18 September 2023
During a routine inspection
Home Instead is a domiciliary care service providing personal care to adults who live in their own houses and flats. At the time of our inspection, 97 people were receiving personal care.
Not everyone who uses domiciliary care services receives personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.
People's experience of using this service and what we found
People's medicines were not always managed safely and the provider's processes for checking the accuracy of people's medicines records were not always robust.
The registered managers governance arrangements did not always provide assurance the service was well led. Quality assurance systems were not robust and had not identified the shortfalls we found during our inspection.
Effective arrangements were in place to ensure recruitment checks on staff were safe. Minor improvements were required to staff recruitment files. We have made a recommendation about the management of staff recruitment files.
There was limited information in the support plans we reviewed relating to people’s end of life wishes. We have made a recommendation about end of life wishes.
We received positive feedback on the service. One person said, ''The registered manager is very kind and considerate, and the staff always go above and beyond and treat [relative] like family".
Risks to people had been assessed, reviewed, and updated in people's care plans when their needs changed. Staff had access to personal protective equipment (PPE) and there were effective infection prevention control measures in place.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. Staff had a good understanding of people's preference of care, staff promoted people's independence.
People and their relatives were involved in the planning and review of their care. The registered managers had effective policies to respond to complaints and these were handled well.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was outstanding (published 27 October 2017).
Why we inspected
We undertook this inspection as part of a random selection of services rated good and outstanding.
The overall rating for the service has changed from Good to Requires Improvement based on the findings of this inspection.
You can see what action we have asked the provider to take at the end of this full report
Enforcement and recommendations
We have identified breaches in relation to medicines management, good governance, and the notification of incidents. We have a made a recommendation about staff recruitment files and end of life wishes.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.