The service was exceptionally caring. People using the service and their relatives spoke extremely positively about the caring and compassionate nature of the staff. People felt that staff went above and beyond their expectations of care to meet their needs. Two hour minimum visits allowed people and their care workers the opportunity to develop highly positive and caring relationships that took into account people’s individual needs and interests. The additional time that was allocated made a positive difference to people’s lives.

The provider ensured care workers understood the effects of the ageing process and staff showed great compassion and empathy when understanding people’s needs and providing their care.

The service benefitted from outstanding leadership. People using the service and their relatives told us that the service was extremely well managed and praised the high level of care and support they received from the management team which improved their quality of life.

The management team and staff applied the provider’s vision of person centred care. People benefitted from motivated staff that were committed to their work and shared the provider’s values. Staff were extremely positive about the open and honest culture of the service and praised the level of support they received from the management team to carry out their responsibilities.

The management team were dedicated to provide a high quality service and worked in partnership with other organisations. The registered manager had been proactive in working to create a dementia friendly community and was involved in delivering information awareness sessions.

People using the service and their relatives told us they felt safe using the service and staff had a good understanding of how to identify and report any concerns. Staff were confident that any concerns would be investigated and dealt with.

Risks to people were identified during an initial assessment with detailed guidance and control measures in place to enable staff to support people safely.

People who required support with their medicines received them safely and all staff had completed assessments and training in the safe administration of medicines.

Robust staff recruitment processes were in place and staff underwent the necessary checks to ensure they were suitable to work with people using the service. People were assigned regular care workers to ensure consistent levels of care.

The management team understood the legal requirements of the Mental Capacity Act 2005 (MCA) and staff took the necessary action if they had concerns about people’s capacity.

Care workers received a comprehensive induction and training programme to support them in meeting people’s needs. They were introduced to people before starting work with them and shadowed more experienced staff before they started to deliver personal care. Staff felt supported and spoke positively about the content of training and supervision they received.

People’s nutritional needs were recorded in their care plans and staff were aware of the level of support required, with further guidance available for people who needed extra support. People were supported to maintain their health and well-being through access to health and social care professionals, such as GPs, occupational therapists and the community mental health team.

Care was personalised to meet people’s individual needs and was reviewed if there were any significant changes. We saw evidence that people's views were sought and they were involved in the planning of their care. An initial needs assessment was completed from which care plans and risk assessments were developed.

People were provided with information on how to make a complaint and felt comfortable raising concerns if they needed to.

There were effective quality assurance systems in place to monitor the quality of the service provided, understand the experiences of people who used the service and identify any

This inspection took place on 13 January and 14 January 2016 and was announced. The provider was given 48 hours’ notice because we wanted to be sure there would be someone at the office when we called. This was their first inspection since registration with the Care Quality Commission.

Home Instead Senior Care Canary Wharf is a domiciliary care agency which provides personal care and support to people in their own homes. At the time of our visit the service supported 10 people.

There was a registered manager in post at the time of our inspection. A registered manager is a person who has registered with the Care Quality Commission (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 and their relatives told us they felt safe using the service and care workers understood how to protect people from abuse. All staff had received training in safeguarding adults from abuse and had a good understanding of how to identify and report any concerns. Staff also felt confident that any concerns would be investigated and dealt with.

People’s risks were managed and care plans contained detailed risk assessments which were updated regularly. The service had a robust recruitment process and staff had the necessary checks to ensure they were suitable to work with people using the service. The service had an ongoing recruitment policy and had sufficient numbers of staff to meet people’s needs. People had regular care workers to ensure they received consistent levels of care.

People who required support with their medicines received them safely and all staff had completed training in the safe handling and administration of medicines, which was refreshed annually.

Care workers received an induction and a comprehensive training programme to support them in meeting people’s needs effectively and were always introduced to people before starting work with them. They shadowed more experienced staff before they started to deliver personal care independently and received regular supervision from management. They told us they felt very supported and confident in their role.

Staff understood the principles of the Mental Capacity Act 2005 (MCA). Care workers respected people’s decisions and gained people’s consent before they provided personal care.

People’s dietary needs and preferences were recorded in their care plans. Care workers told us they notified the registered manager if they had any concerns about people’s health and we saw evidence of this in people’s care plans. We also saw people were supported to maintain their health and well-being through access to healthcare professionals, such as GPs, physiotherapists and chiropodists.

People and their relatives told us care workers were kind, compassionate and caring and had the right skills to provide the care and support they required. Care workers were knowledgeable about the people they supported and told us about the importance of spending time with people and getting to know them.

People’s health and well-being was monitored and care workers told us they would contact the office or health care professionals if they were concerned. Health and social care professionals confirmed the service was responsive to people’s needs and were made aware of any health issues.

Staff treated people in a way that respected their privacy and dignity and promoted their independence. There was evidence that language and cultural requirements were considered when allocating care workers to people using the service.

People were involved in planning how they were cared for and supported. An initial assessment was completed from which care plans and risk assessments were developed. Care was personalised to meet people’s individual needs and preferences and was reviewed after six weeks to ensure the