The inspection took place on 2 June 2016 and was announced. The provider was given 24 hours’ notice because the location provides a domiciliary care service and we needed to be sure that someone would be available.

Home Instead Senior Care is a domiciliary care provider based in Stone, Staffordshire, providing personal care and support to people in their own homes. At the time of this inspection 142 people used the service.

The service had a registered manager who had been in post since July 2008. 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 in their own homes and told us they felt safe and comfortable with the service provided. Systems were in place to ensure that people who used the service were protected from the risk of abuse. The registered manager and caregivers had received training in safeguarding adults from abuse and were aware of the procedures to follow if they suspected that someone was at risk of harm.

People were offered support in a way that upheld their dignity and promoted their independence. Care and support plans were written in a personalised way based on the needs of the person concerned to ensure the caregivers had information on people’s preferences so that individualised care and support was provided.

Caregivers exhibited a good value base, people told us the caregivers were kind and caring. The principles of the Mental Capacity Act 2005 were followed to ensure that people's rights were respected.

People’s medicines were managed safely; caregivers were well trained and supported people with their medication as required. People were supported to access external healthcare professionals and other agencies in order to ensure their healthcare needs were fully met.

Robust systems were in place to ensure that people were supported by caregivers who were of good character and able to carry out the work. Caregivers received full induction training, annual updates and refreshers to ensure they were fully skilled to provide the support. Caregivers had regular opportunities to meet with their seniors either on a one to one basis or in caregiver’s meetings.

There were clear lines of management responsibility. Caregivers told us they felt supported to fulfil their role and the registered manager and provider were approachable. Systems were in place to continually monitor the quality of the service.

The provider was very committed to continuous improvement. Feedback from people, whether positive or negative, was used as an opportunity for improvement. The provider and registered manager demonstrated a good understanding of the importance of effective quality assurance systems. There were processes in place to monitor quality and understand the experiences of people who used the service. The provider and registered manager demonstrated strong values and a desire to learn about and implement best practice throughout the service.

We spoke with senior staff including the manager and care givers at the time of our visit to the office. We spoke with six people over the telephone. Everyone who used the service told us that they were very satisfied with their care.

The manager told us that there were people that used the service who would not be able to speak with us over the telephone. With the permission of the person and their representative we arranged to visit them in their own homes. We spoke with people and observed the support being provided. One person told us: “I have been able to remain at home; the help I receive from the carers is wonderful".

We saw that people who used the service had consented to their care, treatment and support or had been supported to do so by significant others.

We found that people’s care and welfare needs were being met. People who used the service told us they were very satisfied with the service provided. One person said: "Nothing is too much trouble; in fact the carers go the extra mile to help. They are all very kind, helpful and friendly".

We saw that the service was following the correct recruitment procedures when employing new staff.

Staff received the training they needed to do their job effectively.

We saw that the provider had systems in place for assessing and monitoring the quality of service they provided.

People who used the service told us they had never experienced anything but respect and kindness from the care workers. They told us the care workers were all very good and did what was expected of them.

The manager told us that any referrals for the service were carefully considered before a care package was offered. This meant that people can be assured that their care needs will be fully met. People who used the service had a care and support plan that was discussed and agreed with them.

Staff told us they had received training in safeguarding vulnerable people. We saw systems were in place for the action needed when and if any concerns were identified.

During our inspection we identified that systems were in place to assess and monitor the quality of the service.

We looked at five key outcomes to establish whether people were involved and participated in the service they received; whether care was provided appropriately; whether the agency could adequately ensure people's safety; whether staffing was adequate and whether there was a system for ensuring ongoing quality assurance within the agency.

Home Instead Senior Care was compliant in these five outcome areas.