Home Instead Senior Care provides care and support to people in their own homes in and around the Burton upon Trent area. This announced inspection took place on 13 and 28 March 2018.

At our last inspection, we rated the service Good. At this inspection, we found the evidence continued to support the rating of Good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection. At this inspection, we found the service remained Good.

People continued to receive support in a safe way, and staff understood how to protect people from harm. Enough staff were available to support people. Risks to people were managed to reduce potential hazards and the provider followed safe recruitment processes. Where people required support to take their medicines; this was provided in a safe way. Staff understood their responsibilities in relation to hygiene and infection control.

People continued to receive effective support. Staff had the knowledge they needed to provide effective care and support was delivered in line with good practice guidance. People’s physical health was monitored and support was provided when required. Where required people were supported to prepare meals of their choice and were enabled to have maximum choice and control of their lives.

People continued to receive support that was caring by staff who were kind, compassionate and caring. People were involved in making decisions about their care and their privacy, dignity and independence was respected and promoted.

People continued to receive support that was responsive to their individual needs, including their preferences and routines. The support people received was reviewed with them to ensure it remained relevant. People knew how to raise any concerns or complaints, and these were responded to in a timely manner.

The service continued to be well led. The management team were clear about their roles and responsibilities. Staff felt valued and enjoyed working at the service. People and staff were encouraged to give feedback, and their views were acted on to develop the service. The provider worked in partnership with other agencies and systems were in place to drive ongoing improvements.

Further information is in the detailed findings below.

This inspection took place on the 22 February 2016 and the inspection was announced. This meant the provider and staff knew we would be visiting the service’s office before we arrived. At our previous inspection in August 2015 the service was meeting the regulations that we checked.

Home Instead Senior Care provides care and support to people in their own homes in and around the Burton upon Trent area.

There was a registered manager in 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 understood how to protect people from abuse and were responsive to their needs. People were protected against the risk of abuse, as checks were made to confirm staff were of good character to work with people in their own homes. Sufficient staff were available to meet people's needs and they received their calls as agreed.

Risk assessments and care plans had been developed with the involvement of people. Staff had the relevant information on how to minimise identified risks to ensure people were supported in a safe way. People had equipment in place when needed, so that staff could assist them safely. People received their medicine and were supported to apply any cream they needed to keep well.

People benefitted from having support from staff who had a good understanding of their individual needs and knew how people liked things done. People consented to the care provided and their care records included information about how they wanted to be supported. Staff treated people in a caring way and respected their privacy. Staff supported people to maintain their dignity. People were positive about the way staff treated them. People knew how to make a complaint and were confident that their complaint would be fully investigated and action taken if necessary.

People benefitted from receiving a service from staff who worked in an open and friendly culture and were happy in their work. People felt the service was well managed and they were asked to express their views and be involved in decisions related to the planning of their care. People were involved in the review of their care. The provider had systems in place to assess and monitor the quality of care and encouraged people and their relatives to give their feedback and used this to drive improvements.

Our inspection was discussed and arranged four hours in advance. This was to ensure that we had time to speak with staff, as well as people using the service.

We spoke with six people using the service or their significant other, two healthcare professionals, three staff and the registered manager.

People told us they were treated with care and compassion and the staff responded well to their needs or concerns. One person told us, “I realise how lucky I am. They are all very good, kind, professional and efficient.”

We found people using the service were safe because the staff were given clear instructions, support, training and guidance.

We saw there were effective systems in place to manage medicines safely.

We saw recruitment records demonstrated there were systems in place to ensure the staff were suitable to work with vulnerable people.

There were clear systems in place to monitor and improve the quality of the service.

We found the service was well led because the registered manager supported the staff team and managed risks to the service.

We carried out our annual scheduled inspection in November 2012. During the inspection we made one compliance action about the recruitment of staff. This meant the provider had to make improvements and demonstrate they were fully protecting people who used their service.

This inspection was to look at the evidence available following the action plan we received from the provider, and to see if improvements had been made in relation to recruitment practices.

We found that suitable and sufficient improvements had been made in the area where we had identified concern. We saw the provider had put right what was required. This meant they ensured people using the service received care and support from staff who had all the necessary checks.

During our inspection we spoke with four people using the service or their relative, two staff, the registered manager and the nominated individual. The inspection was unannounced meaning the agency did not know we were coming.

People told us they received the care and support that met their individual needs. We found the provider was delivering a service which had respected people’s views. Assessments and reviews conducted by the agency demonstrated they had consulted with people using the service.

People using the service told us their privacy and dignity were respected. Comments included,”They explain everything. They always close the bedroom door and take the time and effort to make sure I understand what is happening.” People confirmed they always knew when their carers were changed or going to be late.

People told us they felt safe and reassured in the presence of staff and said staff respected their property and belongings.

We looked at the recruitment procedures for staff and found that procedures were in place but that further evidence was needed to ensure people using the service were suitably protected.

The provider had systems in place to check on the quality of the care people received. Complaints were responded to and the provider acted upon any concerns to improve the service.

During the course of the inspection comments were received from several people who had used the agency, including friends and relatives. We asked for their comments on the quality of the service and care given. There was a clear appreciation of the openness and clarity in the preparation and offering of care, one person stated that: "I have the same carers, which is so important, they are very, very good", and "I do depend on them, even in the bad weather they were here for me".

Overall people were satisfied with the care and service they were receiving, they told us that they were treated with respect, and had their dignity upheld. One client confirmed for us that he had, "one main carer, and another regular carer”. Another client we spoke with stated how much she appreciates the company that carers give as well as the service rendered. One person told us that the staff were respectful and maintained her privacy and dignity at all times; "How reliable everyone was, and all willing to help out, gentle and polite".

We examined written comments about the new service which presented a positive outcome and appreciation of a high standard of care, and enhancement of the person’s quality of life.