About the service: Winspear Garth (trading as Home Instead St Helens) is a domiciliary care service that was providing personal care to people living in the St Helens area. CQC only inspects the service being received by people provided with personal care. This includes help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided. At this inspection there were 28 people using the service.

People’s experience of using this service:

People were protected from the risk of abuse and harm. All staff had completed training in topics of safeguarding and they understood their responsibilities for keeping people safe and reporting any concerns about people's safety. The risks people faced in their lives were fully assessed in order to keep them safe. Robust recruitment and matching procedures were followed for staff. The risk of staff not visiting people in a timely manner was eliminated because of a computerised system that ensured people received support to meet their needs. Medicines were safely managed, and people were supported to be as independent as possible with managing their own medicines. Accidents and incidents were reported in an open and transparent way and action was taken to reduce further occurrences and learn from them.

An holistic approach had been followed in the assessment, planning and delivery of people’s care and support. Care plans were detailed and person-centred and reflected people’s personal preferences. They identified a progression to assisting people to become more independent in their daily lives. Staff provided care and support that was provided in a way people preferred and provided consistent and positive outcomes that met their expectations. Staff worked hard to provide a consistently better quality of life for people by supporting them to develop in areas such as communication, social interaction and independence. People consistently spoke highly of the support provided and we heard many examples where people had become more independent following the input of the service.

People and family members were, without exception very positive about how kind and caring staff, and the management team were. They considered the staff team to be completely trustworthy and had developed strong working relationships as a result of the staff approach. Staff and management were highly motivated in providing consistent person-centred care. People told us they felt listened to, valued, respected and included in every aspect of their care and support. Staff and managers had the skills available to support people and their relatives if they were reaching the end of their lives.

The management of the service demonstrated a high level of experience and capability to deliver support. Managers and leaders had knowledge and a person-centred vision which inspired staff to provide outstanding care and inspired confidence and passion in the staff team. The management team placed a strong emphasis on supporting people to become more independent in their lives. Managers sought to gain the views of people in a meaningful way which informed the future development of the service and to act upon suggestions made. The management team were commended by people for operating a well led service. They were praised by people who used the service and their families. This was reflected in testimonies recommending anyone looking for support in their own homes. The management team worked closely in partnership with other agencies who were involved in people’s lives.

Rating at last inspection: The service was rated as good at our last inspection in June 2016.

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

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

For more de

This was an announced inspection, carried out on 21 June 2016. We gave 48 hours’ notice of the inspection because the manager is often out of the office supporting staff or providing care. We needed to be sure that the registered manager or someone who could act on their behalf would be available to support our inspection.

Winspear Garth Senior Care Limited is a domiciliary care agency that is registered to provide personal care to people living in the St Helens area. The provider trades under the name of Home Instead Senior Care. 19 people were using the service at the time of the inspection.

The service has a manager who was registered with CQC in July 2013. 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.

The last inspection of the service was carried out in June 2014 and we found that the service was meeting all the regulations that were assessed.

People were safeguarded from avoidable harm and potential abuse. People felt safe using the service and they were confident about what to do if they came to any harm or felt unsafe whilst using the service. Staff had completed safeguarding training and they had access to information about preventing abuse and about how to respond to an allegation of abuse. Staff were confident about recognising and reporting suspected abuse and the registered manager was aware of their responsibilities to report abuse to relevant agencies.

Procedures were in place to protect people from hazards and to respond to emergencies. Risks people faced and how staff were to manage them were factored into care plans to help keep people safe. Staff were confident about dealing with an emergency situation should one arise.

People’s needs were met by the right number of suitably qualified and experienced staff. Recruitment checks were thorough and staff were only employed to work at the service following the receipt of satisfactory checks on their suitability.

The registered manager and staff had a good knowledge and understanding of the Mental Capacity Act (2005) and their roles and responsibilities linked to this. People's consent was obtained prior to them receiving any care and support.

People were provided with person centred care and support that was tailored to meet their individual needs. Changes in people’s needs were recognised and responded to in a timely way.

People’s needs were continually assessed and they had a care plan which detailed how their needs were to be met. Care plans were personalised and took account of peoples choices and preferences.

People received the support they needed with their healthcare needs. Staff recognised changes in people’s health and they took appropriate action in response to any concerns noted.

Medication was managed appropriately and people received their medication as prescribed. There were processes in place to ensure medication was managed safely. Staff had access to guidance about how to support people with their medicines.

People described staff as kind and caring and they said staff always respected their privacy and dignity. Staff knew people well, including their likes, dislikes and preferred routines. People were supported and encouraged to be as independent as possible.

Staff were well supported in their roles and responsibilities. Staff received ongoing training relevant to their roles and responsibilities and people’s needs. Staff were regularly supervised and attended team meetings which enabled them to discuss their work, training and development needs and updates regarding the service.

Staff were aware of their roles and responsibilities and the lines of accountability within the service.

Staff told us there was an open culture at the s

We considered our inspection findings to answer questions we always ask;

• Is the service safe?

• Is the service effective?

• Is the service caring?

• Is the service responsive?

• Is the service well-led?

This is a summary of what we found.

Winspear Garth (Home Instead) is a Domiciliary Care Service (DCA). The agency were providing support and care to people living in their own homes.

At the time of our inspection, the agency was providing a service to 19 people and they employed twelve Caregivers (care workers).

Is the service safe?

We saw that people had been cared for in their own homes and the service had checked if this was safe, clean and hygienic. We were told by people using the service that the staff arrived on time and stayed for the correct amount of time.

We visited two people in their own homes, some of their comments were, “It’s better than I thought it would be”, “I look forward to the carer coming” and “I am always respected and treated with dignity”. We reviewed records which demonstrated that there were sufficient staff available to meet people’s needs.

Is the service effective?

People who used the service told us they were happy with the care that had been provided. Some of the comments were, “I always get my correct amount of time” and “The carer will do anything I ask, couldn’t be any better”. We spoke with two members of staff when we visited the people in their own homes and they had a clear understanding of people’s needs and how to meet them.

We found that staff training was consistent, with appropriate and relevant training being provided. We saw that supervision of staff was regularly provided. This meant the provider could demonstrate that the staff employed to work for the service had the training and support to meet people’s needs.

Is the service caring?

The staff we spoke with during our inspection gave good examples of how they supported people in a caring and sensitive manner. Staff expressed how they felt enthusiastic about caring for people. Some of the comments were, “I love doing care work, over 16 years now” and “I wish I had come into this work years ago, absolutely love it”.

People we visited told us, “She’s (carer) the best, couldn’t wish for anyone better” and “My life is much better since the carer has been coming to me. We get on very well”.

Is the service responsive?

We saw that people’s needs were assessed before they were offered a service; this was to make sure the agency could meet people’s needs. Care plans contained detailed and informative background and social history for people using the service. The care plans were person centred and individualised.

One person we visited said, “The manager visited me yesterday; she visits me fairly regularly and asks how things are going”.

Is the service well-led?

The agency provided a quality monitoring form to the people using the service, on a monthly basis. This was to obtain people’s opinions and views of the service they had received. This meant that the provider would be able to ascertain people’s opinions and views, which could positively change the service delivery.

Some of the comments from people using the service were, “No I have never complained, but I would know what to do if I needed to complain about anything”, “I would recommend them to everyone” and “They are lovely and very good at understanding my needs”. Some of the staff comments were, “Its good working for them” and” The manager is brilliant and very supportive”.

We visited two people who were receiving care and support from Winspear Garth in their own homes. The people we spoke with told us about their views and experiences of the service they had received. People told us they were satisfied with the care and support provided to them and that they were always treated with respect. One person said “Everybody is very kind and helpful.” Another person told us they had been using residential respite care and the service offered by the agency had meant they had been able to live independently in their own home again.

We found the agency to be very well organised with clear systems and records in place to aid the effective delivery of care. Each person had a care journal, which outlined all their care needs. Arrangements were in place to provide new staff with appropriate support through induction and all mandatory training was up to date. The agency had effective quality assurance systems in place to monitor the care being provided and people were regularly asked for feedback about their care.