Home Instead Senior Care (Bexhill) home care service is a domiciliary care agency which provides personal care to older adults and people living with a dementia in their own houses and flats in the community. The service provided was described as a relationship-led service to clients with a call of a minimum one-hour duration, with the same staff member attending at the same time and day that is convenient to the client and their family. At the time of inspection the service provided support to 25 clients eleven of whom were supported with personal care. This is the first inspection of the service.

There was no 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. The registered manager had resigned from their position in November 2017 and had left their post at the end of December 2017. The owner had taken on the role in the interim and a new manager had been appointed and was due to start their post at the end of March 2018.

Since taking on the interim management role the owner had carried out a full assessment of the service and as part of this process had identified some areas where improvements were needed. For example, staff meetings had not been held and staff who had completed their probationary period had not attended regular formal supervision. Whilst staff had regular opportunities for training, the owner wanted to expand the depth and variety of courses available to staff to enable the service to take on more complex packages of care. An action plan had been drawn up to address these areas and timescales had been set to achieve them.

Staff were fully involved and committed to achieving the service’s values and vision. The organisation had extensive systems to monitor and review the quality of the care provided.

People told us they had continuity of carers. They said staff always arrived on time and stayed for their allocated time. They told us staff always completed the tasks required of them along with any additional requests. For example, one person told us, “I only have to ask and it’s done.”

People were supported by staff who demonstrated kindness, enthusiasm and passion. Staff knew people well and were well matched to the people they supported in terms of personalities. They understood people’s physical, social and emotional needs. We received numerous positive comments. For example, “They are like family,’ and ‘I couldn’t manage without them.’

People knew how to complain but everyone said they had no need to. They said they would have no hesitation in picking up the phone if needed as they were confident the office staff would address any issue brought to their attention.

Staff had a good understanding of safeguarding procedures and knew what actions to take if they believed people were at risk of abuse. Emphasis was placed on ensuring recruitment was thorough and ensured as far as possible staff were suitable and safe to work with people. Risk assessments were carried out in relation to people’s homes and to their individual needs and where necessary actions were taken to mitigate risks to reduce the risk of accidents or injuries. Where appropriate people were given advice to seek additional support, for example in relation to fire safety.

There were good systems for the management of medicines. These ensured people received support in a safe way. There was information in care plans about how people liked to take their medicines. Care staff had received training on medicines and there were systems to monitor their competency in this area.

Spot checks were carried out to monitor staff performance. Staff attended regular training to ensure they could meet people’s needs. There was a thoro