About the service:

Atkins Care Services Limited a domiciliary care agency that was providing personal care to 80 people predominately aged 65 and over at the time of the inspection.

What life is like for people using this service:

People and their families were at the heart of everything this agency did whether this be carefully matching staff to people or organising a vast array of interesting activities to help people remain active and reduce lonliness. People received an extremely effective service where staff quickly recognised the care and attention they needed and made sure this was provided in a timely and efficient way. This had helped people to stay as well as possible and receive the right support or advise.

People and relatives described staff as exceptionally caring, compassionate and kind. Staff were approachable and friendly with people they cared for and knew them very well. When staff described people, they cared for they were extremely respectful. Three people told us, "She’s like a ray of sunshine coming in.", "I can’t fault the carer, she is more of a friend" and "They lift my spirits when they come in".

Staff also told us that the provider and registered manager cared for them and supported them with their work and any difficulties they experienced whether that be child care or housing.

Staff cared for people in an exceptionally person-centred manner treating each person as an individual. and involving them in their care at every stage. One person told us, “The carer is excellent – young and brings life into me.” Another person said, “I’m very satisfied. They are very caring, very professional.” One more person added, “A great relaxed crew that I am happy to spend leisure time with.”

People told us that they were visited consistently by the same staff, unless due to leave or sickness but even then, they had been previously introduced. They said staff were well trained and experienced, along with being exceptionally caring and compassionate toward them and their relatives. People and relatives said that staff went, ‘the extra mile’ by doing things like caring for someone’s dog when they were in hospital, making sure someone’s garden looked lovely as they knew how much this meant to them at the end of their life. Staff made sure one relative was not left alone the night their family member passed away. Where needed, staff were quick to support people to have access to health care professionals such as a GP, occupational therapist or, when necessary, emergency services.

Care plans were created in partnership with people and relatives to ensure they were person centred and tailored to peoples’ needs, preferences and routines. There was a wide range of individual and group activities on offer including trips and two ‘dementia’ cafes which offered support, teaching and resources advice as well as charity fundraising involving people and relatives. People and relatives commented on how much these activities helped them and how much they appreciated them. They also reduced social isolation and, in some cases, had led to improved health, mobility and wellbeing.

People who received care from Atkins Care Services Limited told us consistently that they felt safe and supported by staff who visited them. Staff were punctual and always stayed for the full visit times.

The service was exceptionally well managed by a supportive and progressive management team. The provider was working towards a goal of being a local resource and education provider which supported people with dementia, their families as well as the whole community. People, staff and relatives were involved in helping the service improve. The provider and registered manager were involved in many local and national initiatives with the aim of improving the standards of care for all, not just for those they directly care for.

More information can be seen in the main body of the report for each Key Question below.

Rating at last inspection:

At

The inspection took place on 19 July 2016 and was announced. We gave the provider 48 hours' notice because they provide a domiciliary care service and we wanted to make sure someone would be available for the inspection.

The last inspection took place on 10 January 2014 when we found there were no breaches of Regulation.

Home Instead Senior Care provides personal care and support to people who live in their own homes in Elmbridge and East Spelthorne in the county of Surrey. The agency was offering personal care to 39 people at the time of our inspection and offered additional support such as housekeeping and companionship to approximately 90 people. Home Instead Senior Care is a franchise run by Atkins Care Services Limited.

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 and associated Regulations about how the service is run.

People using the service and their relatives were happy with the care they received. They liked the staff (care givers) who cared for them and felt they had developed good relationships with them. People were involved in planning their own care and choosing the care givers who supported them. They said care visits took place on time and the care givers stayed for the required amount of time. Care and support was planned to meet individual needs and reflected people's preferences. There were examples of the care givers providing care and support beyond what was expected and planned for in order to make people happy or meet a specific need.

The care givers told us they were well supported. They had the training and information they needed to care for and support people. They liked working for the agency and found the manager and provider supportive.

The agency had organised and ran some innovative schemes designed to meet the needs of people who required care and their families. For example, they had run a number of fun events including a session at a local garden centre and dementia friendly cinema screenings.

The service was well managed. The provider was involved in the day to day running of the agency alongside the registered manager. They had good systems for monitoring the quality of the service and they had plans for future improvements which reflected the needs, interests and wishes of the people who they supported. They offered support, guidance and help to families, including information about what to expect when caring for a relative with dementia. External professionals who worked with the agency told us they felt the service was very good and focussed on meeting individual needs.

We carried out a themed inspection looking at domiciliary care services as part of a targeted inspection programme of domiciliary care agencies. The inspection had particular regard to how people's dignity was upheld and how people can make choices about their care. We asked people to tell us what it was like to have received services from the agency.

The inspection team was led by a CQC inspector joined by an Expert by Experience with personal experience of using or caring for someone who had used this type of service.

We used surveys, telephone interviews and home visits to people and their relatives to gain views about the service.

We spoke with 18 people who use the service and two relatives. People and their relatives were extremely positive about the service. We were told that “the carers are really good, “ and “extremely nice. ” People also told us that staff were “always very polite and helpful.”

Each person that we spoke with said that they were treated with dignity and respect and were able to make choices about their care. One person said that care staff showed their respect in “loads and loads of ways.” Each person told us that they felt involved in decisions about their care and were able to make choices about their care and support.

People told us that they felt safe using the service and if they had concerns they would speak with somebody from the office or a family member or friend.

People were complimentary about how staff helped people to make choices and told us that “they (the staff), help in any way I want.” One person said that they were “extremely satisfied with Home Instead.” Another person told us they were “impressed with the quality of care.”

We spoke to four people who use the service and one relative. All agreed that they were very pleased with the care that the carers provide. One said that “Staff nearly always arrive at the same time each day, I really look forward to seeing them, I couldn’t be more satisfied with the service I receive”. Several people said they have never had to make a complaint but they believed the agency would take it seriously if they did.

All the people spoken with made the following comments regarding their overall impression of the agency.

“I have been very impressed by the staffs caring and professional attitude”. “ Yes I am very satisfied with care”,

“Staff are attentive, they come on time, I have no complaints, hopefully it will continue. I am very happy with the service so far”.

“I am very impressed with the carers, and extremely happy with the service all round”.

“They are my life line, the carers are so accommodating and nothing is too much trouble. Staff are flexible and very kind from the carers to the manager”.

We found that people and their relatives had been very involved about identifying and planning the care that they wanted. One relative told us that “They were very pleased with the service, felt comfortable they had been listened to”. We reviewed the care plans and noted that they were very detailed and personalised to the people who use the service. People told us that staff had “Knowledge of people’s individual needs”.

We found that the recruitment process of new staff was effective; staff have regular supervision with the registered manager and on-going professional development. One relative told us “Carers are kind maintain routines like one of the family”.

Feedback from people and relatives to monitor the quality of the service is undertaken by the registered manager. There are different mechanisms in place to gather information, questionnaires, telephone surveys and home visits. The provider collates the information about the level of satisfaction about the service.