We conducted an inspection of Home Instead on 31 March 2017. Home Instead provides care and support to people living in their own homes. There were 30 people using the service when we visited. At our previous inspection on 11 August 2014 we rated this service “good”. At this inspection we found that the service remained “good”.

There was a registered manager at the service. 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.

Staff had completed medicines administration training within the last two years and were clear about their responsibilities.

Risk assessments and care plans contained clear information for staff. Records were reviewed every three months or where the person’s care needs had changed.

Staff demonstrated knowledge of their responsibilities under the Mental Capacity Act 2005. Care records documented that consent to care had been obtained and records were signed by people using the service or their legal representative.

Staff demonstrated an understanding of people’s life histories and current circumstances and supported people to meet their individual needs in a caring way.

People using the service were involved in decisions about their care and how their needs were met. People had personalised care plans in place that reflected their assessed needs.

Recruitment procedures ensured that only staff who were suitable worked within the service. There was an induction programme for new staff, which prepared them for their role. Staff were provided with appropriate training to help them carry out their duties. Staff received regular supervision and appraisals of their performance and these were documented. There were enough staff employed to meet people’s needs.

People were supported to maintain a balanced, nutritious diet. People were supported effectively with their health needs and were supported to access a range of healthcare professionals as required.

People using the service and staff felt able to speak with the registered manager and provided feedback on the service. They knew how to make complaints and there was a complaints policy and procedure in place.

The organisation had adequate systems in place to monitor the quality of the service. This included monthly monitoring of medicines administration charts (MAR) and daily care notes. We saw evidence that feedback was obtained by people using the service and the results of this was positive.

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 was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008 and to pilot a new inspection process being introduced by CQC which looks at the overall quality of the service.

The service provides care and support to people living in their own homes. Home Instead is a care service with numerous offices operating throughout the UK. We visited the Kensington and Chelsea branch of Home Instead, which is located in Fulham but provides care and support to people living in and around Kensington and Chelsea. At the time of our inspection, five older people were receiving support with personal care from the service.

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.

Staff had a good understanding of how to identify abuse, and knew how to respond appropriately to any concerns to keep people safe. Staff were meeting the requirements of the Mental Capacity Act (MCA) 2005.

Recruitment procedures were in place to ensure that only people who were deemed suitable worked within the service. There was an induction programme for new staff which prepared them for their role. Staff were provided with a range of training to help them to carry out their roles effectively. They had regular supervision meetings with their manager and annual appraisals to support them to meet people’s needs. There were enough staff employed by the service to meet people’s needs.

People had care plans in place which reflected their assessed needs. People were supported effectively with their health needs and were involved in making decisions about what kind of support they wanted.

Staff treated people with kindness and compassion and cared for them according to their individual needs. Staff had a good understanding of people’s needs and preferences and we received positive feedback from relatives about the service provided by care workers.

People using the service, relatives and staff were encouraged to give feedback on the service. They knew how to make complaints and there was an effective complaints management system in place.

The service carried out regular audits to monitor the quality of the service and to plan improvements. Where issues were identified action plans were put in place to rectify these.

At the time of the inspection there were two people using the service. We spoke with one person who used the service and looked at recently completed feedback forms. These indicated that people were satisfied with the care they had received from Home Instead. We were told that people were introduced to two carers when they started using the service to provide continuity of care if one was absent.

People were given written information on what to expect from the service. They were also assessed by a care manager from Home Instead to ensure that the service could meet their needs safely. This initial assessment gave people the opportunity to ask questions and to tell Home Instead their preferences. People felt they were involved in planning their care and that they were treated with dignity and respect. One person had written, "thank you for supporting us through what could have been a really stressful time".

People were cared for by staff who had been through a recruitment process, which included carrying out the necessary checks before they could start work. Staff were also required to complete an induction training programme, which included basic life support and how to respond to any safeguarding concerns.

There were systems in place to monitor the quality of service provided. The care manager conducted monthly spot checks and obtained feedback regularly. People who use the service told us they felt able to raise a complaint if they had one.