This inspection took place on 8 and 9 December 2016 and was announced. We gave the provider 48 hour’s notice of our inspection. This was so that staff and people would be available to talk with us. At the last inspection on 20,21 Feb 2014 the service was meeting the regulations we checked.

Home Instead Senior Care provides domiciliary care and support to around 100 people living in Bath and Wiltshire and the surrounding area. There were around 30 people receiving personal care when we carried out the inspection. Home Instead Senior Care is part of a franchise that delivers care to people in many areas of the United Kingdom. The services provided included support with personal care such as assistance with bathing and dressing. It also included support with eating and drinking, medicines and home help covering all aspects of day to day housework.

There was a registered manager for 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.

People who needed support with their medicines were supported by staff to receive them safely. This was because the staff had completed in depth training in safe handling and administration of medicines. There were safe systems and processes in place to help to protect people from the risk of harm. For example, new staff were only recruited after a robust recruitment procedure was undertaken. When selecting new staff the agency placed a strong emphasis on the candidates caring approach and life history so far as well as previous experience in the care industry. This was to help them recruit staff that were suitable to work with the people who used the service. For example staff who were very extrovert or introvert were matched with people who wanted support from staff who matched their own personality.

People felt safe and staff knew what the different types of abuse were and what constituted poor practice. Staff knew the correct action to take if abuse was suspected. Risks to people were well managed. Care records contained up to date guidance as well as detailed risk assessments. These were updated regularly when people's needs changed. Accidents and incidents were closely monitored. If actions were required after an incident these were discussed with staff and the people involved.

People received a consistently high standard of care and support. The staff were led by an experienced and proactive registered manager and provider. The team were very motivated and committed to ensuring each person had a good quality of life and were able to stay independent.

People told us staff were very kind and caring and knew how to provide the care and support they needed. People and their relatives were all very positive about the caring attitude and approach of the staff. People repeatedly told us that the agency was “The best in the area.” Staff demonstrated that they knew each person they visited as a unique individual. Staff told us, people mattered to them and every staff member told us that they loved their work.

The staff knew the people they supported very well. They knew each person's personal life histories and were matched with people according to their needs, wishes and interest’s .People were fully involved in planning how they were cared for and supported. Care records were person centred and written to meet people's individual needs. Care plans were reviewed regularly with the involvement of the person concerned.

The staff felt they always had access to the information they needed to meet people's needs, including receiving regular up to date information. Changes in people's needs were identified and their care packages were updated to meet their changing needs. The service was flexible and re

We spoke to five people who used the agency and two relatives during this inspection. We were told "I asked several agencies to come and see me when I needed help and chose to use Home Instead. I made a good decision”, “they provide me with the help I need" and "I am very well treated and the carers are polite and always ask me for my agreement”.

People told us that they received their support from the same care giver or a small team of care givers. The manager told us that they matched their staff to the person being supported and always introduced the care giver to the person before a service commenced.

The agency referred to their staff as care givers therefore we have used this term throughout our report. Care givers we spoke with talked confidently about the people they supported and demonstrated their competency in the role. They told us they received training and were well supported to do their job.

People were asked to provide feedback about the service they received.

Home Instead Senior Care Bath and West Wilts was a small domiciliary agency. The services that were provided included personal care, and other unregistered services such as companionship and home help. The agency referred to their staff as ‘care givers’ and we have used this term throughout our report.

We visited the agency's office and spoke with the providers, the registered manager and three care givers. We spoke with three people who used the agency and received comments that included “I have no query about them. I have the same girl for five days every week. They are very kind and thoughtful” and “No concerns they are lovely. They look after me as much as possible”.

Care documentation provided care givers with detailed information about how people should be supported with their care. Risk assessments had been completed to ensure care givers knew how to support people through safe methods.

There were enough qualified, skilled and experienced care givers to meet people's needs. Those spoken with demonstrated a good understanding of how to recognise abuse so that people using the service were protected from harm. The provider had responded to any allegations of abuse appropriately.

There were systems in place to monitor the quality of the service included seeking the views of the people who used the agency and reviewing their care on a regular basis.