Home Instead Tunbridge Wells, Sevenoaks & Edenbridge

Home Instead Senior Care Tunbridge Wells, Sevenoaks & Edenbridge is a domiciliary care agency. It provides personal care to people living in their own homes in the community. On the day of the inspection, the service was supporting 11 people with a range of health and social care needs, such as a physical disability, sensory impairment or people living with dementia. Support was tailored according to people’s assessed needs within the context of people’s individual preferences and lifestyles to help people to live and maintain independent lives and remain in their homes. Not everyone using Home Instead Senior Care Tunbridge Wells, Sevenoaks & Edenbridge receives the regulated activity; 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 take into account any wider social care provided.

People’s experience of using this service:

People using the service were consistent in their view that the service was unique in its delivery of care and delivered outstanding care. Typical comments included, “They are a great company and a great help to me” and “They are so much better than any company we have used before, by a million miles”.

We found areas of outstanding practice in the effectiveness of the care provided by Home Instead Senior Care Tunbridge Wells, Sevenoaks & Edenbridge. The provider had developed innovative and effective systems that promoted people’s health, improved their independence and enabled them to live in their own home for as long as possible. People and staff universally had their equality, diversity and culture celebrated, and their rights promoted and respected. The service was inclusive, educational and empowering.

Outstanding, person centred and innovative training resources equipped staff with the skills, knowledge and understanding to meet the challenges of supporting people with diverse and complex needs. Bespoke training had been developed to ensure that people remained safe and had their health and wellbeing protected at all times. This increased the overall skills of the staff team which complemented the delivery of high quality care. There was a culture of embracing learning and development within the service. People and their relatives felt confident in the skills of the staff and they received effective care that met their needs.

The registered manager and dedicated and enthusiastic staff demonstrated an exceptional commitment to enabling people to live well with dementia. People received outstandingly high-quality care that met and exceeded their needs, and improved their wellbeing, independence and happiness. Staff treated people with respect, dignity and compassion. They were motivated, passionate and proud of their jobs and people had a regular team of care workers and felt they had become part of the extended family. People and their relatives felt respected, valued and listened to.

The service had built an outstanding model of care and support provided to people. People told us they thought the service was well managed and they received high quality care that met their needs and improved their wellbeing from dedicated and enthusiastic staff. One person told us, “It’s a fantastic service, I literally have no complaints”. Innovative and practical technology was used to enhance peoples care, but also to entertain and teach people and staff new skills and increase their knowledge.

Sufficient staff were available to ensure people's wellbeing and safety was protected. A robust recruitment and selection process was also in place. 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.

The provider had systems of quality assurance to measure and monitor the standard of the service and drive improvement. These systems also supported people to stay safe by assessing and mitigating risks, ensuring that people were cared for in a person-centred way and that the provider learned from any mistakes.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection: Outstanding (report published 30 March 2017).

Why we inspected: This was a planned inspection based on the previous rating.

Follow up: We will continue to monitor the intelligence we receive about this service and plan to inspect in line with our re-inspection schedule for those services rated Outstanding.

Home Instead Senior Care is registered as a domiciliary care agency, providing personal care and support to people in their own homes. The office is located in Tonbridge. The services provided include companionship services, home help services and personal care services. People can receive one visit or continued visits and overnight support can be provided when required. The service provides support for older people, some who are living with dementia, as well as people with physical or learning disabilities. The service is a privately owned franchise and the provider was involved in the day to day management of the service. At the time of the inspection the service was providing support to 23 people which included personal care being provided to three people. The care of these three people is the only part of the service that is registered with the Commission and as such our inspection focused on this aspect of the service only. Staff who work for the service and support people in their own home are called ‘Caregivers’, and these staff will be referred to as staff throughout the report.

There was a registered manager for the service, who was also the registered provider. 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 and associated Regulations about how the service is run. We refer to the provider and registered manager as the registered manager throughout this report.

The feedback about the service we received from people was positive. People using the service who received personal care expressed satisfaction and spoke highly of the staff. For example, one person said, “Yes, they (staff) are very helpful and caring”. A person’s relative told us, “We are very happy, they do a really exceptional job.”

People received personalised care that was delivered by staff that understood what was important to them. Staff were skilled in meeting their needs and were creative in tackling challenges. People received a responsive and consistent service from staff they had developed positive relationships with. People who used the service felt they were treated with kindness and told us their privacy and dignity was always respected. Staff understood the importance of promoting people’s independence and ensuring their retained their self-esteem.

The registered manager demonstrated an exceptional commitment to enabling people to live well with dementia. The registered manager had provided free training in dementia for families of the people the service supported. They gave examples of how this training had made a difference to the lives of the people they were supporting.

The service had suitable processes in place to safeguard people from the potential of different forms of abuse. Staff had been trained in safeguarding people and in the whistleblowing policy. The registered manager had carried out risk assessments which included an environmental assessment of people’s homes. Incidents and accidents were recorded and checked by the registered manager to see what steps could be taken to prevent these happening again. The registered manager ensured that they had planned for foreseeable emergencies, so that should they happen, people’s care needs would continue to be met.

The service had robust recruitment practices in place to ensure staff were safe and suitable to work with people. Comprehensive training was provided and training was refreshed at regular intervals. All staff received induction training and they worked alongside experienced staff when they first started employment. Staff had their competency assessed before they were allowed to work on their own.

People were supported to choose a healthy and balanced diet. Where staff 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. People were supported to manage their medicines safely. The registered manager ensured that staff had a full understanding of people’s care needs and had the skills and knowledge to meet people’s needs. People received consistent support from staff who knew them well. People felt safe and secure when receiving care.

People were given information about how to make a complaint and the people we spoke to knew how to go about making a complaint if they needed to. People and their families thought the service was well run. People’s views were obtained through meetings with the person and meetings with families of people who used the service. The registered manager checked how well people felt the service was meeting their needs, by carrying out quality surveys.

The registered manager was committed to continuous improvement of the service. Effective quality assurance systems were used to identify shortfalls and make improvements. There were processes in place to monitor quality and understand the experiences of people who used the service.

People were complimentary about the way the support and care was organised. People told us that support workers were reliable and always arrived on time and stayed for the length of time arranged. A relative of a person who used the service told us '[Staff] are always on time'. One person who used the service told us 'They are flexible and respond to what we need'

People were protected from the risk of abuse. A relative of a person who used the service told us 'I know that [my relative] will be safe when I go out for the day'. A member of staff told us 'I am trained to recognise abuse yearly. If I saw anything, I would report it straight away to the manager' There was a system in place that supported people with monies handled by staff on their behalf. A person who used the service told us '[Staff] often do shopping and they complete detailed records'.

People who used the service were supported by trained and supervised staff who knew how to meet their needs. A relative of a person who used the service told us 'The training is very good. [Staff] seem to be trained and skilled to do their jobs'. Staff told us 'Induction training was very comprehensive' and 'The manager does spot checks, I've had two' and 'There is good support for staff. If you have a problem or something you're worried about, even if it's insignificant, you get a phone call immediately and it's resolved. There is always someone there'.

There was a system in place to regularly assess and monitor the quality of service that people received. People were asked for their views about the service provided, which were acted upon. Relatives of people who used the service told us '[A senior member of staff] has come round about three times with a list of questions and asked how the service is and is everything OK and is there anything else we need' and 'I have nothing but praise for Home Instead'.

People spoke very positively about the staff and felt that they fully supported their care needs. One person said, 'they are very friendly. I look forward to their visits'.

People spoken with told us that their care was personalised to their needs. Comments included, 'We've finally found a care provider who does what they say they will do. I can't speak highly enough of them'.

People were aware of their care plan and had their own copy. They confirmed that they and sometimes their family had been involved in discussions about their care, when the service had first started.

People felt that staff had received training and had the necessary skills in order to meet their needs.

People told us that they felt safe when staff visited and if they had any concerns they would speak with the provider. One person said, 'Staff have a relaxed attitude and they listen carefully to us'. People, who had used the service for sometime, confirmed they had been asked to give feedback on the service provided. One person said, 'With Symone's (the provider) leadership it's 100% reliable and good quality'. Another person said, 'I can honestly say Symone has not once let us down, I cannot praise them enough'.