Background to this inspection
Updated
24 March 2020
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 Care Act 2014.
Inspection team
There was one inspector in the inspection team.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own homes.
The service had a manager registered with the Care Quality Commission. Registered managers and the provider are legally responsible for how the service is run and for the quality and safety of the care provided. They had been in post for 19 weeks.
Notice of inspection
We gave the service 48 hours’ notice of the inspection. This was because we needed to be sure that the provider or registered manager would be in the office to support the inspection. The second day of the inspection was also arranged so that the registered manager was able to be present during the inspection.
Inspection activity started on 4th November 2019 and ended on 12 December 2019. We visited the office location on 5th and 14th November 2019.
What we did before the inspection
The provider was not asked to complete a provider information return prior to this inspection. 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. We took this into account when we inspected the service and made the judgements in this report. The inspector reviewed information held on our systems including notifications sent into us by the registered provider as well any contact initiated by members of the public to discuss the service.
During the inspection
We spoke with 16 members of staff including the provider, registered manager, care managers, senior care workers and care workers.
We reviewed a range of records. This included 10 people’s care records and multiple medication records. We looked at three staff files in relation to recruitment checks. A variety of records relating to the management of the service, including policies and procedures were also reviewed.
After the inspection
We contacted 18 people and spoke with 12 people and their relatives by phone to ask them about their experience of care.
We also reviewed further documentation the registered manager asked us to review as part of the inspection.
Updated
24 March 2020
About the service
Home Instead is a domiciliary care service providing personal care to approximately 100 people aged 55 and over at the time of the inspection.
People’s experience of using this service and what we found
People were happy with the support they received. People felt safe around staff that had been introduced to them and who they knew well. Staff attendance at calls was monitored to reduce the risk of people being left in a vulnerable position by a missed call. Risks to people’s health were known to staff. Risks were monitored regularly and updated as appropriate. Staff underwent background checks to assure the registered provider of their suitability to work at the service. The registered manager reviewed practices to ensure there was continual learning. The registered manager also incorporated best practice when they were reviewing and improving people’s care.
People’s needs were assessed prior to their care commencing so the registered manager could fully understand and plan for their needs. Staff had access to regular training and supervision. Where staff required additional training, this was provided. New staff undertook shadowing to learn people’s needs. People had choices in the food and drinks that were prepared for them. Staff had links with the local GPs and district nurses and where appropriate, escalated concerns. Staff contacted emergency services when they needed to.
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.
People liked the staff supporting them because they had a good understanding of their needs. People told us they had continuity of staff which meant they were able to develop a friendship with the staff supporting them. Staff had training and understood the importance of respecting people’s human rights and cultural needs. People told us they were treated with dignity and respect. Staff also supported people to remain as independent as possible.
People told us they were involved in planning their care and involved in reviewing and updating their care plans as their needs changed. People also told us care was responsive to their individual needs and circumstances. People understood they could complain if they needed to, and understood the process for doing so. People felt assured the registered manager would take appropriate action when needed.
People told us they felt the service was well run and managed well. Staff told us they were happy working at the service and received the support and guidance they needed to support people to ensure they got the care they needed and wanted. The registered manager was supported by both by the registered provider and the management team who strived to continually review people’s needs and update their plans of care. The registered provider understood their responsibilities and took an active role in ensuring people received the care they needed. The registered provider took pride in developing partnerships to further their understanding and implement best practice when providing care.
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 Outstanding (published 05 May 2017).
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 reinspection programme. If we receive any concerning information we may inspect sooner.