Home Instead Senior Care is a registered with the Care Quality Commission to provide ‘personal care’ to people living in their own houses and flats in the community. It provides a service to older adults. Home Instead Senior Care office base is located in Southport. The office building has accessibility for people who required disabled access.

At the time of our inspection the service was supporting 100 people who were located in Southport and wider areas of Sefton. At the last inspection, the service was rated Good.

At this inspection we found the service remained Good. The service met all relevant fundamental standards.

A registered manager was in post. The registered manager had led the care team consistently for eight years.

The key strength of the service was that support was provided to people on a flexible basis and in accordance with their identified needs. People who received care and support provided us with consistently positive feedback. They said they received a reliable service and an excellent standard of support from caring, kind and compassionate staff. One person said, “They are very compassionate; my [relative] has developed a bond with one of them in particular” and “There is an element of companionship. They are always interested in you as a person.”

Relatives we spoke with were equally positive and spoke about the quality of the supportive relationship care staff had built. One relative commented, “I am relieved that it has gone so well and I can relax. It is quite amazing how well they have got to know [person] – the set-up is quite astonishing.”

There was a consistent staff team and a key quality initiative of the service was staff being matched to people with the same interests to help build a positive relationship. This was central to the ethos of the service. A staff member said, “We always have time for clients.”

People told us that staff treated them with kindness and respect. It was clear from care and incident records that staff were vigilant in monitoring people’s moods and behaviours and provided care in accordance with people’s needs.

There were policies regarding equality and diversity. Care records contained information about people’s individual preferences and history which would include areas of cultural diversity and protected characteristics.

The service maintained effective systems to safeguard people from abuse and individual risk was fully assessed and reviewed. This included when people needed support with managing their medicines.

We saw evidence that the service learned from incidents and issues identified during audits. Records showed evidence of review by senior managers.

People’s needs were assessed and recorded by suitably qualified and experienced staff. Care and support were delivered in line with current legislation and best-practice.

The service ensured that staff were trained in appropriate subjects. This training was subject to regular review to ensure that staff were equipped to provide safe, effective care and support.

We saw clear evidence of staff working effectively to deliver positive outcomes for people. People reviewed were receiving effective care and gave positive feedback regarding staff support.

We saw evidence that the service worked effectively with other health and social care agencies to achieve better outcomes for people and improve quality and safety. The professional that we contacted did not express any concerns about the quality and effectiveness of these relationships. We saw evidence in care records of people being supported with input from community professionals such as occupational therapists and professionals from the palliative care team.

The service operated in accordance with the principles of the Mental Capacity Act 2005 (MCA).

We checked the records in relation to concerns and complaints. The complaints’ process was understood by the people that we spoke with. We saw evidence that complaints had been responded to in a pr

Home Instead is a domiciliary care agency who support people within the Southport and local areas.

People we spoke with who used the service were very happy with the care and support they received. A relative told us "The staff are lovely, they know how we like things done.”

Another relative told us “My family member has the same care givers for continuity of care; they feel comfortable with them all.”

We heard from relatives that their family members were treated respectfully.

We reviewed care files and found them to be of a person centred approach. This means the care documentation is individual to each person's needs and support.

Home Instead managed staffing level rotas appropriately and there were suitable arrangements in place to deal with foreseeable emergency cover.

Staff told us they felt well supported by their management and peers.

Prior to our inspection, concerns had been raised to us about how confidential information at the Home Instead Senior Care offices was stored. People we spoke with told us that they were happy with the care provide by Home Instead Senior Care and that their privacy and dignity was maintained when receiving personal care. People told us that staff (called CAREgivers) were “Very efficient” and “Reliable.” One person we spoke with told us that they were very impressed by the “Professionalism and dedication” of their carers.

People who used the service told us that the staff in the office are very helpful and will usually let you know if CAREgivers were going to be delayed in attending a call. People told us they could request which CAREgivers they would like to have regularly and staff told us they try to factor this in when planning visits.

The inspection was carried out on 28 & 29 July 2015. We gave the provider 48 hours’ notice of the inspection in order to ensure people we needed to speak with were available.

Home Instead Senior Care is owned by Sefton & Merseyside Senior Care Services Limited. The agency is registered with the Care Quality Commission to provide personal care and support to people in their own homes. Home Instead Senior Care is based in Southport and provides a personal care service for approximately 106 people in Southport, Formby, Crosby and Ormskirk. The service is for older people and younger adults who may have a dementia, mental health need, physical and/or learning disability or sensory impairement.

A registered manager was 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.

Our findings showed care and support was provided to people in their own home on a flexible basis and in accordance with individual need. The amount of support provided varied and people were offered a service between several hours per day to 24 hour support, seven days per week if required.

The manager was motivated and very passionate about providing a service which took into account people’s individual needs and their wishes. A lot of time was spent with people during the initial assessment to get to know them and their family thus making sure the support was exactly right for each person.

Everyone we spoke with told us they felt safe when the agency staff were in their home

People told us they received care and support from a consistent staff team and the visits by staff were conducted on time.

Staff rotas showed there were sufficient numbers of staff to meet people’s needs.

Risks to people’s safety and welfare had been assessed and information about how to support people to manage risks was recorded in their plan of care.

The manager had a clear knowledge and understanding of the Mental Capacity Act (MCA) 2005 and their roles and responsibilities linked to this. People told us they were able to make their own choices and were involved in decisions about their support.

There were processes in place to help make sure people were protected from the risk of abuse and staff were aware of safeguarding vulnerable adults’ procedures.

Medicines were administered safely to people by staff. We found in some cases there was a lack of clarity around recording the level of support people needed with their medicines. This was brought to the manager’s attention during the inspection and appropriate actions taken

Recruitment checks were robust to ensure staff were recruited safely to work with vulnerable people.

People’s medical conditions were known by the staff and staff liaised with healthcare professionals to help monitor and maintain people’s health and wellbeing.

We observed staff supporting people in their own home, this support was carried out in accordance with what the person needed and wished to receive.

Staff supported people with their nutrition and food preparation.

People had a plan of care. Care plans varied in detail however overall they provided information to enable staff to provide care and support in accordance with individual need. We discussed with the manager the need for more ‘person centred’ plans (care/support plans tailored to the individual), so that staff had a more rounded picture of how people wished to be supported.

Speaking with care staff confirmed their knowledge about the people they supported and how they would respond if a person was unwell or there was an emergency situation.

Staff were supported by on-going training, supervision, appraisal and staff meetings. Formal qualifications in care were offered to staff as part of their development.

People who used the service told us the staff treated them with kindness and staff were polite and respectful.

The agency had a whistleblowing policy, which was available to staff. Staff told us they would feel confident using it and that the appropriate action would be taken.

Staff we spoke with told us how much they enjoyed working for the agency as they received a good level of support from the manager.

A complaints procedure was in place and details of how to make a complaint had been provided to people who used the service. People we spoke with knew how to raise a complaint.

Systems and processes were in place to monitor the service and drive continuous improvements. A number of audits (checks) on how the service was operating were also undertaken. These included visits approximately every three months to see people in their own home. The purpose of this was to monitor staff practice and also to check whether people were satisfied with the support they received.

People's views had been sought through the use of questionnaires, as part of pursuing ‘excellence’. The overall feedback from the questionnaires and from our inspection was very positive about the agency.