About the service:

• Home Instead Senior Care is a domiciliary care service based in Norwich, providing care in Norwich and the surrounding areas, primarily to older people.

• At the time of the inspection, the service was providing personal care to 56 people living in their own homes and there were 61 staff.

People’s experience of using this service:

• People were protected from abuse, neglect and discrimination. Staff ensured people's safety and acted when necessary to prevent any harm.

• Individual risks to people were assessed and managed to keep people safe.

• Medicines systems were organised and people were receiving their medicines when they should.

• The service was very person centred and assessed people's needs and individual preferences.

• The service was very reliable and developed caring relationships with people using the service.

• The service operates a minimum one-hour care call length, 14 days’ notice to cancel calls and standardised call times which they believed contribute to greater staff retention and thereby improved relationships and care giving to people using the service; however, some people told us this reduced flexibility in the service provided.

• Staff told us that the training they attended was good and gave them the skills and knowledge they needed to support people.

• Health care professionals such as district nurses, the GP and occupational therapists had been involved in people's care.

• People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

• The service was going through a positive management restructure and was well led and managed.

• People and staff were overall positive about the management of the service changes, although people receiving care needed more information on the new management team.

• The views of people and staff were actively sought by managers to develop and improve the service for the future.

• The service was committed to empowering the local community to grow old well and had links with the local community to enhance the lives of people using the service.

Rating at last inspection:

• At our last inspection, published in July 2016, the service was rated “Good”.

Why we inspected:

• This inspection was part of our scheduled plan of visiting services to check the safety and quality of care people received, based on their rating at the last inspection.

Follow up:

• We will continue to monitor the service to ensure that people received safe, compassionate, high quality care. Further inspections will be planned for future dates.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

This announced inspection was carried out on 15 June 2016. Home Instead Senior Care provides support and personal care to people in their own homes in Norfolk. On the day of the inspection there were 137 people using the service of which 73 received personal care.

The service had a registered manager in place at the time of our inspection. 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.

People were supported by staff who understood the risks people could face and knew how to make people feel safe. People were encouraged to be independent and risks were mitigated in the least restrictive way possible.

People were supported by a regular individual or group of staff who they knew. People’s medicines were not always managed according to best practice guidance.

People were provided with the care and support they wanted by staff who were trained and supported to do so. People’s human right to make decisions for themselves was respected and they provided consent to their care when needed.

People were supported by staff who understood their health conditions and ensured they had sufficient to eat and drink to maintain their wellbeing.

People were treated with respect by staff who demonstrated compassion and understanding. People were involved in determining their care and support and were treated in the way they wished to be.

People were able to influence the way their care and support was delivered and they could rely on this being provided as they wished. People were informed on how to express any issues or concerns they had so these could be investigated and acted upon.

People who used the service and care workers were able to express their views about the service which were acted upon. The management team provided leadership that gained the respect of care workers and motivated them as a team. There were systems in place to monitor the quality of the service and make improvements when needed.

People or their relatives told us that they or their family members were treated with consideration and respect. One person told us they were treated “….very courteously.” Another person told us, “All staff are polite and friendly.” One person told us that they were asked when the service commenced how they wished to be addressed. They wanted to be addressed as Mr and Mrs [surname] as opposed to their first names being used. Staff had respected this request.

People’s needs were assessed by the manager prior to service agreements being signed by both parties and the service commencing. The manager would visit people in their own homes and carry out needs assessments and risk assessments. Care records were personalised. Detailed relevant information was obtained to show the way in which people wanted to be supported, rather than list of tasks to be completed.

People who use the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.

Staff were supported through training, appraisals and support meetings. Staff told us they felt supported by the agency's management team.

Various systems were in place to obtain people's views and monitor the quality of the service provided. These included annual surveys and audits. Where complaints had been made they had been dealt with appropriately and promptly.