Home Instead Lewes District and Uckfield

Updated 21 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 inspection was announced. We gave the service 48 hours’ notice of the inspection visit because it is small and the registered manager is often out of the office supporting staff or providing care. We needed to be sure that they would be in. The inspection was carried out by an inspector and an assistant inspector made phone calls to people and relatives.

Before the inspection, we checked the information held regarding the service and provider. This included any statutory notifications sent to us by the service. A notification is information about important events which the service is required to send to us by law. We also reviewed the Provider Information report. This is a form that asks the provider to give some key information about the service, what they do well and improvements they plan to make.

The inspection started on 14 December and ended on 18 December 2018. On 14 December 2018 we visited two people in their homes to gain their experiences of care provided and to review their care documentation. We also met with a relative of one person. We visited the office location and met with the owner, the registered manager, office staff and two care givers. We viewed care records and policies and procedures.

On 18 December 2018 we spoke with two carer givers, one person and a relative by telephone. At the office site we spent time reviewing records, which included four support plans. We looked at two staff files, medication administration records, staff schedules and training records. Other documentation related to the management of the service such as incidents, meeting minutes, daily records and quality monitoring records were also viewed.

This was Home Instead Senior Care Lewes District and Uckfield’s first inspection with the Care Quality Commission.

Updated 21 February 2019

Home Instead Senior Care Lewes District and Uckfield is a domiciliary care agency which specialises in the care of older people living in their own homes. The service provision varied from minimum one-hour visits daily to support people with personal care but they also provided companionship services and home help services.

Not everyone using the service received a regulated activity. CQC only inspects the service received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do, we also take into account any wider social care provided. At the time of inspection, the service provided personal care support to 14 people.

There was 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.

This was the first inspection of the service. The inspection was carried out on 14 and 18 December 2018 and was announced.

The organisation had identified problems in relation to recording errors around medicine management. Appropriate action had been taken to address these matters but further time was needed to determine if the measures taken had been effective. Record keeping in areas around complaints and some aspects of care plans lacked detail and we made a recommendation to improve record keeping in these areas.

There were effective systems to monitor and review the quality of the care provided. The owner was aware that as the service developed and increased in size, the systems to monitor and review the service would also need to be developed further. The technology to achieve this was being put in place.

People told us they had continuity of care givers. They said care givers always arrived on time and stayed for their allocated time. They told us care givers always completed the tasks required of them along with any additional requests.

People were supported by care givers who demonstrated kindness and had a caring approach. Care givers knew people well. They understood people’s physical, social and emotional needs. We received numerous positive comments. One person said, “Yes, they are very good. They are very friendly. Whenever there are any issues they are straight on it. There is always someone on the end of a phone.” Another person said, “The standard of the care is very high, they are really nice people. They don’t rush, it’s almost like having a friend in the house.”

People knew how to complain but everyone said they had no need to. They said they would have no hesitation in picking up the phone if needed as they were confident the office staff would address any issue brought to their attention. One person told us, “I wouldn’t be concerned about ringing up the office, in fact they themselves are always encouraging me to ring up if I have any issues.”

Care givers had a good understanding of safeguarding procedures and knew what actions to take if they believed people were at risk of abuse. There were thorough recruitment procedures that ensured as far as possible, care givers were suitable and safe to work with people. As part of the assessment process, risk assessments were carried out in relation to people’s homes and to their individual needs. Where necessary, actions were taken to mitigate risks to reduce the risk of accidents or injuries.

There was information in care plans about how people liked to take their medicines. Care givers had received training on medicines and there were systems to monitor their competency in this area.

Spot checks were carried out at regular intervals to monitor care giver’s performance. Care givers attended regular training to ensure they could meet people’s needs. There was a thorough induction to the service and care givers felt confident to meet people’s needs before they worked independently. People told us they valued the fact office staff came to check on care givers as this meant they cared about their staff.

The owner and staff had a good understanding of their responsibilities in relation to the Mental Capacity Act 2005 (MCA). The MCA are regulations that have to be followed to ensure people who cannot make decisions for themselves are protected. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

Care plans gave staff detailed advice and guidance on how to meet people’s needs. People told us they had been involved as part of the process. If professional advice and support was sought then this was included within the documentation. People had the equipment they needed to keep them safe.

The owner worked hard to make the agency known within their local area. They ran a Saturday memory cafe twice a month. This provided a free afternoon of activities and social support for people living with dementia or other health care needs, within the community and their families/carers. They were also on numerous committees and groups that helped them to signpost people to gain support in a variety of different settings. This was particularly important as people generally lived in rural or semi-rural areas.