Home Instead Senior Care is registered to provide personal care for people who live in their own homes. At the time of our inspection 60 people were receiving personal care.

The inspection took place on 24 January 2017. We gave short notice of the inspection to make sure the people we needed to speak with were available.

A registered manager was in post at the time of our inspection. 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 was run.

People were protected from the risk of potential abuse and told us they felt safe because of the way staff cared for them. Staff took action to care for people in ways which promoted their safety and people's care plans gave clear guidance for staff to follow in order to promote people's well-being. There were enough staff employed to care for people and people and their relatives felt they could rely on staff to provide the care they needed. Where people wanted assistance to take their medicines this was given by staff who knew how to do this safely.

People benefited from receiving support from staff with the knowledge and skills to care for them. Staff cared for people in ways which promoted their rights and recognised where people were independent.

There were no mental capacity assessments in place where there were concerns about people’s ability to retain information and make decisions. We have made a recommendation regarding this.

Where people needed care so they would have enough to eat and drink this was given by staff. People were supported by staff who understood the risks to people's well-being and worked with people and health professionals where needed, so people were supported to maintain their health.

Caring relationships had been built between people and staff and staff took time to chat to people so they did not become isolated. People were treated with dignity and respect and their right to privacy was taken into account in the way staff cared for them. Staff listened to people and took action to make sure people were receiving their day to day care in the ways they wanted.

People were involved in deciding how their care should be planned and risks to their well-being responded to. Where people were not able to make all of their own decisions the views of their relatives and representatives were acted upon. Care plans and risk assessments were updated as people's needs changed.

People and their relatives knew how to raise any concerns or complaints about the service. Systems for managing complaints were in place, so any lessons would be learnt.

Staff understood how the registered manager expected people's care to be given so people would receive the care they needed in the way they preferred. People and staff were encouraged to give feedback on the quality of the service and to make suggestions for developing the service further. The registered manager checked the quality of the care provided and introduced changes to develop people's care further.

We spoke with three people who used the service and with one relative of a person. All the people we spoke with were positive about the care they received and of how involved in their care they were. One person said. "they really do deliver, I would be lost without them." Another person said, "the carers always have the time and don't leave until they know I am settled." The relative told us, "we have seen a huge change in my relative and they are eating well and seem to be much happier."

We looked at ten people's care plans and saw how involved people were in planning the care they received. One person told us, "I can change my care plan with the member of staff on the day of the visit and they always listen to what I want." Staff told us they always ask people what they would like to be done before giving them care and support.

People's needs were assessed before planned care began. People were able to identify what type of support they required and how often. The care plans gave staff clear guidelines on the delivery of care. People were involved in choosing who their staff (care giver) was. The manager told us they tried to match people with care givers who had similar interests.

We looked at staffing and saw the service employed sufficient numbers of care givers to support people. A member of staff said, "we work very closely with people and sometimes I have to remind myself I am at work as it is like helping a friend." This was echoed by a person saying, "my care givers are like extended family to me."

The service regularly asked people for feedback on the quality of the service. They responded to comments and suggestions to improve the service.

We spoke with four people’s relatives who received a service, one person and seven members of staff. All the relatives we spoke with were very complimentary about the service provided by the care givers. They said they were always respectful and the care givers arrived on time. They were always informed if they were running late. When asked if staff upheld their relatives privacy and dignity, they replied "Oh yes most definitely". Another person told us "Yes, and I have no concerns or worries about the care provided". They felt involved in their care and had been consulted about their care plan. One person told us “staff knew what they were doing and how to do it. They seemed to recruit good quality staff".

People’s views and experiences were taken into account in the way the service was provided and delivered in relation to their care. They experienced care, treatment and support that met their needs and protected their rights. People were protected against the risks associated with medicines because the provider had appropriate arrangements in place. People were cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard. Staff had access to training which was relevant to their role and the needs of people in their care. The provider had an effective system to regularly assess and monitor the quality of service that people receive. Records were stored in a secure, accessible way that allowed them to be accessed quickly.

The people we spoke with gave consistent and positive feedback, particularly in relation to the responsive and flexible service that they received. Another point that came across strongly was how pleased people were with the way that the agency matched care staff to meet their individual needs and interests.

People told us they had been involved in the assessment and care planning process, which the service carried out to ensure that it could meet their individual needs. They said that the care was delivered as planned and the service they received met their expectations.

People said that staff were always punctual and kept accurate records of their visits and the support they provided. They described staff as helpful, polite, courteous, respectful and friendly. They said that staff took time to help people to do things for themselves, maintaining their dignity and independence.

People told us that they felt they were in safe hands with the agency. They said they were confident that staff had the right knowledge and skills to perform their work. They said they felt that they could raise any concerns with the agency and these would be dealt with appropriately.

People said the agency regularly reviewed the service it provided to them and checked that they were satisfied with it. They said the agency communicated well and kept in touch with them.