Home Instead Senior Care

Home Instead Senior Care is a domiciliary care agency that was providing personal care to 56 people at the time of the inspection.

The service was exceptional in placing people at the heart of the service and its values. It had a strong person centred, community and partnership ethos and we saw multiple examples of this creating positive outcomes for people. Staff and the service's management told us how important the services' shared values were to them, and how they were passionate about providing outstanding person-centred care to people when they needed it. Many people that were being supported told us they thought of their carers as being like family members and friends, and told us they were highly compassionate, caring and flexible in their approach.

People's needs, and wishes were met by staff who knew them well. We saw and were told of many examples of staff going 'above and beyond' to help and support people they cared for. The service carefully matched people to carers which in turn contributed to creating a 'personal touch' and a strong, visible person centred approach. People were truly respected and valued as individuals; and empowered as partners in their care from an exceptional service. The staff and management team recognised and worked with people to reduce social isolation, they were particularly sensitive to times when people needed caring and compassionate support.

The provider had developed innovative and creative ways of training and developing their staff. This meant that the registered manager and provider supported staff to put their learning into practice to deliver outstanding care that meet people’s individual needs. Home Instead Senior Care is an outward looking service which means it was continuously looking to work alongside and in partnership with healthcare professionals and other organisations to make sure staff received training which followed best practice and where possible, contribute to the development of best practice. Staff were supported to identify and complete a personalised Learning & Development Programme. The programme was designed to include face to face training, eLearning and workbooks to ensure the individual training needs of staff were included to ensure maximum learning. We saw an example of how Home Instead had developed Innovative ways of reinforcing staff learning.

The service was extremely well led and the management team's vision and values put people at the centre of the service. We saw these values had been integrated into the selection and training of staff and continued through day to day care ensuring people received a safe, caring and responsive service. There was a clear management structure in place that supported the registered manager in their role. Each staff members roles and responsibilities were clearly defined which helped to ensure that the service ran efficiently. Managers were encouraged to develop their leadership skills and those of others.

Staff were safely recruited. Staff were aware of how to report any concerns about neglect or

abuse and were confident they would be addressed. They felt they were listened to and were part of an organisation that cared for them and their wellbeing, as well as the people they were supporting.

The last inspection of the service was carried out in November 2013. No concerns were identified with the care being provided to people at that inspection.

The service is a homecare agency based in Egham, Surrey that provides for the local community around that area. It is an independently-run franchise of the national Home Instead brand. At the time of this inspection, they were providing a regulated care service to 34 people living in their own homes.

The service had a registered manager, which 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 company director also took a hands-on approach to the running of the service, having set it up five years ago.

People using the service, their representatives, and community health and social care professionals all provided positive feedback about the service. Everyone said they would recommend it to others.

We found that the service provided to people was very caring and responsive to their individual needs; in their own words, to be ‘companionship-led.’ It strived to match care staff to people based on shared interests, cultures and life histories, and to provide people with the same care staff. People were listened to and their care adjusted accordingly. The service’s approach was to enable people’s well-being to be enhanced.

Staff were encouraged to go ‘the extra-mile’ for people in terms of companionship and engagement, not just to provide care. The service’s one hour minimum visit time benefitted individuals in terms of improved engagement and quality of life. People were treated respectfully by staff, and were encouraged to be as independent as they wanted to be.

The provider placed a lot of emphasis on the promotion of positive images of dementia in the community. They ran regular Memory Cafés to help local people engage and avoid social isolation. Workshops and gatherings were also provided to local people’s family members, to help them understand dementia.

Staff were employed for their ability to show compassion and go ‘the extra mile’ in their care visits. They were intensively trained on understanding the different ways individuals experienced dementia and physical conditions of old age. This helped staff to empathise and engage well with people so as to support them to experience a better quality of life.

Staff were also vetted and trained to ensure that they were safe to work in people’s homes. Their competency was checked on for key processes such as hoisting and providing medicines support. People’s care packages were assessed for safety concerns and were kept under review.

The service ensured that there were enough staff to provide a safe service and that staff arrived punctually at people’s homes. People were provided with good support for health and nutritional matters. The service worked well with community health and social care professionals to help meet people’s needs.

The service listened to people and their relatives, and adjusted people’s care packages accordingly. Action was taken to stop concerns developing into formal complaints.

The service was well-led. The management team was passionate about providing people with high quality, individualised care. Staff were recognised and valued as part of this, and were provided with good support for meeting people’s care needs and preferences.

The service audited how effectively it was providing individualised care, including through asking people and their representatives their views. Where areas for improvement were identified, the service made plans to address matters, and changes were subsequently made.

Overall, the service promoted a positive and empowering culture that was focussed on making a difference to the well-being of people using it.

People told us that the staff were very kind and helpful. One person said 'They are very friendly people. We have a set of six carers that we know very well.' Another told us 'The staff are really good to us. They turn up on time and are a really good support to us.'

Staff talked to us about they how they gained consent from people. One staff member told us 'All people have a form that they have signed to agree their care. We always check with them that everything is still the same before we deliver care to them.'

Care plans and risk assessments were in place and the registered manager, or a named person from the office, carried out the assessments. Staff confirmed they looked at each person's folder in order to carry out the correct care for the individual.

Staff told us they had received safeguarding vulnerable adults training. They were able to tell us the types of abuse they may see and knew how to report any incidents.

We saw that the provider had carried out appropriate checks when they employed staff. This ensured staff were of good character.

Regular audits took place to ensure the quality of the care and service provided by the agency.

Relatives told us that they felt (their relative) was safe in the staff's care and that they were treated with dignity and respect. One relative told us 'We are very happy, we can't speak too highly of the carer.'

We found that appropriate checks were undertaken before any member of staff started work at the service. We looked at staff files and spoke to staff who confirmed this.

The service had systems in place to monitor the quality of the service and to identify when things needed to be improved. We saw that this included sending questionnaires to people and relatives and to gather their views of the service.