Home Instead

Updated 6 January 2021

The inspection

As part of a pilot into virtual inspections of domiciliary and extra-care housing services, the Care Quality Commission conducted an inspection of this provider on 10 November 2020. The inspection was carried out with the consent of the provider and was part of a pilot to gather information to inform CQC whether it might be possible to conduct inspections in a different way in the future. We completed this inspection using virtual methods and online tools such as electronic file sharing, video calls and phone calls to gather the information we rely on to form a judgement on the care and support provided. At no time did we visit the provider’s or location’s office as we usually would when conducting an inspection.

Inspection team

The inspection team consisted of an inspector, a medicines inspector and an Expert by 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

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

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

This inspection was announced. The provider was aware we would be inspecting between October and the end of November as we had to seek their agreement to participate in the pilot. We then gave the service two working days’ notice of when we would be carrying out the inspection. Inspection activity started on 10 November 2020 and ended on 20 November 2020.

What we did before the inspection

We reviewed the information we had received about the service. 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. We used all of this information to plan our inspection.

During the inspection

We spoke with five people and eight relatives of people who used the service about their experience of the care provided. We spoke with the registered manager and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We sought feedback from the local authority. We contacted seven care staff.

We reviewed a range of records. This included five people’s care plans including risk assessments. We looked at five staff files in relation to recruitment. A variety of records relating to the management of the service quality assurance were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We reviewed all the information we had received from and about the provider.

Updated 6 January 2021

This report was created as part of a pilot which looked at new and innovative ways of fulfilling CQC’s regulatory obligations and responding to risk in light of the Covid-19 pandemic. This was conducted with the consent of the provider. Unless the report says otherwise, we obtained the information in it without visiting the Provider.

About the service

Home Instead Senior Care is a domiciliary care service providing personal care to 19 people aged 65 and over at the time of the inspection. 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

We have made a recommendation about checking medicines information and investigating medicines related incidents.

Staff knew about safeguarding and whistleblowing procedures. People had risk assessments to keep them safe from the risks of harm they may face. Staff were recruited safely. People were protected from risks associated with the spread of infection. Accidents and incidents were recorded and action taken to prevent reoccurrence.

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. Care staff sought consent from people before delivering care.

People and relatives told us staff were caring. Staff understood how to deliver a fair and equal service. Staff knew the people they supported well. People and relatives were included in decision making about the care being delivered.

Care was personalised and people’s choices were promoted. The provider included companionship in care plans and people were supported to maintain their social and cultural links. People were supported with end of life care when appropriate in line with their wishes.

People, relatives and staff spoke positively about the leadership in the service. The provider understood their responsibility to notify relevant authorities about safeguarding concerns and incidents. The provider had a system of checking the quality of service provided including obtaining feedback from people using the service and staff. People received joined up care because the provider worked in partnership with other agencies and professionals.

Rating at last inspection The last rating for this service was good (published 03 January 2019).

Why we inspected

This was a planned pilot virtual inspection. The report was created as part of a pilot which looked at new and innovative ways of fulfilling CQC’s regulatory obligations and responding to risk in light of the Covid-19 pandemic. This was conducted with the consent of the provider. Unless the report says otherwise, we obtained the information in it without visiting the Provider.

The pilot inspection considered the key questions of safe and well-led and provide a rating for those key questions. Only parts of the effective, caring and responsive key questions were considered, and therefore the ratings for these key questions are those awarded at the last inspection.

Follow up We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.