Background to this inspection
Updated
28 February 2019
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
This comprehensive inspection took place on 14 December 2018 and 08 January 2019. Due to unexpected circumstances on behalf of the Care Quality Commission (CQC) we were unable to complete the inspection immediately after the first day. The inspection team consisted of one inspector, an assistant inspector and an expert by experience. An expert by experience is a person who has a personal experience of using or caring for someone who uses this type of care services. On the first day of inspection the expert by experience made telephone calls to people who use the service, and the assistant inspector spoke to care staff. On the second day, the inspector visited the office premises to undertake the inspection with the management of the service. The inspection was announced. We gave the provider 48 hours' notice of the inspection because the location provides a domiciliary care service and we needed to be sure the manager, staff and people we needed to speak to were available.
Before the inspection we reviewed information we held about the provider including any notifications that we had received. A notification is information about important events which the provider is required to send to us by law. We contacted other health and social care professionals who have experience of the provider to obtain their views. We used the information the provider sent us in the Provider Information Return. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make.
During our inspection we spoke with seven people who used the service and one relative. We looked at five care plans and we visited one person in their home to pathway track their care. Pathway tracking is where we check that the care detailed in individual plans matches the experience of the person receiving care. During the inspection we spoke to the registered manager, the recruitment and retention manager and six staff. We looked at a range of documents including policies and procedures such as safeguarding, incident and accident records, medication protocols and quality assurance information. We looked at complaints and compliments and feedback from people who used the service. We reviewed four staff files including information about recruitment and training.
Updated
28 February 2019
Home Instead Senior Care Horsham is a domiciliary care agency registered to provide personal care to people living in their own houses. It is registered to provide care to older people, including people living with dementia and physical disabilities.
Not everyone using this service receives a regulated activity. The Care Quality Commission (CQC) only inspects the service being received by people provided with personal care, which means help with tasks related to personal hygiene and eating. Where people receive personal care we also take into account consider any wider social care provided. At the time of our inspection the service supported 23 people with their personal care needs.
This comprehensive inspection took place on 14 December 2018 and 08 January 2019 and was announced.
At our last inspection we rated the service Good. At this inspection we found the evidence continued to support the rating of Good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns.
At this inspection we found the service remained Good.
Home Instead Senior Care Horsham had a registered manager who had been in post with since 2015. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.
People continued to be protected from avoidable harm. There was a safeguarding policy and staff received training. Staff knew how to recognise the potential signs of abuse and knew what action to take to keep people safe.
People continued to feel safe. One person told us, “They are very careful with me, I trust them.” Risks to people and the environment continued to be assessed and staff understood how to manage risks to help ensure people were safe. People continued to be supported to receive their medicines safely by staff that were trained in administering medicines.
People continued to be supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice. Staff understood best interest decision making where people lacked capacity in line with the principles of the Mental Capacity Act 2005. Staff sought people’s consent before giving personal care.
People continued to be supported to maintain their health and had assistance to access health care services when they needed to. One person told us, “On one occasion I was poorly, they called an ambulance … I trust them.”
People continued to be supported to remain engaged in activities and interests. People continued to be supported to maintain relationships with people who were important to them. Staff knew the people they looked after well. One person said, “They know my likes and dislikes.” Concerns and complaints remained well managed and were responded to.
People continued to receive compassionate care from staff who were kind and caring. One person said, “I feel at home with them.” Staff said they enjoyed working for the service and felt supported by the registered manager. A staff member said, “The support is incredible.”
The service continued to be well-led. The registered manager was engaged in the day to day running of the service and proactively looked for ways to improve on a continuous basis. One person said, “It’s a very well managed service.” People, staff and relatives remained engaged and involved in the service provided. A member of staff said, “There’s a positive atmosphere, I can always ask questions.”
Further information is in the detailed findings below.