Home Instead Wembley

Updated 16 January 2020

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 carried out by one inspector. Following the inspection, one expert by experience telephoned people who received care from the service and relatives to obtain feedback about their 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

The service is a domiciliary care agency. It provides personal care to people living in their own homes. It provides a service to older adults and people with other needs including mental health conditions and physical disabilities. Not everyone who used the service received personal care. The Care Quality Commission (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.

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 two working days' notice of the inspection because the service provides care to people in their own homes and we wanted to make sure that management were available on the day of the inspection site visit.

Inspection activity started on 5 December 2019 and ended on 12 December 2019.

What we did before the inspection

Before the inspection visit, we reviewed information we had received about the service since the last inspection. This included information about incidents the provider must notify us of, such as any allegations of abuse. 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.

During the inspection

We visited the office location on 5 December 2019 to see management and office staff and review a range of records which included people’s care records, medication records, staff files in relation to recruitment and staff training, incident and accident records. We also reviewed a variety of records relating to the management of the service, including quality assurance audits and checks.

After the inspection

One expert by experience telephoned people who received care from the service and relatives after the inspection. The expert spoke with four people who received care from the service and five relatives about their experiences of the service. The inspector telephoned care workers and spoke with five caregivers.

We continued to seek clarification from the provider to validate evidence found. We looked at training data, MARs and quality assurance records.

Updated 16 January 2020

About the service

Home Instead Senior Care is a domiciliary care agency registered to provide personal care to people in their own homes. The service provides support to people of all ages and different abilities. At the time of our inspection the service was providing care and support to a total of 37 people, of which 16 people received personal care.

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

Feedback from people who used the service and relatives was consistently good. People told us they felt safe when being cared for by caregivers and this was confirmed by relatives we spoke with. People and relatives were complimentary about caregivers and the service. They told us that caregivers were caring, patient and respectful. They also told us that the service was professional and well run.

Positive relationships had been developed between caregivers and people they supported. People told us calls to their home were never missed and that caregivers usually arrived on time. Consistency was an important aspect of the care provided. The majority of people told us they received care and support from the same group of caregivers.

We looked at medicines management in the service. We found there were occasions where caregivers were not always accurately recording on Medication Administration Records (MARs) if medicines were being administered and MARs were not always completed fully using the key codes. The service had audits in place to check the completion of MARs. However, we found instances where audits failed to clearly detail what the issues were with regards to the completion of MARs. We raised this with the nominated individual and the registered manager and they explained that they would take immediate action in respect of this.

Systems were in place to help ensure people were protected from the risk of abuse. There were appropriate policies in place. People were protected from abuse by caregivers who understood how to identify, and report abuse concerns.

Assessments were carried out to ensure people's needs could be met. Where risks were identified, there was guidance in place for caregivers to ensure that people were safe.

Comprehensive recruitment processes were in place and the service carried out appropriate checks so only caregivers who were suitable to work with people using the service were employed.

Caregivers had completed a comprehensive induction programme, mandatory training and other training relevant to the needs of people. They were supported through regular supervisions and a yearly appraisal to ensure they performed their roles effectively.

People were supported in making healthy lifestyle choices for themselves and to maintain good health. Caregivers supported people to access healthcare services and liaised with health and social care professionals promptly when required.

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 had been assessed and each person had a detailed care plan which reflected their care and support needs. People using the service were involved in the development of their care through regular review meetings.

All caregivers we spoke with told us they enjoyed working at the service and they were well supported by the management team. Staff felt valued, motivated and were committed to the people they were supporting. The service held quarterly team meetings and at each session, a 'Caregiver of the Quarter' award was given to a caregiver who went the extra mile to help and support their client.

The service had a comprehensive system in place to monitor the quality of the service being provided to people. This involved telephone calls, regular visits and a questionnaire. Quality assurance systems and processes included audits looking at key aspects of 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 4 July 2017).

Why we inspected

This was a planned inspection based on the previous rating.

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.