliary care service and we wanted to be certain the registered manager and key staff would be available on the day of our inspection. We also wanted to give them sufficient time to seek agreements with people that we could visit them in their homes to find out their experience of the service. This service was registered on 14 March 2016. This was their first inspection.

Home Instead Senior Care (Ipswich, Woodbridge & Felixstowe) is part of the Home Instead Senior Care franchise which delivers care to people within the United Kingdom and in several countries across the world. The service provides personal care to people such as assistance with bathing, dressing, eating and medicines. The staff who support people wish to be known as ‘caregivers’ and therefore we have used this term throughout this report.

The provider of Home Instead Senior Care (Ipswich, Woodbridge & Felixstowe) was a company working under the franchise of Home Instead. The service had been compliant at previous inspections but at a different address. The directors of the company were a husband and wife team who were fully involved in the day to day running of the service. They were supported by 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.

Home Instead Senior Care (Ipswich, Woodbridge & Felixstowe) was exceptionally well led. There was visible and effective leadership in an open and transparent culture that resulted in an effectively organised and well run service. The provider and the registered manager were able to demonstrate how their robust quality assurance systems had sustained continual development and improvement at the service. They were clear about their expectations relating to how the service should be provided and led by example. They were supported by a management team and caregivers that were remarkably passionate and fully committed to delivering the highest standard of care to each individual. Morale was extremely high, at all levels within the service

Without exception people and their relatives were extremely complimentary about their experience of using the service. They were full of praise about their caregivers and told us that they were incredibly kind, compassionate and respectful towards them. They described how they trusted and felt safe with the caregivers, who knew them well and encouraged them to be as independent as possible. They shared examples with us of how the caregivers consistently provided them with personalised, tailored care; taking the time to ensure every small detail of the care provided met the person's individual needs and wishes. Everybody we spoke with said that they would highly recommend the service.

All the staff teams were highly motivated, enjoyed their jobs and understood their roles and responsibilities. They were proud of where they worked and told us they felt valued and respected. They shared positive experiences about the way the service was managed, how they were continually supported and encouraged to professionally develop.

Caregivers were highly skilled and competent to meet people’s needs. They demonstrated an enhanced understanding and knowledge of living with dementia. Exceptional person-centred training systems in line with current practice had been established. These took into account the different learning styles and needs of all the staff providing them with a holistic training package.

The high quality of the service’s training had been recognised recently in the Suffolk Care Awards 2017 as winner in the ‘excellent training’ category and was highly commended in the category for innovative approaches to service for dementia in the community.

People and or their representatives, where appropriate, were continually involved in making decisions about their care and support arrangements. As a result people received tailored care and support which was planned and delivered to meet their specific needs.

Detailed care plans were in place. These covered all aspects of a person’s health and personal care needs, how they wanted to be supported, their daily routines and preferences. The care plans were regularly reviewed and updated. Where changes were identified peoples' care packages were amended to meet their changing needs. The service was extremely flexible and responded positively to people's requests where possible.

People were safe; caregivers knew what actions to take to protect them from abuse. The provider had processes in place to identify and manage risk. Regular assessments had been carried out and care records were in place which reflected individual needs and preferences.

Recruitment of caregivers was done safely; checks were carried out to ensure they were fit to care for people using the service. There were sufficient numbers of caregivers to meet people’s needs. Where people required assistance with their medications, safe systems were followed.

Where caregivers and or the management team had identified concerns in people’s wellbeing there were systems in place to contact health and social care professionals to make sure they received appropriate care and treatment. Where required people were safely supported with their dietary needs.

Caregivers listened to people and acted on what they said. They understood the need to obtain consent when providing care. They had completed training in relation to the Mental Capacity Act 2005 (MCA). Procedures and guidance in relation to the Mental Capacity Act 2005 (MCA) were followed which included steps that the provider should take to comply with legal requirements.

People’s feedback was valued and acted on. Their comments, concerns and complaints were appropriately investigated and responded to and used to improve the quality of the service.

Robust systems were in place to assess and monitor the service, identifying any areas where improvements were needed to ensure a high standard of quality care was provided. The provider and registered manager demonstrated an open, reflective leadership style working in partnership with other stakeholders to drive continual improvement within the service and to raise awareness of the needs of people living with dementia within the local community. Feedback from health and social care professionals cited collaborative and highly effective working relationships.