We carried out a review of the data available to us about Home Instead on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Home Instead, you can give feedback on this service.
Home Instead is a domiciliary care agency providing personal care to older people, people living with dementia and people with mental health issues. At the time of our inspection there were 29 people using the service who received support with personal care.
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
People were kept safe from harm by staff who understood their responsibilities around safeguarding. Risks to people were assessed and safely managed by staff who knew them well. People and their relatives were positive about how well staff knew and supported them. There were enough staff to support people and staff deployment was managed well and based on people's needs and preferences. Medicines were managed safely.
Managers and staff were clear about their roles and worked to promote a culture that was person centred and empowering for people. People and their relatives told us staff supported them to remain independent. There were regular opportunities for people and relatives to give feedback on support they received, and this was welcomed by staff.
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.
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 15 May 2018).
Why we inspected
This inspection was prompted by a review of the information we held about this service. As a result, we undertook a focused inspection to review the key questions of safe and well led only. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has remained good based on the findings of this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Home Instead on our website at www.cqc.org.uk
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
There was no registered manager in post. 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. The registered manager had resigned from their position in November 2017 and had left their post at the end of December 2017. The owner had taken on the role in the interim and a new manager had been appointed and was due to start their post at the end of March 2018.
Since taking on the interim management role the owner had carried out a full assessment of the service and as part of this process had identified some areas where improvements were needed. For example, staff meetings had not been held and staff who had completed their probationary period had not attended regular formal supervision. Whilst staff had regular opportunities for training, the owner wanted to expand the depth and variety of courses available to staff to enable the service to take on more complex packages of care. An action plan had been drawn up to address these areas and timescales had been set to achieve them.
Staff were fully involved and committed to achieving the service’s values and vision. The organisation had extensive systems to monitor and review the quality of the care provided.
People told us they had continuity of carers. They said staff always arrived on time and stayed for their allocated time. They told us staff always completed the tasks required of them along with any additional requests. For example, one person told us, “I only have to ask and it’s done.”
People were supported by staff who demonstrated kindness, enthusiasm and passion. Staff knew people well and were well matched to the people they supported in terms of personalities. They understood people’s physical, social and emotional needs. We received numerous positive comments. For example, “They are like family,’ and ‘I couldn’t manage without them.’
People knew how to complain but everyone said they had no need to. They said they would have no hesitation in picking up the phone if needed as they were confident the office staff would address any issue brought to their attention.
Staff had a good understanding of safeguarding procedures and knew what actions to take if they believed people were at risk of abuse. Emphasis was placed on ensuring recruitment was thorough and ensured as far as possible staff were suitable and safe to work with people. Risk assessments were carried out in relation to people’s homes and to their individual needs and where necessary actions were taken to mitigate risks to reduce the risk of accidents or injuries. Where appropriate people were given advice to seek additional support, for example in relation to fire safety.
There were good systems for the management of medicines. These ensured people received support in a safe way. There was information in care plans about how people liked to take their medicines. Care staff had received training on medicines and there were systems to monitor their competency in this area.
Spot checks were carried out to monitor staff performance. Staff attended regular training to ensure they could meet people’s needs. There was a thorough induction to the service and staff felt confident to meet people’s needs before they worked independently.
The owner and staff had a good understanding of their responsibilities in relation to the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). The MCA and DoLS are regulations that have to be followed to ensure people who cannot make decisions for themselves are protected. They also ensured people were not having their freedom restricted or deprived unnecessarily.
Care plans gave staff detailed advice and guidance on how to meet people’s needs. People told us they had been involved as part of the process. Care plans were reviewed regularly and as and when people’s needs changed. If professional advice and support was sought then this was included within the documentation. If people needed support to attend health related appointments this was provided. People had the equipment they needed to keep them safe. Feedback from professionals who had contact with the agency was very positive. One professional told us the agency ‘Offer tailor made support.’ They went on to say they worked closely with other professionals.