About the service: This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats. It provides a service to 105 older adults. Not everyone using Home Instead received the regulated activity of personal care. CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

People’s experience of using this service:

People consistently described the service as being exceptionally caring, and able to meet their needs in a personalised and thoughtful way. Consistency with rota's enabled people and staff to develop working relationships which were meaningful. The registered provider looked at creative ways to meet people’s needs.

People felt safe with the staff supporting them. Systems were in place to ensure people’s safety and enough staff had been recruited to ensure people received a reliable service. Recruitment processes were thorough. People were supported to take their medicines safely.

Staff had a thorough understanding of people's needs. An induction was provided and staff could access a range of training which provided them with the level of skills and knowledge needed, to deliver safe care.

The registered manager looked at ways person-centred care could be provided, which met people’s needs, wishes, preferences. Staff supported people to meet their nutritional and health care needs. Risk assessments were in place. These looked at a range of areas, but needed to be more detailed for people who were at risk of choking. We have made a recommendation about supporting people to eat in a safe way.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

Some staff had been trained in end of life care and understood the specific requirements to meet the needs of people at the end of their life. We have made a recommendation about end of life care.

People and their relatives told us they were actively encouraged to share their views and provide feedback about the service. A robust audit system was in place. The registered provider worked in partnership with other organisations and took part in several good practice initiatives, designed to further develop the service.

This service met the characteristics of Good; more information is in the full report

Rating at last inspection: This service was last rated Good. (1 September 2016)

Why we inspected: This was a planned inspection based on the previous rating.

Follow up: We will continue to monitor intelligence we receive about the service until we visit again in line with our inspection programme and scheduling. If any concerning information is received we may inspect sooner.

Home Instead Senior Care is a service that provides personal care and support to adults in their own homes. In addition to providing personal care, Home Instead also provides a companionship service, which supports people with activities and help with domestic duties. This element of the service, although provided by Home Instead Senior Care would not need to be registered with the Commission if this was their sole purpose. We focussed our inspection on the people in receipt of personal care only. On the day of our inspection there were 93 people using the service, 17 of which received personal care.

There is a Registered Manager at this location. 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 kept safe by staff that had a thorough understanding of their responsibilities to protect people they were caring for from harm or abuse.

People’s needs were met and they were cared for by sufficient numbers of staff. The risks to people were identified and reviewed to ensure people remained safe.

People had positive relationships with their care workers and had confidence in the service. There was a strong value base to ensure workers were caring and compassionate. People who used the service felt they were treated with kindness and said their privacy and dignity was respected.

Medicines were managed safely and staff members understood their responsibilities.

The principles of the Mental Capacity Act 2005 (MCA) had been properly followed in regard to obtaining consent to care. Where people held either Enduring or Lasting power of attorney (EPA or LPA) documents were retained within the care plan.

People who used the service, family members and staff were regularly consulted about the quality of the service they received. The registered manager conducted regular audits and improvements were carried out when these had been identified. The quality of the service was monitored and assessed consistently.

Activities were arranged for people who used the service based on their likes and interests and to help meet their social needs.

People who used the service, family members and visitors were made aware of how to make a complaint and there was an effective complaints policy and procedure in place.

The service regularly used community services and facilities and had links with the local community.

People we spoke with told us that they were happy with the care support and level of service that they received. They told us that staff treated them. Staff told us that they were supported and provided with appropriate training to help them deliver care and support safely and effectively.

We saw that people who used the service were involved in making decisions about they way in which their care was planned and delivered. People were consulted regularly to make comments and suggestions about the service they received and how it may be improved. Any comments or suggestions made by people using the service in tn relation to their care, were acted upon and any issues were addressed promptly.

People's needs were assessed and an individualised plan of care was developed taking into account the person's preferences. Risks to the health, safety and welfare of people who used the service, and the staff who supported them were identified and so far as possible minimised.

There were arrangements for protecting people using the service against the risk of abuse. Staff were trained in recognising and reporting abuse and they had access to suitable policies and procedures.

Staff were recruited robustly, trained and supported to deliver care and support safely and to a good standard.

There were effective arrangements for monitoring and improving the quality and safety of services provided.