Home Instead

Updated 16 December 2023

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 Health and Social Care Act 2008.

Inspection team

The inspection was undertaken by 1 inspector, and 2 regulatory co-ordinators.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own homes.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

We gave the service 24 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.

Inspection activity started on 23 November 2023 and ended on 29 November 2023. We visited the location’s office on 23 November 2023.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 4 people and 2 relatives. We spoke with 9 members of staff including the registered manager, and the directors, which included the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We reviewed 3 people’s care files, including their medicine administration records (MARs). We reviewed various other documents and policies relevant to the management of the service.

Updated 16 December 2023

About the service

Home Instead is a domiciliary care service providing personal care to people in their own homes. It provides a service to older people and younger adults as well as people who may be living with a learning disability or autistic spectrum disorder, dementia, mental health needs, a physical disability or a sensory impairment. At the time of our inspection there were 110 people receiving support from this service. Sixty-nine people were receiving a regulated activity.

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.

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

At the time of the inspection, the location did not care or support for anyone with a learning disability or an autistic person. However, we assessed the care provision under Right Support, Right Care, Right Culture, as it is registered as a specialist service for this population group.

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

Right Support:

People were supported by a service which promoted choice, control and independence. Staffing levels ensured people’s needs were met and staff told us they received regular training. People who were supported with their medicines received these as they should. However, care plans did not always contain the most up-to-date information about people’s medicines and appropriate information about the application of topical creams was not in place.

We have made a recommendation about the management of some medicines.

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.

Right Care:

Risk assessments were in place. However, control measures had not been regularly reviewed. People received person-centred care which met their individual needs and preferences. People were always treated with dignity and respect. Staff understood their responsibility to protect people from abuse and were clear about how to report concerns. Staff were confident these would be acted upon.

Right Culture:

The service did not have a scheduled approach to audits and governance checks. Care plan reviews had not been undertaken regularly as planned. There was no clarity about whether staff had received checks on their competency, although we observed some of these checks had been undertaken.

We have made a recommendation about how the provider ensures good governance and oversight of the service.

The service had an empowering culture with clearly defined outcomes for people. People and their relatives were communicated with regularly. People and relatives were involved in developing people’s care plans.

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 25 January 2018).

Why we inspected

This inspection was part of CQC’s scheduled inspection approach.

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.

Recommendations

We have made recommendations to the provider about medicines and governance. We will review these recommendations at the next inspection.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.