This inspection took place on 13 and 15 July 2016 and was announced. The registered manager was given 48 hours’ notice of the visit to the office. This was to ensure that they would available at the office.

For the purpose of this report CareGivers are the preferred title of staff and people who use the service are referred to as clients.

There was a registered manager who was in charge of the day to day running of 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 and associated Regulations about how the service is run.

Home Instead is a domiciliary agency providing personal care, support and companionship to people in their own homes. The agency operates across the Bolton borough. At the time of the inspection the service was supporting 52 clients with various care needs including personal care. There were also 46 clients supported with domestic tasks such as shopping and household tasks and companionship for trips and appointments. The majority of the visits undertaken were for one hour or more. There were also some 30 minute visits for where CareGivers supported clients with prompting or administering medication. The agency had 52 CareGivers with a further seven CareGivers who were in the process of completing their induction.

The service was flexible which meant that times of visits could be changed if clients had appointments they needed to attend and wished a Caregiver to accompany them. One client spoken with told us, “The service is excellent they [Caregiver] will change my visit time to suit my needs and any appointments”.

CareGivers working at the service were safely recruited and were able to complete training to meet the support the clients needed. The service also enabled Caregivers to undertake nationally recognised training to help them progress in their work. The service prided themselves on supporting clients living with dementia.

Home Instead participates in the City & Guilds Accredited Training Programme for Alzheimer's & Dementia Care. One of the directors was accredited by the Alzheimer's Society as a Dementia Friends Champion. This awareness programme was offered to all Home Instead staff and also to groups in the local community. Home Instead also ran free Family Workshops in the community for family members supporting those living with dementia.

We received some outstanding feedback from clients spoken with and from families. One client told us, “Fantastic service” another said “Absolutely excellent “. One relative told us, “We have peace of mind knowing that our [relative] is being supported by excellent carers”.

Clients spoken with told us they felt safe knowing that Caregivers would do their best to enable them to maintain their independence. We saw there were robust systems in place to manage risks to clients. For example referrals to the falls team for equipment to keep clients safe. This demonstrated that they had acted on the information gained at the assessment.

We saw that a comprehensive assessments were completed with the client and their family, where appropriate enabling them to make choices about the support they required. The assessment formed the baseline of the care records. Clients spoken with told us they had a care record in their home and these were completed after each visit.

CareGivers did not wear uniforms as following consultation with clients it was found they preferred Caregivers not too especially when accompanying them on trips and outings. All CareGivers carried an identification badge at all times. There was a dress code policy which CareGivers adhered to.

Clients told us that they were introduced to their CareGivers prior to the package of care commencing. If the CareGiver was on annual leave or sick leave the

We found Home Instead Senior Care ensured people who used the service were provided with appropriate information. A home visit to assess and discuss people’s needs, expectations and wishes was arranged prior to the service commencing. We were told a care record is kept in each persons home.

People we spoke told us. “The service is brilliant. They let you know if there is a problem and they are running late, but that hardly ever happens”. We were told, “They never let you down, they are really good, and the service is excellent”.

We saw written feedback from some people who used the service their comments included: ‘The office staff are courteous and professional at all times’ and ‘The quality of the service is good, no changes are required’.

One member of staff spoken with told us, “Everything is fine, I have no concerns”.

We spoke with two relatives who act on behalf of people who used the service. One person said, “I have total confidence in this service. They are excellent. They have become trusted friends not just carers. They treat people with dignity and respect. I would recommend them to any one looking for care for a relative”.

Another said, “They are very good, they arrive on time for every visit. If you need to contact the office for any reason you can always get hold of someone.

It’s reassuring to know that our relative is receiving good care”.

People we spoke were complimentary about the agency and the carers who visit them. We were told, “We have used other agencies that have not suited our needs. We were often let down by carers not turning up. This has never happened with this agency, they are wonderful”.

Another person told us that, “We always have the same carers. We like that because they get to know us and we can have a chat and a laugh with them”.

We saw feedback from this years satisfaction questionnaires. Comments included,

“We were provided with excellent information about this service”.

“The standard of care is excellent”.

“I am very pleased with the service I receive. My carer is very helpful, nothing is to much trouble”