About the service:

Chesterfield Home Care Ltd, also known as Home Instead Chesterfield, is a domiciliary care agency. The service is registered to provide personal care. Not all people using the service received personal care. The service was providing personal care to 38 people at the time of the inspection.

People’s experience of using this service:

People who used the service received exceptional care from a very well led service. People consistently told us how they were supported with great kindness and respect. We received extremely positive feedback from people, relatives and professionals on how staff had developed caring relationships with people and their relatives.

The culture of the service was one of building positive relationships with people, assisting them wherever possible and going the extra mile to make sure people were happy and safe. People spoke about looking forward to the visits from staff. One person said, “Home Instead Chesterfield provide an absolutely first-class service in every respect.”

People were placed at the centre of the service and were consulted on every level. Respect for privacy and dignity was at the heart of culture and values of the service. Everyone told us staff asked them before carrying out tasks and involved people in deciding on how they wanted to be supported.

Relatives told us the staff noticed things that only close family members would and were willing to take on supporting people with any task, big or small, to ensure they were comfortable and happy. The willingness of staff to step in and help and their attention to detail was highlighted as particularly valuable by people’s relatives.

We saw instances of the service providing an extremely high standard of care and support to people at the end of their lives. This included helping people to fulfil their end of life wishes and creating special memories with and for their loved ones.

The service was especially well run. Staff and the registered manager shared the visions and values of the service and these were embedded within service delivery. There were systems to assess the quality of the service provided. The registered manager and director worked hands on with the staff team, training staff to a high standard, knowing people's needs and ensuring these were being met.

Staff worked in partnership with external health and social care professionals to ensure they supported people well. The lessons were learnt where appropriate to improve the service further.

People were supported by consistent and very well-trained staff. There was a very strong emphasis on continuous improvement with staff attending training on a range of subjects to ensure they supported people appropriately. This included the provider supporting staff to study for additional qualifications in areas such as dementia and end of life care. Staff spoke highly of the training and support they received.

People and their relatives told us they received safe care. Staff understood their responsibilities in protecting people from the risk of harm. Risks to people's well-being and their environment were detailed and updated when circumstances changed. People received support to take their medicines safely and as prescribed. Regular checks on staff and their ability to do their jobs in a safe way meant people could be reassured they were receiving good quality care.

More information is in the full version of the report.

Rating at last inspection:

At the last inspection the service was rated good (report published 14 December 2016). For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Why we inspected:

This was a planned inspection based on the rating at the last inspection.

This announced inspection was carried out on 23 November 2016. Home Instead Senior Care Chesterfield provides support and personal care to people living in their own homes in Chesterfield and surrounding areas. Prior to our visit the registered manager told us there were 45 people using the service who received personal care.

The service had a registered manager in place at the time of our inspection. 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.

People were supported by staff who understood the risks people could face and knew how to make people feel safe. People were encouraged to be independent and risks were mitigated in the least restrictive way possible.

People were supported by a regular staff member or group of staff who they knew. People who required support to take their medicines received assistance to do so when this was needed.

People were provided with the care and support they wanted by staff who were trained and supported to do so. People’s human rights to make decisions for themselves were respected and they provided consent to their care when needed.

People were supported by staff who understood their health conditions and ensured they had sufficient to eat and drink to maintain their wellbeing.

People were treated with respect by staff who demonstrated compassion and understanding. People were involved in determining their care and support and were treated in the way they wished to be.

People were able to influence the way their care and support was delivered and they could rely on this being provided as they wished. People were informed on how to express any issues or concerns they had so these could be investigated and acted upon.

People who used the service and care workers were able to express their views about the service which were used to improve the service. The registered manager provided leadership that gained the respect of care workers and motivated them as a team. There were systems in place to monitor the quality of the service and make improvements when needed.

As part of our inspection we spoke with two people receiving care, three relatives, the manager and staff working at Chesterfield Home care services. We visited some people in their homes and viewed records at the service.

Below is a summary of what we found.

Is the service safe?

People told us that they felt safe. We were told that they know who is coming to care for them and that they have identity badges. Also, if it’s a different carer then the service always lets the people know. We were told that they always meet the carers before they start looking after the people. The provider had good procedures for handling of peoples’ monies and carers were able to explain this to us.

Safeguarding procedures were robust and staff told us they understood how to protect people they supported.

This meant that people would be safeguarded as required.

Although the care staff had not had training in Deprivation of Liberty Safeguards (DOLs), the manager was aware of how to recognise if people were at risk of being deprived of their liberty and what action to take if this was the case.

Is the service effective?

People's needs were being met by the service. We found that people's needs were assessed and their care files included information about people's diagnosed health conditions or disabilities. This meant people received care that protected their welfare and safety. One person told us “They are wonderful and they saved my life.” Another person told us “They do what I want and help me to remain independent.”

People told us their support needs had been reviewed on a regular basis to meet any changing needs.

One person's relative told us “The care agency is professional, approachable and excellent.”

Care staff told us “For them communication is important and is the service strength.”

Is the service caring?

When we spoke with people, we found they were highly satisfied with the care and support. One person told us “I could not manage without them they are more like family. They are all excellent.” Another person told us “They are never late and are friendly and pleasant.” When speaking with the care staff it was clear that they had a good rapport and they genuinely cared for the people.

Is the service responsive?

People told us they could raise any concerns about their care and they would be dealt with. They told us that the service was flexible and that their needs had been met. One person told us,” The service is very flexible. They fit around my appointments, and give me help when I need it even overnight."

People’s likes and dislikes had been detailed and care and support had been provided in accordance with people’s wishes.

People were treated with dignity and respect and care staff we spoke with were able to explain how they would ensure people were treated with dignity and respect when assisting with care.

Is the service well-led?

The manager completed regular checks of people's care records and other arrangements for the safe running of the service. Records showed quality audits were reviewed by the manager and changes were made to improve the service where required.

People using the service, their relatives and care staff were invited to complete satisfaction surveys every six months and records showed that action was taken where any improvements were required. Staff received regular supervision and team meetings were held where staff were asked for their views about the care support arrangements.