This inspection was announced and took place on 22 November 2016. We gave the provider short notice of the inspection as we needed to make sure we were able to meet with the registered manager, access records and gain permission from people who used the agency to telephone them.

The last inspection of the service was carried out on 3 February 2014. No concerns were identified with the care being provided to people at that inspection. At the time of the inspection they were providing personal care and support for 180 people in their own homes.

Home Instead Senior Care Epsom is a Domiciliary Care service, which operates from offices in Epsom, Surrey. They provide supportive care and companionship to older people within the Epsom and Mole Valley areas. The service calls their care workers ‘caregivers’ which is the name they are referred to throughout this report. We also refer to other staff by title or staff.

There is a 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 providers of the agency were also the directors of the company with overall responsibility for the service. The providers worked together to co-ordinate the day-to-day running of the service. They worked together when recruiting new staff and making decisions about taking on new work and the future plans and development of the service. The service had a clear vision and set of values. These were understood and put into practice.

The service demonstrated a very strong and visible person centred culture and they were committed to providing a service which put people at the heart of everything they did. People were kept informed about any development within the service by regular contact with the management team. The providers were involved in the local community and worked alongside other professionals, putting people at the heart of the service

Safe and effective recruitment practices were followed to make sure that all staff were of good character and suitable for the roles they performed. The provider told us they ensured the “right people” who had empathy, and a desire to make a real difference to people’s lives, were recruited. Staff told us they received a comprehensive induction, and were not allowed to start work until all checks had been completed.

Staff spoke highly of the support they received from the providers and management team and were confident they could raise any issues or concerns, knowing they would be listened to and acted upon. The strength of leadership throughout the service contributed to the outstanding level of care, attitude of staff and quality of life for people using the service. Staff were dedicated and knew what was expected of them, feeling privileged to be able to care for people and to support them to remain independent in their own homes.

Each person had their needs assessed before they started to use the agency. This was to make sure the agency was appropriate to meet the person’s needs and expectations. The assessments gave details about the assistance the person required and how and when they wished to be supported. Following a successful induction period caregivers were matched with people with similar interests.

People and their relatives were very complimentary about the quality of the service provided, the management and staff team. They felt they were matched by similar interest with their caregiver and the companionship and care was exceptionally good. People received companionship care, which meant caregivers stayed for a minimum period of two hour visits. If people wanted support for fewer hours the provider and registered manager signposted them to other agencies or resources within the local

We visited Home Instead Senior Care Epsom to look at the care and welfare of people who used the service. We spoke to ten people who used the service or their relatives and had 23 surveys returned. We spoke with eight members of staff, including the registered manager.

All of the people we contacted were very happy with the service. One person told us “They do everything I need them to. They arrive and leave on time and are very punctual.” Another person told us “They are marvellous, I couldn’t cope without them.” A third person told us “They are fantastic. The office and carer are amazing, and well trained.”

People told us that staff asked their permission before they did things for them. One person said “They always ask me if I am happy with what they are doing.” Another said “If my family member doesn’t want to do something staff will respect that.”

People received care and support that met their needs. One person told us “They are very careful to choose staff that will match my needs.”

People told us they felt safe with the staff that supported them. Staff understood their roles with regards to safeguarding vulnerable people from abuse.

We saw that the provider carried out appropriate checks when they employed staff. This ensured staff were of good character and had the necessary skills and experience to do the job.

The manager had regularly sought the views of people to ensure they were happy with the service.

We visited Home Instead Senior Care in Epsom and looked at the care and welfare of people who used the service. We looked at files in the office and talked with the registered manager and staff.

We spoke with eight people who used the service. All said that staff treated them with respect and they had been involved in the planning of their care. One person said “They are very nice people, always asking what we want to do.” Another told us “They are always very friendly; they took time to chat to find out what we needed from them.”

People told us the service met there care needs. One person told us “We told them what we wanted them to do, and they do it.” Another said “They do their job very well; they always ask if I need anything before they go.”

We looked at how the service managed people’s medication. We saw that staff recorded when they assisted with medication.

People were happy with the skills and experience of staff. They told us how staff were chosen to meet their needs. One person said “They found someone who can play dominoes and likes poetry, these are things my husband likes to do.” Another said “My husband loves fishing. They sent us a carer who also likes to go fishing and they go out together.”

The manager was regularly seeking the views of people to make sure they were happy with the service. People who used the service told us if they were unhappy about anything they could tell the staff and something would be done.

We did not talk to people using the service about this outcome as we had previously spoken to them on our last visit.

We spoke a person who used the service and two representatives of people who used the service who told us that they were very happy with the care being provided. They described the staff as “excellent” and that the service do a “fantastic job”.

We were told that the care staff were always polite, friendly and did “above and beyond” what they should.