Background to this inspection
Updated
21 April 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 is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
This inspection visit to the service took place on 15 March 2018 and was announced. We gave the provider six day’s notice to give them time to become available for the inspection. The inspection was undertaken by an inspector and an expert by experience who telephoned people using the service and their relatives after the inspection. An expert by experience is a person who has direct experience of care services.
Before our inspection we asked the provider to complete a Provider Information Return (PIR).The PIR contains information about the service and how it is managed by the provider. We also sent questionnaires to people using the service, their relatives, staff and professionals to gather their views on the service. We received responses from five people who used the service, five staff and three relatives and friends and two professionals. We reviewed this information as part of our inspection.
Before the inspection our expert by experience spoke with two people using the service and ten relatives.
During the inspection we spoke with the two directors, the registered manager, a care-coordinator and four care workers. We looked at four people’s care records to see how their care was planned, records relating to medicines management, three care workers’ recruitment files and records relating to the management of the service.
After our inspection we contacted five health and social care professionals to gather their feedback and we received responses from two.
Updated
21 April 2018
This inspection took place on 15 March 2018 and was announced. We gave the provider six days’ notice to become available for the inspection. This was our first inspection of the service since they registered with us on 6 March 2017.
Home Instead Senior Care provides personal care and support to older people in their own homes. There were 15 people receiving the regulated activity, personal care. Most people funded their care privately.
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.
People received care from a service which was extremely caring. Staff cared for people in a very kind, compassionate manner. The provider had excellent systems to match people with staff who had complimentary personalities, shared linguistic and cultural backgrounds or shared hobbies and interests. People received full choice in their care, including choice of staff who cared for them. The provider went the extra mile in ensuring people received high quality, compassionate care. People developed open and honest relationships with staff.
People received care from a service which was highly responsive. People were supported in creative ways to live full lives and to do activities that were important to them. Staff understood and met people’s dementia-related needs and staff were trained to be ‘dementia friends’. The provider established excellent links with the local community and supported local charities and business in understanding how to recognise if people may have dementia and how to respond to them.
People were supported to maintain their independence and were treated with privacy, dignity and respect.
Staff were trained in end of life care and were able to provide practical and emotional support to people at the end of their lives. The service had a suitable procedure in place to investigate complaints. People were supported to receive care at the right time through an electronic monitoring system. People’s care plans contained sufficient detail about their needs to guide staff and people were involved in their care plans.
The provider supported people to integrate into their local community by training local businesses, charities, GP and hospital workers to be dementia friends. The service took a key role in the local community as a member of the Croydon Dementia Action Alliance which aimed to support organisations help people with dementia live well. The provider also actively supported local charities and community groups.
People were safeguarded from abuse and improper treatment due to systems the provider had in place. People felt safe with staff and staff received training in their responsibilities to safeguard people.
Risks relating to people’s care were reduced because the provider had systems to identify and manage risks. Risks relating to medicines management were also reduced. Records showed people received medicines as prescribed and the provider had systems to check this.
Recruitment processes were followed by the provider to check staff were suitable to work with people. There were sufficient numbers of staff deployed to support people.
Care workers received effective support to carry out their roles through induction, training, supervision and appraisal. Staff were supported to understand some of the difficulties older people may experience as part of their induction. In addition staff were encouraged to do diplomas in dementia to enhance their understanding of people’s dementia-related needs.
People received care in line with the Mental Capacity Act (2005). If the provider had reason to suspect people lacked capacity in relation to their care they carried out MCA assessments. Where the provider found people lacked capacity they made decisions in people’s best interests through liaising with their relatives and others involved in their care.
People were supported to maintain their health. People received their choice of food and drink. The provider matched people with staff who could prepare food from their cultures where possible. The provider assessed people’s needs and helped people receive coordinated care when they moved between services.
The service was well-led with a strong management team. The provider had good systems to communicate openly with people, relatives and staff. The provider had quality assurance systems in place to monitor people received good quality care and to improve the service if necessary. The provider worked in partnership with key organisations to provider joined-up care to people.