In Home Care Ltd

Updated 21 April 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

This inspection was carried out by one inspector and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

We gave a short period notice of the inspection because we needed to be sure that the provider or registered manager would be in the office to support the inspection. Inspection activity started on 23 December 2019 and ended on 10 January 2020. We visited the office location on 30 December 2019 and 03 January 2020.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke with seven people who used the service and three relatives about their experience of the care provided. We spoke with the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We also spoke with the registered manager, deputy manager, a care supervisor, two senior care workers, and one care worker.

We reviewed a range of records. This included seven people’s care records and multiple medication records. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We spoke to one care worker by phone and we received written feedback from 13 care workers. We received feedback from two local authority social service professionals. We continued to seek clarification from the provider to validate evidence found and received further information from the registered manager.

Updated 21 April 2020

About the service

In Home Care Ltd is a domiciliary care agency providing personal care to people in their own homes. The service was supporting 80 people with personal care at the time of the inspection, including older people and those living with dementia, people with a physical disability, sensory impairment or a mental health condition.

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.

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

People and relatives told us the service continued to provide safe care. Safeguarding concerns were acted on and risks to people were assessed and managed safely. Staff worked proactively with other professionals and agencies to ensure people had the care and resources they needed to live safely. People were supported by enough staff with the competence and skills to meet their needs. Staff were recruited safely and employed because they shared the values of the service, to provide person centred care. People received their medicines from trained staff who were assessed as competent in their role. Staff used safe infection control processes to protect people from the risk of infection. The service analysed incidents and any trends to make improvements to the care people received.

People were supported to have maximum choice and control of their lives and staff supported in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. People and relatives spoke highly of the staff who they found to be skilled, professional and competent. Staff completed an induction into their role and were supported in their on-going professional development. The service ensured people were supported by staff who had the training and skills to meet their specific needs. There was a holistic approach to the assessment of people’s needs and to ensuring people had access to the support and resources they needed which had resulted in positive outcomes for people.

The service provided outstanding care from staff who delivered an exceptionally kind and compassionate service. Staff often exceeded expectations by going the extra mile to promote people’s wellbeing and quality of life. Staff built positive relationships with people, their families and these relationships were valued by people and staff. The culture of the service supported staff to provide high-quality person-centred care. People and relatives told us they were fully involved in expressing their views so that care could be delivered in line with their preferences and decisions. People were asked about their protected characteristics under the Equalities Act (2010). This provided people with the opportunity to discuss their diverse needs, should they wished to do so and supported person-centred care.

People told us their needs were met and care plans described how they preferred these to be met. This included people’s communication and activity needs to help prevent social isolation. People and relatives told us the service was responsive to their needs and acted on any concerns or complaints promptly. No one was being supported with end of life care at the time of our inspection however, the service had the experience and guidance available for staff should the need arise.

Feedback from people, relatives and staff was consistently positively about the management of the service. The culture of the service was inclusive, and person centred and achieved good outcomes for people. People told us, and evidence confirmed they were regularly consulted about their experience of the service and their feedback was acted on. Systems were in place to monitor the quality and safety of the service and staff were supported to be accountable in their role through supervision, team meetings and observations.

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 08 February 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 re-inspection programme. If we receive any concerning information we may inspect sooner.