Home Instead Senior Care

Home Instead Senior Care is a domiciliary care service covering Taunton and the surrounding areas. It is part of the Home Instead Senior Care franchise. Staff who provide direct care to people are called care givers and are referred to as such throughout this report.

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 the agency was supporting between 60 and 70 people. This figure can change daily as people’s needs change and new clients are accepted.

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

Without exception people praised the quality of service they received and told us they would definitely recommend it to other people who required this type of support.

The provider was committed to providing people with a safe service and worked in partnership with other organisations to help people to take positive risks and maintain control of their personal safety.

People were supported by small teams of care givers who they were able to build trusting relationships with. People told us they received consistent support from well trained care givers who knew them well. Many people referred to their care givers as more like friends or family.

The provider used imaginative approaches to make sure staff training was meaningful and led to positive changes in the care people received. The provider worked with other professionals and organisations to share training and promote positive outcomes for people.

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. Staff made sure people’s legal rights were respected.

People received their support from a service where care and compassion were embedded into everything they did. This led to people receiving an extremely caring service. Many people told us staff often went over and above their job roles which demonstrated their kindness and consideration for the people they supported.

People’s care was personalised to their wishes and preferences and took account of their individuality. The provider matched care givers to people to help them to build connections and share interests and hobbies. People were comfortable and relaxed with the care givers who visited them.

The provider and staff worked to reduce loneliness for people and ensured people had access to a range of social opportunities. People told us how social events and being able to follow their interests had enhanced their well-being.

People received a service from an agency which was exceptionally well led and continually looked for ways to expand and improve the care they provided. People were involved and consulted about their care and the service. Complaints and incidents were seen as opportunities to learn and improve. Changes were made to practice where it was felt this would benefit people.

Staff felt well supported and were highly motivated which gave them a commitment to providing high quality care. People praised the staff and told us they had helped them to remain independent in their own homes.

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

Rating at last inspection. Good (Report published 22 October 2016)

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Why we inspected

This was a planned inspection based on the previous rating.

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 provides personal care to people living in the areas of Taunton, Wellington, Wiveliscombe, Bridgwater and surrounding villages. At the time of this inspection they were providing personal care for 48 people. They also provided a domestic service to people living in their own homes.

The last inspection of the service was carried out in August 2014. No concerns were identified with the care being provided to people at that inspection. There is a registered manager in post. 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 2008 and associated Regulations about how the service is run.

In this report we refer to care workers as CAREgivers as this is the title used by Home Instead Senior Care for their care staff.

People who received personal care and support from Home Instead Senior Care told us they were happy with the service provided. They said the registered manager and staff were open and approachable, cared about their personal preferences and kept them involved in decision making around their care. One person said, “The people in the office are extremely forthcoming. If I have any questions they will ring me. They are very proactive and care for you. They put themselves in your shoes. I am extremely happy. I have nothing but good to say about them.”

People were supported by sufficient numbers of staff who had a clear knowledge and understanding of their personal needs, likes and dislikes. We observed staff took time to talk with people during our home visits. One person said, “I have my regular team who I have got to know very well.” Another person said, “I know who is coming and when. I know them all like old friends now.”

People’s care needs were recorded and reviewed regularly with, senior CAREgivers and the person receiving the care or a relevant representative. All care plans included written consent to care. CAREgivers had comprehensive information and guidance in care plans to enable them to deliver consistent care the way people preferred. One person’s care plan clearly showed how they liked their care provided and the exact routine they liked to follow. The registered manager had also included picture guidance for things such as catheter care so staff could see what the specific catheter looked like.

People also experienced consistent care and support when moving between services. Assistance had been given to one person to ensure they received a care package without delay when they moved to another part of the country.

People were protected from abuse because the provider had systems in place to ensure checks of new staffs characters and suitability to work with vulnerable adults were carried out. Staff had also received training in protecting vulnerable people from abuse. People said they felt safe when being cared for; we observed people were happy and relaxed with care workers during our home visits.

Staff told us they received plenty of training, staff attended the organisations mandatory training which included regular updates of subjects such as, manual handling, dementia awareness, medication, safeguarding vulnerable adults, infection control, health and safety, food hygiene, first aid and nutrition. They also attended training in areas specific to people’s needs such as diabetes care, catheter care and awareness of Parkinson’s. Staff were also supported to attain a nationally recognised qualification such as an NVQ or diploma in health and social care

Home Instead Senior Care’s principle objective was to “Provide supportive care and companionship which both enables and encourages our clients to remain independent in their own homes for as long as possible.” The nominated individual said they wanted to, “Provide the standard of care we would want for our own loved ones. The client is always at the centre.” It was evident that all the staff spoken with supported and understood the organisation values and ethos.

Staff monitored people’s health with their consent and could refer and direct to healthcare professionals as appropriate. Support was provided for people to attend hospital and doctor appointments. The service supported people to be “heard” when they attended their appointments.

The service had a complaints policy and procedure that was included in people’s care plans in large print. People said they were aware of the procedure and had numbers they could ring. People and staff spoken with said they felt confident they could raise concerns with the registered manager and senior staff. Records showed the service responded to concerns and complaints and learnt from the issues raised.

There were systems in place to monitor the care provided and people’s views and opinions were sought on a daily basis. Suggestions for change were listened to and actions taken to improve the service provided. All incidents and accidents were monitored, trends identified and learning shared with staff to put into practice.

Is the service safe?

People told us they felt safe receiving the service in their own homes. Safeguarding procedures were robust and staff understood how to safeguard people they supported.

People receiving the service spoke very positively about the services. One person told us they felt that since the service had provided their care the experience had been 'Blissful, I now have no worries' People using the service felt the locality of the service was a great benefit, they were always cared for people 'they knew and never a stranger'

Systems were in place to make sure that managers and staff would learn from any events that might occur, such as accidents and incidents, complaints, concerns, whistleblowing and investigations. This reduced the risks to people and ensured the service would continually improve.

The registered manager worked closely with staff, people using the service, relatives and other professionals ensuring people's needs were taken into account. This ensured that people's needs were always met.

We spoke to people who use the service who told us 'The company was easy to contact, any problems were dealt with immediately'

We saw how staff received training, which reduced the risk of vulnerable people being abused and observed safe working practises during our visit.

Is the service effective?

People's health and care needs were assessed with them and they were involved in writing their plans of care. We were told that care needs were constantly monitored and kept up to date, with changing care needs taken note of. People who use the service told us they 'have plenty of time allocated to deliver care, never feel rushed at any time'

The manager told us their phone was manned 24hours a day and could respond to unexpected needs. People told us that out of hours care had been provided when needed.

Is the service caring?

People told us that they greatly appreciated the continuity of carers; they felt the carers really knew and understood them and their individual requirements; this enabled the carer to deliver their care to a very high standard.

We observed the interaction between carers and people receiving the care were respectful with a genuine concern for welfare. We were told that 'nothing was too much trouble' People told us they felt very comfortable with the carers and could ask them about any concerns they may have.

Is the service responsive?

People knew how to make complaints if they were unhappy with any part of the service.

We were told the company was very easy to contact, with a quick response. One person told us that during a stressful time the carer stayed with them until the night carer arrived, ensuring they were not left alone.

People who used the service told us they felt the care given was exactly what they wanted, with any extra or new needs responded to very quickly.

Is the service well led?

The service has an effective quality assurance system in place.

The manager and staff worked together to identify any problems and improve the service provided. Staff told us they received strong and effective support from the management, with regular meetings and appraisals. Staff told us the management was very approachable and listened to any suggestions they may make. People told us they had total confidence in the staff and management.