About the service:

¿ Home Instead Senior Care is a domiciliary care agency, providing care to people living in East Hampshire and Midhurst.

¿ It provides personal care to people living in their own houses/flats.

¿ Home Instead Senior Care call their care staff, CAREGivers and this term is used throughout this report.

¿ The service was providing personal care to 20 older and younger people at the time of the inspection. Some of whom were living with dementia or a disability.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

People’s experience of using this service:

¿ People told us they received very high quality care from exceptionally dedicated and caring staff, which professionals confirmed. A staff member told us, “The clients come first with Home Instead.” People valued the hands-on approach of the provider who completed their initial assessment.

¿ The provider took great care to match people and CAREGivers and introduce them, prior to the first care call. CAREGivers had sufficient time to spend with people at each call, which enabled the provision of thoughtful, unrushed care.

¿ CAREGivers went the ‘extra mile’ for people in the provision of their care. They were sensitive to what was important to people and went out of their way to help them.

¿ People living with dementia derived great pleasure and benefit from the provider’s ‘Music and Memories’ café. CAREGivers supported people to go out into the community to pursue their interests.

¿ CAREGivers sensitively discussed with people their end of life wishes.

¿ People were involved in planning their care. Their care plans were individualised.

¿ People received safe and effective care from competent staff

¿ Staff worked closely with other professionals to ensure people received seamless care.

¿ The service was family run and well led. The provider was highly visible and involved with the service.

¿ The provider promoted people’s safety in the community.

¿ People’s consent to their care was sought. The registered manager was acting to ensure mental capacity act assessments were only completed for people where required and documented.

¿ The provider had acted and was taking further action to ensure medicines recording reflected best practice.

¿ We have made a recommendation about staff refreshing their formal safeguarding training.

Rating at last inspection:

¿ At the last inspection the service was rated Good (06 January 2017).

Why we inspected:

¿ This was a planned inspection to check that this service remained Good.

Follow up:

¿ We will follow up on the recommendation we have made at the next inspection.

The inspection took place on 5 and 6 December 2016 and was announced to ensure staff we needed to speak with were available. Home Instead Senior Care is registered to provide personal care to people living with dementia, people with a learning disability, people living with mental health issues, older people, people with a physical disability and younger adults. In addition to the regulated activity Home Instead Senior Care provides companionship and home help services to people in their homes. At the time of the inspection there were 17 people receiving the regulated activity.

The service had a manager who had applied to become the registered manager. 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 felt safe in the care of staff who understood how to manage risks to them. People’s experience of the service was that their care was provided to them safely.

Staff had undertaken relevant training to enable them to understand their role and responsibilities in relation to safeguarding people. Processes were in place to safeguard people from abuse.

The provider ensured risks to people were assessed and measures put in place to manage them. Staff had a good understanding of their responsibilities for responding to and reporting accidents, incidents or concerns about people. Processes were in place to manage any unexpected or out of hours events for people’s safety.

There were sufficient staff to provide people’s care. People received consistency in the care staff rostered to provide their care. People’s care was provided by staff who had received guidance about their care needs and to whom they were introduced prior to their care commencing.

Staff had undergone relevant recruitment checks to ensure their suitability to work with people.

Medicines assessments identified the level of support people needed with the administration of their medicines. Peoples' medicines were managed and administered safely by trained and competent staff.

People’s experience of the service was that their care was provided effectively.

There was a process in place to ensure staff received a relevant induction and that their competency to deliver people’s care safely and effectively was then assessed. Not all staff had updated their training as required to ensure it remained current. The manager was aware of this issue and these staff were booked to attend refresher training.

People’s consent was sought for their care. People were cared for by staff who had undertaken Mental Capacity Act training relevant to their role. The provider was able to tell us how they had assessed that where people lacked the capacity to consent to their care, it was in their best interests to provide the care. They have assured us they will now be documenting these decisions for people to ensure there is a record of how these decisions have been reached.

People’s records documented their arrangements for meals; this ensured there was clear guidance for staff. Where risks to people associated with eating or drinking had been identified there were arrangements in place for staff to manage them.

Staff supported people to access health care professionals as required and liaised with them to ensure the effective provision of people’s care.

The provider and staff understood the importance of people experiencing caring relationships from caring staff. The provider told us and records confirmed that staff visits to people were a minimum of one hour; this ensured staff had sufficient time to spend with people, focused on them. Staff listened to people and empowered them to make decisions about their care.

People told us staff upheld their privacy and dignity. Staff di