Home Instead Senior Care

Updated 21 February 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, and to provide a rating for the service under the Care Act 2014.

This was the services first inspection since they registered with CQC in February 2016. One adult social care inspector carried out this inspection.

Prior to the inspection we looked at information we had about the service. This information included the statutory notifications that the provider had sent to CQC. A notification is information about important events which the service is required to send us by law.

Before the inspection, we had asked the provider to complete a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they planned to make. We reviewed the information included in the PIR and used it to assist in our planning of the inspection.

For the purpose of the inspection we contacted and spoke with four people who used the service, four caregivers and six health and social care professionals working in the local community who have experience of the service. We also read written testimonies from people who used the service and staff who had recently completed the first annual quality survey. We spent time with the provider, registered manager and senior supervisor.

In addition we read written reflective accounts from the provider and registered manager. We looked at four people’s care records, together with other records relating to their care and the running of the service. This included the policies and procedures relating to the delivery and management of the service, minutes of meetings, accidents, incidents, complaints and, audits and quality assurance reports. We also received completed CQC surveys from people who use the service.

Updated 21 February 2018

This inspection started with a visit to the office location on 8 November 2017 and was announced. We gave the provider 48 hours’ notice of the inspection to ensure that the people we needed to speak with were available. On 9 November we made calls to people who use the service and staff to gain their views and experiences. This was the first inspection of the service since they registered with CQC in February 2016.

The inspection was carried out by one adult social care inspector. At the time of this inspection the service was providing the regulated activity of personal care to 27 people who lived in their own homes. These services were managed by the agency from an office in Bristol. People using the service, their families and the staff used the term ‘caregivers’ when referring to care staff. Therefore, we will refer to individual staff members as caregivers in the report and staff when we refer to them collectively.

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. The provider had a very ‘hands on’, active approach and presence within the service, with clients, the local public and staff. He was constantly referred to us with praise and always by his first name. For the purpose of the report we will refer to him as the provider.

The feedback we received from people was extremely positive throughout. Those people who used the service expressed great satisfaction and spoke highly of all staff and services provided. One person told us, “The whole experience has been first class, I couldn’t have wished for more”.

The safety of people who used the service was taken seriously and the registered manager and staff were aware of their responsibility to protect people’s health and wellbeing. There were systems in place to ensure that risks to people’s safety and wellbeing were identified and addressed.

The whole staff team were highly motivated and proud of the service. The registered manager told us, “We have recruited the most incredible and special people who share our values of compassion, joy, empathy, creativity, intuition and who recognize that dignity, respect and integrity are at the heart of what we do. Without our incredible caregivers the service we deliver would be compromised and pretty meaningless”.

All staff were fully supported by the management team and a programme of training and supervision enabled them to provide a good quality service to people. One caregiver wrote in the CQC survey, “This is a fantastic company, the training and the quality of care provided is highest on their list. I truly love my job and enjoy giving support to clients in their homes”.

The registered manager, provider and all staff understood the principles of the Mental Capacity Act (MCA) 2005 and, worked to ensure people's rights were respected.

The registered manager ensured that staff had a full understanding of people’s care needs and had the skills and knowledge to meet them. People received consistent support from caregivers who knew them well. People had positive, caring relationships with their carer giver and were confident in the service. There was a strong emphasis on key principles of care such as compassion, respect and dignity and promoting independence. People who used the service felt they were treated with ‘extreme’ kindness and said their privacy and dignity was always respected.

People received a service that was individualised and based on their personal needs, preferences and wishes. One social care professional told us, “Home Instead in North Bristol is a well-respected care agency who take the person centred approach very seriously”. Changes in people’s needs were quickly identified and their care was amended to meet their changing needs. The service was flexible and responded very positively to people’s requests. People who used the service felt able to make requests and express their opinions and views. One person wrote in the CQC survey, “I find the company very efficient and caring. When I have made a request for a change to be made to the usual plan, they are very accommodating”.

People benefitted from a service that was well led. The vision, values and culture of the service were clearly communicated to and understood by staff. The provider had implemented a programme of ‘planned growth’ that had been well managed. The provider and registered manager were totally committed to continuous improvement. The provider and registered manager demonstrated strong values and, a desire to learn about and implement best practice throughout the service.

The provider and registered manager demonstrated an excellent understanding of the importance of effective quality assurance systems. There were processes in place to monitor quality and understand the experiences of everyone who used or came into contact with the service.