This inspection was announced and took place on 7 and 9 November 2016. This was our first inspection since the provider registered with us after moving their office base in February 2016. Home Instead Senior Care was registered to provide personal care support to people living in their own homes in the Sutton Coldfield, Lichfield and Tamworth areas. People who used the service had physical health needs and/or were living with dementia. At the time of our inspection, 65 people were receiving personal care support.

There was a registered manager 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.

Staff gained people’s consent before they were supported. However, when people were not able to make decisions about their care, even though the provider had considered their capacity, they had not assessed this and was not able to show why decisions made on behalf of these people were in their best interests.

People felt safe having the support and staff knew how to protect people from harm and abuse. There were arrangements in place to keep people safe in their homes and the provider had considered staff safety when at work. Risks to people were assessed and managed and staff knew how to supported people in a safe manner. There were enough staff to meet people’s needs and the provider had safe recruitment processes in place. People were supported to have their medicines safely.

Staff were equipped with the knowledge and skills required to carry out their roles. When required, people were supported to have a balanced diet and maintain their health and wellbeing.

People were supported by staff who were kind and compassionate and knew them well. They felt listened to and were enabled to maintain their independence. People were treated with dignity and their privacy was respected.

People were involved with the planning of their care, and the support was responsive to their needs. They received support that was individual to them and their care records were personal to them. People knew how to raise concerns or complaints, and the provider acted on these in a timely manner.

The service was well managed and there were systems in place to monitor the quality of the service. This was through feedback from people who used the service, their relatives and staff, and the registered manager had a programme of audits that were used to drive continuous improvement within the service.