Home instead is a domiciliary care service that provides care and support to people within their own homes. Home Instead is owned by Home Instead UK limited. The office is situated in Hartford near Northwich and is centrally located for the service.

On the days of this inspection there were 74 people using the service.

At the last inspection on 12 March and 9 April 2015 the service was rated Good. At this inspection we found the service remained Good.

There was not a registered manager in place at this service. A new manager had been appointed and had applied to be registered with the Care Quality Commission. 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 told us they were very happy with the service provided and that the staff were caring, kind and friendly. People said “It’s all going well, I am happy”, “The staff treat me nicely”, “The staff are absolutely wonderful” and “The staff do everything for me”.

Staff told us they enjoyed working at the service and providing support to people who used the service. They said they were supported by the office and management team and they appreciated on call support that was available to them.

Care plans were well documented and up to date. They gave clear guidance to the staff team. Risk assessments were undertaken for a variety of tasks which included moving and handling, falls and the environment. These were reviewed regularly and up to date. The management of medication was safe.

Staff were aware of how to report a safeguarding concern. They were aware of the policies and procedures available to safeguard people from harm and told us they would not hesitate to report any concerns.

Staff had received a range of training that included moving and handling, safeguarding, medication and fire awareness. A range of other training was available to the staff team. Staff told us that the training was good. Staff had access to supervision sessions, annual appraisals and were invited to attend regular staff meetings.

Staff recruitment files showed that robust recruitment processes were in place. Staff attended an induction process prior to working alone. Staff told us that they worked alongside an experienced staff member before going it alone. They confirmed the induction process was good and that they had the information they needed to perform their role.

People had access to information about the service. They said that they knew the information was in their care folder and some people had read this. Other people said they were not bothered about the folder but knew the information was available. An initial visit was undertaken by one of the management team prior to the service starting.

A complaints policy was available and each person had this information within the care folder. Processes were in place to deal with any complaints received.

Quality assurance processes were in place which included observations of staff to ensure that care and support standards were being maintained and reviews of people’s care. Audits were undertaken in relation to the service provided and these monitored the services safety and effectiveness.

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.

Further information is in the detailed findings below.

We visited this service on 12th March and 9th April 2015 and we gave short notice to the service that we were visiting. This was to ensure that people were available at the office.

Home Instead is a domiciliary care service that provides care and support to people living in their own homes. At the time of this report they were supporting 126 people within the local community.

The service has a registered manager in place. 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 told us that they were very happy with the staff at Home Instead and they felt that the staff understood their care needs. People commented “The staff are respectful and helpful”, “Staff are very pleasant”, “The staff are interested in me” and “I have confidence in what the staff do.” People confirmed that staff stayed for the length of time allocated and arrived on time. People also confirmed that calls are rarely missed and that a duty manager was always available. All of the people we spoke with had no complaints about the service.

We found that people were involved in decisions about their care and support. Staff made appropriate referrals on behalf of people who used the service, to others such as the GP, where it had been identified that there were changes in someone’s health needs. During discussions with the staff we saw that they understood people’s care and support needs. Staff gave good examples of how they cared and supported people explaining that they tried to encourage people to be as independent as possible.

The care records contained good information about the support people required and were written in a way that recognised people’s needs. This meant that the person was put at the centre of what was being described. The records we saw were complete and up to date.

The provider had systems in place to ensure that people were protected from the risk of potential harm or abuse. We saw there were policies and procedures in place to guide staff in relation to safeguarding adults.

We found that good recruitment practices were in place which included the completion of pre-employment checks prior to a new member of staff working at the service. Therefore people who used the service could be confident that they were protected from staff that were known to be unsuitable.