We completed an announced inspection at Home Instead on 09 January 2017 and 10 January 2017. This is the first ratings inspection since the service registered at a new location on the 11 September 2015.

Home Instead Senior Care are registered to provide personal care. People are supported with their personal care needs to enable them to live in their own homes and promote their independence. At the time of the inspection the service supported 30 people in their own homes.

There were two registered managers at 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. We were told that one of the registered managers would be de-registering with us as they no longer undertook the role of registered manager at the service.

Staff and the registered manager understood their responsibilities to keep people safe where abuse may be suspected.

People's risks were assessed. Staff knew people's needs and carried out support in a safe way whilst they ensured that people's independence was promoted.

There was a system in place to monitor incidents and accidents and actions had been taken to lower the risk of further occurrences.

There were enough suitably qualified staff available to meet people's assessed needs. The provider had an effective system in place to monitor the staffing levels against the needs of people who used the service.

We found that people's medicines were managed and monitored in a way that kept people safe from harm.

Staff received training which was updated regularly to ensure they had the knowledge and skills required to meet people's needs effectively.

People consented to their care and where they were unable to consent mental capacity assessments had been carried out in line with the Mental Capacity Act 2005 (MCA). Staff showed they understood and applied the requirements of the MCA. This ensured that when people had the ability to make decisions for themselves, their decisions were respected. It also ensured decisions were made in people's best interests if they were unable to do this for themselves.

People were supported to eat and drink sufficient amounts and staff understood people's nutritional needs and preferences when they supported people with their diet.

People were supported to access health professionals and referrals for advice were sought by the registered manager, which ensured people's health and wellbeing was maintained.

People received care that was caring and compassionate and they were enabled to make choices about their care. People's dignity was maintained when they received support from staff.

People were involved in the planning and review of their care, which was planned and carried out in a way that met their preferences.

People told us they knew how to complain and the provider had an effective system in place to investigate and respond to complaints.

People and staff were able to approach the registered manager and director. Staff felt supported to carry out their role.

Feedback was sought from people and staff, which was acted on by the registered manager to make improvements to the quality of care people received.

Effective systems were in place to assess, monitor and manage the service. The registered manager was committed to making improvements to the quality of the service.