Home Instead Central Hemel Hempstead and Chilterns is a domiciliary care agency providing personal care and support to people living in their own homes. The service provides support with personal care, medication, meal preparation, domestic tasks and bespoke services agreed with individuals.

This comprehensive inspection took place on 24, 25 and 29 August 2017, and was announced.

At the last inspection in May 2015, the service was rated Good.

At this inspection we found the service remained Good.

The service has a registered manager. A registered manager is a person who has registered with the CQC 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 told us that they felt safe and were supported by consistent, reliable staff. Staff understood their responsibilities with regards to safeguarding people and had received relevant training. There were systems in place to safeguard people from the risk of possible harm.

Risk assessments that gave staff guidance on how individual risks to people could be minimised were completed and updated regularly.

The service had robust recruitment procedures in place. There were sufficient staff to meet the care and support needs of people and an effective system to schedule people’s care visits.

Staff were skilled and competent in their roles and were supported by way of spot checks and supervisions. These were consistently completed for all staff and used to improve and give feedback on performance.

People were supported, where required, with their meals and the preparation of food. People were supported to maintain their health and well-being and accessed the services of health professionals.

Staff were kind, compassionate and caring. They provided care in a respectful manner and maintained people’s dignity. People were involved in making decisions about their care and their consent was sought. Positive relationships existed between people and staff.

People’s needs had been assessed and they had been involved in planning their care and deciding in which way their care was provided. Staff were knowledgeable about the people they were supporting and provided personalised care.

People, their relatives and staff knew who to raise concerns to. The provider had a robust process for handling complaints and concerns.

There were effective quality assurance processes. Feedback on the service provided was encouraged through quality visits, spot checks and surveys.

There was an open culture. Staff told us there was positive leadership in place. Staff felt valued, motivated and were committed to providing quality care.

We carried out this announced inspection by visiting the office on 21 May 2015. Between this date and 02 June 2015, we spoke with people who used the service and members of staff. At the time of the inspection, the service provided care and support for 73 older people in their own homes.

The service has a registered manager. 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.

There were systems in place to safeguard people from the possible risk of harm. There were risk assessments in place to provide guidance to staff on how risks to people could be managed and minimised.

The provider had effective recruitment processes in place to ensure that staff employed to work for the service were fit and proper for their roles and of good character. There were sufficient numbers of staff to support people safely.

Staff were skilled and knowledgeable in how to support people in accordance with their agreed care plans. Staff received regular supervision and support, and had been trained to meet people’s individual needs.

Staff were aware of their responsibilities and understood their roles to seek people’s consent prior to care being provided. People received care and support from a team of caring and respectful staff.

People’s needs had been assessed, and care plans included their individual needs, preferences, and choices. The provider had a formal process for handling complaints and concerns.

There were effective quality monitoring processes in place. Regular checks and audits had been carried out and people’s views had been sought regarding the quality of the service.

People that we spoke with were complimentary and positive about the care and support they received and one person told us that: “The carers are superb and the care is very good”. People told us that they were able to discuss any changes to their care and support and that their views were always taken into account. Care and support was well co-ordinated and the care plans we saw were ‘person centred’ and detailed how people preferred their care and support to be delivered.

The provider had ensured that there was information available for staff regarding reporting safeguarding to the local authority safeguarding teams. Staff had received safeguarding training and information about how to report any incidents of abuse.

There were effective recruitment procedures in place ensuring that all appropriate checks had been made prior to staff starting work. There was an induction programme where mandatory training was provided to ensure that new staff were competent to deliver care.

Quality assurance procedures were in place to monitor the effectiveness of the agency. People using the service were able to raise any issues and concerns with the management team.

Everyone spoken with about the service and the care provided were positive about the quality and efficiency of it. It was clear that this was a person centred service which took notice of the care required for individuals. We spoke with staff who described a good level of support and training in the organisation and the emphasis that was placed on the rights of the people they worked with. Care and support was well coordinated. Everyone spoken with expressed their "pleasure in working with the agency".

We read documents and gained feedback from relatives and people who use the service who indicated that they were satisfied with the service provided. All documentation about people, the staff, the organisation was accessible and well presented.

It was evident that the managers knew all of the people who used the service and all of the staff group. We observed that the staff we met had a positive attitude towards the people that they worked with and enjoyed their roles. Comments included by relatives of the people that the provider worked with included, " the care has always been well given" and "the carer became part of the family".