Home Instead Ascot, Camberley & Wokingham

Home Instead Bagshot is a care agency providing personal care to people in their homes. 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. At the time of the inspection they were supporting 64 people with the regulated activity who were aged 65 and over and were living with cognitive impairments such as dementia.

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

People told us that the service went “above and beyond” what they would expect from a care service. People who use the service told us, “They’re so helpful with every aspect of my life, they’re amazing” and “I don’t know what we would do without Home Instead” and “It’s like [person] has an extended family with Home Instead, they are so kind, considerate and brilliant at what they do.”

People, and where appropriate, their relatives were involved in care planning and received regular updates about people’s progress. Since our last inspection, the service had introduced an electronic call monitoring system for staff member’s smart phones which ensured up to date information was added to care plans. Where appropriate, relatives had access to log on to the system and review updates.

People’s privacy, dignity, equality and diversity were respected by all staff. People were encouraged to provide feedback to the staff and any suggestions were acted upon.

People were kept safe by staff who were appropriately trained and had been recruited safely. Medicine administration and infection control practices were safe. Where possible, staff and the management team learnt lessons from incidents and installed new practices to avoid reoccurrence going forward.

People were supported to have a balanced healthy diet that met their nutritional needs. People were supported to take part in hobbies and activities they enjoyed. The registered manager worked collaboratively with organisations to create more opportunities for people living with dementia to access the community.

Staff received regular supervision where they could express their views and provide suggestions to improve the service. Both people and staff stated they were supported well by the management team and people felt involved with decisions made relating to their care.

Staff supported people to access healthcare professionals and followed any advice given by them to ensure people received the correct care to meet their needs. There was a robust complaints procedure in place that ensured any concerns were fully investigated and the best outcome for the person was reached.

There were effective assurance systems in place that ensured standards of care were monitored. The provider proactively monitored the quality of the service, risk management plans, training for staff amongst other areas.

There was a positive culture within the service, led by the management team who provided strong leadership. Staff were proud to work for the service and felt they were an active part of an organisation where they mattered, people mattered and all voices were heard.

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 2 March 2017)

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.

Home Instead Senior Care Bagshot provides care and support to people in their own homes. The service supported 92 people at the time of our inspection, 47 of whom were receiving personal care. The registered provider of the service is Martin Care Services Ltd.

There was a registered manager in place at the time of our inspection. Like registered providers, registered managers 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.

People felt safe when staff provided their care because their care workers understood their needs and any risks involved in their care. Relatives were confident their family members were safe when receiving their care. People told us that they could rely on their care workers. They said their care workers had never missed a visit and the agency contacted them to let them know if a care worker was running late. The provider had identified those people most at risk if their care was interrupted and had developed plans to prioritise the delivery of their care in the event of an emergency.

Staff received training in safeguarding and recognising the signs of abuse. The provider described situations in which staff had taken action to protect people and keep them safe. The agency carried out risk assessments to ensure that people receiving care and the staff supporting them were kept safe. Where an incident or accident had occurred, there was a record of how the event had occurred and what action could be taken to be taken to prevent a recurrence. People were protected by the provider’s recruitment procedures. The provider carried out pre-employment checks to ensure they employed suitable people to work at the agency.

People received their care from regular care workers who knew their needs well. New care workers were always introduced to people by the provider before they began to provide their care. The provider understood the importance people placed on having regular care workers and ensured people received a consistent service from familiar staff. Staff had access to the training and support they needed to fulfil their roles. All staff attended an induction when they joined the agency and shadowed experienced colleagues until the provider was confident in their ability to provide people’s care safely and effectively.

The agency worked co-operatively with people’s families to ensure they received the treatment they needed. Relatives told us staff were observant of any changes in their family member’s needs and said the provider contacted them if they had any concerns about people’s health or welfare. People’s nutritional needs were assessed during their initial assessment and any dietary needs recorded in their care plans. Where people needed assistance with eating and drinking there was a care plan in place to outline the support they required.

People were supported by kind and caring staff. People told us their care workers were polite and treated them and their property with respect. They said they had developed good relationships with their care workers. Relatives told us staff knew how their family members preferred their care to be provided and cared about their welfare. The provider was actively involved in a range of initiatives designed to improve local services and support for people living with dementia and their family carers.

People’s needs were assessed before they began to use the service to ensure the agency could provide the care they needed. An individual care plan was drawn up from the assessment. People were encouraged to be involved in the development of their care plans to ensure they reflected their needs and preferences.

People received a service that was highly responsive to their individual needs. People and their relatives told us the provider always tried to accommodate requests for changes to their care, including at short notice. The provider had agreed with some people’s relatives that staff would be available at short notice if needed, for example if the person’s partner became unwell or required admission to hospital. We heard examples of how staff had responded to keep people safe and provided additional support when necessary.

Attention was given to which care worker was ‘matched’ with each person receiving care. The provider aimed to match people with staff who shared similar interests and gave us examples of how this approach had achieved positive outcomes for people. The provider ensured that staff had an awareness of people’s individual histories and expected staff to use this knowledge to engage with people. The provider organised events to enable people who may become socially isolated to meet and socialise with others.

The provider responded positively if concerns or complaints were raised and used these to improve the service. Where the provider’s investigations of complaints identified shortfalls, action was taken promptly to address them.

The management team were approachable and supportive to staff. Staff told us there was an open culture in which they felt able to express their views and any concerns they had. The provider had clear organisational values and expectations in terms of behaviours, to which staff were introduced in their induction. The provider encouraged people, relatives and professionals to contribute their views and these were acted upon. People received regular visits from the management team at which they were asked for feedback.

The provider had developed effective systems to monitor the quality of care people received. Staff practice was assessed through regular spot checks and any improvements needed were addressed through supervision. The management team worked together to ensure that the agency operated effectively, planning the delivery of care and carrying out quality checks. The records we checked in the agency’s office relating to people’s care were accurate, up to date and stored appropriately. Care records were regularly monitored by the management team to ensure that the quality of recording was appropriate.

Relatives told us that they and people who used the service had confidence in their security while being cared for and supported by care givers. One relative said, 'I know my relative looks forward to their visits and I have complete trust in the managers and care givers to keep them safe'.

We found that there were sufficient numbers of care staff to meet the needs of people who used the service. On care giver said, 'I would say there are enough of us. I have never known a call to be missed and most of us are available to do additional calls if required'.

We found evidence of good systems to monitor care standards and performance including an effective complaints and comments process. This meant that people, their relatives and staff were confident that feedback about the care provided was responded to promptly and appropriately.

We found that the provider knew the requirement to notify other incidents to the CQC and the evidence confirmed that they had done so as required.