Home Instead Senior Care (Huntingdon) is a domiciliary care agency. It provides personal care to people living in their own houses and flats. It is registered to provide a service to older people, people living with dementia and people with mental health needs. Not everyone using Home Instead Senior Care (Huntingdon) received a regulated activity; the Care Quality Commission (CQC) only inspects the service being received by people provided with 'personal care'; help with tasks related to personal hygiene and eating. Where they do, we also take into account any wider social care provided.

This announced inspection was carried out between 18 and 21 June 2018. At our previous inspection on 5 and 6 April 2017 we asked the provider to take action to make improvements to ensure staff knew how to safeguard people from harm and that notifiable incidents were reported to the Commission. The provider submitted an action plan and said they would make the necessary improvements by date 15 June 2017. At this inspection, the necessary improvements had been made and the service was rated Good. At the time of our inspection there were 29 people using the service.

The service did not have a registered manager. A new manager was in post. Following our inspection their application to be registered was agreed by the Commission. A registered manager is a person who has registered with the CQC 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 a safe service. Staff understood their responsibilities in relation to safeguarding. They had received training and were able to recognise any safeguarding concerns. There were safeguarding procedures in place to guide staff on steps to take if they had a concern. The manager used information from accidents and incidents helped them learn lessons to prevent any potential recurrence. The staff recruitment process helped ensure that the necessary checks were completed before new staff commenced their employment. Sufficient staff who had been given the necessary training were in post and they were deployed to keep people safe.

Where risks to people were identified, for example falls, there were risk management strategies in place to guide staff on how to minimise those risks.

Staff were provided with the training and assessed as competent to provide people with support to take their medicines as prescribed. Effective action had been taken to ensure staff administered medicines as defined in the provider’s policies.

People received a service that met their needs. Following an initial assessment people were allocated staff members who had the right skills to meet their specific needs and promote their independence. People were enabled to access health care services and as a result this maintained their health and wellbeing. People were supported to have sufficient quantities of food and drinks of their preference.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People received a caring service. Staff had developed caring relationships with people. Staff enabled people to express their views including with support from advocacy services. Advocates are independent of the service and they can support people to raise and communicate their wishes. Staff respected people’s privacy and dignity. Staff had been given time for their training and this helped people to be cared for with compassion. Staff supported people in an equal way no matter what each person’s needs and independent living abilities were.

People received a responsive service. People, and or their relatives, were consulted about how their care was to be provided. Concerns raised by pe

This inspection took place on 5 and 6 April 2017 and was announced.

At the previous inspection in August 2014 the service was rated as ‘Good’.

Home Instead Senior care Huntingdon is a domiciliary care service that provides a personal care service to people living in their own home. At the time of our inspection 28 people were using the service. The service office is based on a business park near Huntingdon.

A registered manager was 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.

Staff had been trained on how to keep people safe and they knew who they could report any incidents of harm to. However, we found that not all incidents of harm or potential harm had been reported by the registered manager or acted upon by them. This put people at risk of harm and meant that organisations responsible for investigating safeguarding were not able to respond in a timely manner to assure people’s safety.

Not all risk assessments were in place to support people with their safety. Where accidents and incidents had occurred action had not been taken to update people’s risk assessments to help prevent the potential for a reoccurrence. This increased the risk of people being exposed to a risk of harm.

Medicines were administered and managed safely by staff whose competency had been assessed. Accurate recording of medicines was in place as a result of the reminders to staff to ensure they recorded administered medicines accurately.

A sufficient number of staff with the necessary skills had been recruited to safely meet people’s needs.

Staff possessed the necessary care skills to meet people's nutritional needs. Staff enabled people to access health care support from external healthcare professionals when required.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. The registered manager was aware of what they were required to do should any person lack mental capacity. No one using the service needed to be lawfully deprived of their liberty.

People were looked after with kindness, compassion and with respect for their privacy and dignity.

People, their legal representative or relatives were enabled to be involved in identifying, determining and planning the review of their care.

People were supported to be as independent as they wanted to be where this was safe. People were supported in such a way that prevented any risk of social isolation. This included assistance with their hobbies, interests and pastimes.

An effective system was in place to gather and act upon people’s suggestions and concerns before they became a complaint.

The registered manager was supported by an operations’ and training manager, care schedulers, senior care staff and care staff. Staff had the support that they needed to fulfil their role effectively.

People, their relatives and staff were involved and enabled to make suggestions to improve how the service was run.

The registered manager and provider had not always notified the CQC about important events that that they were legally required to do. This prevented other statutory organisations responsible for investigating incidents to be alerted. Not all quality monitoring and assurance processes that were in place were effective. Trends in accidents and incidents were not always acted upon. This put people at risk of harm.

We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and one breach of the Care Quality Commission (Registration) Regulations 2009.You can see what action we told the provider to take at the back of t

People that we spoke with were positive about the care and support they received and one person commented that: “The care is very good and the carers are kind and cheerful”. People told us that they were able to discuss any changes to their care and support and that their views were always taken into account. Care and support was well coordinated. The care plans we saw were ‘person centred’ and detailed how people preferred their care and support to be delivered.

The provider had ensured that there was information available for staff regarding reporting safeguarding to the local authority safeguarding teams. Staff had received safeguarding training and information about how to report any incidents of abuse.

There were effective recruitment procedures in place which ensured that all appropriate checks had been made prior to staff starting work. There was an induction programme in place for new staff and mandatory training was provided to ensure they were competent to deliver care.

Quality assurance procedures were in place for monitoring the running of the agency and people using the service were able to raise any issues and concerns with the management team.

People who we spoke with said were positive about the care and support they received. Their comments included, “The care is very good and is working like clockwork” and “The carers are like my family”. People told us that they felt involved in their care and support and that their views and concerns were listened to and properly dealt with.

Care and support was well coordinated and care planning documentation was detailed and evidenced peoples’ agreement, involvement and planning of their support.

Staff told us that they were supported by their manager and that they had received appropriate training and updates in a variety of subjects during the year.

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 and to pilot a new inspection process being introduced by CQC which looks at the overall quality of the service.

This was an announced inspection. This was to ensure that the manager knew we were visiting and that management and staff were available. At our previous inspection in January 2014 we identified that the provider was meeting all the Regulations we inspected them against.

Home Instead Senior Care Huntingdon provides care and support to approximately 30 people living in their own homes. The service is provided for people living in the Cambridgeshire area.

At the time of our inspection a registered manager was employed at the service. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.

People and their relatives told us they were happy and felt safe with the support that they received from staff They said staff knew about their support needs, treated them with respect and kindness and maintained their privacy and dignity.

Arrangements were in place to ensure that only staff with the right skills and background were only recruited after all essential pre employment and criminal records checks had been satisfactorily completed. This was to ensure they were suitable to work with vulnerable people.

People’s needs were assessed and care plans were based upon people’s care and support needs. Risk management procedures were in place to ensure people’s health risks were identified and plans were in place to manage those risks.

All of the people we spoke with told us they were involved in planning and reviewing their care. People we spoke with told us that they were provided with the same and consistent staff and that only this agency’s staff were used.

There were appropriate policies and procedures in place to support people should they ever have a need to complain or raise concerns. People we spoke with knew how to raise concerns.

There were systems in place to assess and monitor the quality of support provided for people. People’s views were sought at regular and frequent periods to ensure that issues were addressed before they ever turned into a complaint.