The inspection took place on 30 March and 7 April 2016 and was announced to make sure that the people we needed to speak with were available to assist us with the inspection. At our last inspection on 22 February 2014, the service was found to be meeting the required standards in the areas we looked at. Home instead senior care Watford is registered to provide personal care and support to people who lived independently in their own homes.

There was a manager in post who had applied to become registered with the Care Quality Commission (CQC). A registered manager is a person who has registered with the CQC 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 and associated Regulations about how the service is run.

People felt safe, and were happy with the way they were supported in their homes. Staff had received training in how to safeguard people from the risk of abuse and knew how to report concerns both within the organisation and externally if necessary. Recruitment practices were safe and effective to help ensure that all staff were suitable to work with people in their own homes.

Relatives and people who were being supported by the service were positive about the skills, experience and abilities of staff who worked in people’s homes. Staff received training and refresher updates relevant to their roles and had regular supervision meetings to discuss and review their development and performance.

People were supported to maintain good health and had access to health and social care professionals when necessary. People were supported with shopping and meal preparation where required.

Care was provided in a way that promoted people’s dignity and respected their privacy. People received personalised care and support that met their needs and took account of their preferences. Staff were knowledgeable about people’s background histories, preferences, routines and personal circumstances.

Staff established what people’s wishes were and obtained their consent before providing personal care and support, which they did in a kind and compassionate way. Information about local advocacy services was available to help people access independent advice if required.

Staff had developed positive and caring relationships with the people they supported and clearly knew them well. People were involved in the planning, delivery and reviews of the care and support provided. People’s personal information was securely maintained within the office.

People were supported to pursue hobbies that they were interested in and that was relevant to their needs. They felt that staff listened to them and responded to any concerns they had in a positive way. Complaints were recorded and investigated thoroughly with learning outcomes used to make improvements where necessary.

Relatives, people and staff were complimentary about the management team and how the service was run and operated. There were systems in place to monitor the quality of services provided. Feedback was obtained and used to make improvements.

People told us they were very happy with the care that was provided to them. People described the agency as a "high quality service" and said that all aspects of the service was "well managed" and personalised. Staff also spoke positively about working at Home Instead Senior Care (HISC Watford). They told us they were well supported in a structured organisation.

We reviewed the arrangements for obtaining consent and found that the provider had an appropriate process in place to obtain consent. We found that care plans were detailed and person centred, and that risk assessments had been undertaken and were reviewed regularly. There was a policy in place to safeguard vulnerable adults from abuse. There were clear procedures to recruit and support staff in their workplace and the quality of the service was monitored as a way of ensuring high standards were maintained.

The people who used the service told us that the care staff were their friends and almost part of the family. They said that the staff made their lives easy and added colour and fun. We were told that without the staff the people would find life difficult and they looked forward to their visits from the staff.

We found the service was well run and managed. Staff had rotas setting out their work each day with enough time allocated to complete the care of the people assigned to them. They were also given enough time to travel between the different people they cared for without being rushed or arriving late. If staff were delayed we were told that they always phoned the person to let them know.

We saw that staff were appropriately recruited and trained to meet the needs of the people they cared for.