This announced inspection took place on the 11, 12 and 13 October 2016. Home Instead Senior Care provides a personal care service to people who live in their own homes in the East Hertfordshire and Uttlesford area. At the time of our inspection the service was supporting 133 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 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 had care plans that were personalised to their individual needs and wishes. Records contained detailed information to assist care workers to provide care and support in an individualised manner that respected each person's individual requirements and promoted treating people with dignity.

People were cared for safely in their own home. There were risk assessments in place to mitigate any risks which supported people to live independently. Staff understood the need to protect people from harm and knew what action they should take if they had any concerns. Staff understood their role in caring for people with limited or no capacity under the Mental Capacity Act 2005.

Staffing levels ensured that people received the support they required safely and at the times they needed. The recruitment practice protected people from being cared for by staff that were unsuitable to work in their home.

People received care from staff that were compassionate, friendly and kind and who would go the extra mile to support people and their families. Staff had the skills and knowledge to provide the care and support people needed and were supported by a management team which was receptive to ideas and committed to providing a high standard of care.

The registered manager supported a management team which was approachable and supportive. There were systems in place to monitor the quality of the service provided and actions taken to improve the service. Staff and people were confident that issues would be addressed and that any concerns they had would be listened to.

People told us they understood the care and support choices available to them and that their privacy, dignity and independence had been respected. One person’s relative told us, “We have been happy since day one with [relative’s] care, they left no stone unturned and looked at everything.”

People who used the service received appropriate care and support that met their individual needs. We found that people's plan of care was developed with them or those acting on their behalf. One staff member told us, “Before I walk through a client’s door I know what they like for breakfast, how they like to be supported, even what hobbies they have.”

People’s health, safety and welfare was protected when more than one provider was involved in their care and treatment. This was because the provider worked in co-operation with others.

We found that people were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines.

People were cared for, or supported by, suitably qualified, skilled and experienced staff.

The provider used a range of systems to monitor the quality of service they provided to people. We saw that one person had commented in a recent satisfaction survey, "Please pass on my praise, a very grateful client who would be lost without them."

People who used the service told us that freedom of choice had been available all the way through their care experience. They said they had been well consulted about their care provision and had the opportunity to ask questions of care workers and the care manager at any time and were always provided with thorough explanations.

People told us they were treated respectfully and their privacy and dignity was considered at all times. They told us that they had copies of their care plans and documents telling them about the service. People also told us that the staff were very good and professional and they usually got the same carers visiting them. They said the visits were usually on time and they were contacted if their care worker was going to be late.

People we spoke with told us that the staff team were very good and reliable. They said they considered the staff to have been well trained and believed that the managers provided them with the necessary support to do their work.

People said they felt confident to share their views and opinions and felt listened to by the staff and management team.