This announced inspection took place on 16, 18, 21 and 22 January 2019.

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to adults. At the time of inspection, the provider was supporting 59 people with personal care.

Not everyone using Home Instead Senior Care – Milton Keynes may receive regulated activity; 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.

At the last inspection, on 27, 29 July and 1 August 2016, the service was rated 'Good'. At this inspection we found the evidence continued to support the rating of 'Good' and there was no evidence or information from our inspection and on-going monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

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.

Home Instead Senior Care – Milton Keynes actively promoted a culture that encouraged staff to focus on people as individuals and treat them with kindness, dignity and respect.

The staff were very kind and caring and people’s relationships with staff had a hugely positive impact on their lives. People were supported by staff who were passionate about enabling people to live as independently as possible in their own homes. Staff continually strived to provide individualised person-centred care and ensured that people's privacy and dignity was protected.

People had control of their lives and were empowered to express their choices and wishes.

People were supported in a safe way. Staff understood the signs of abuse and the procedures they should follow to report abuse. People had risk assessments in place to cover any risks that were present within their lives, but also enabled them to be as independent as possible.

Staff recruitment procedures ensured that appropriate pre-employment checks were carried out to ensure only suitable staff worked at the service. Staffing deployment ensured continuity of care. Staffing planners showed that staffing was consistent.

There were safe systems in place for the administration of medicines and people received their medicines as prescribed. Staff supported people in a way which prevented the spread of infection.

Staff attended induction training where they completed an in-depth training programme and had many opportunities to undertake further training. Staff were well supported by the registered manager and senior staff and had regular one to one supervisions.

Where needed staff supported people to have access to suitable food and drink. Staff supported people with health appointments when necessary. Health professionals were involved with people's care as and when required.

Care planning was personalised and considered people's likes and dislikes, so that staff understood their needs fully.

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 service had a complaints procedure in place. This ensured people and their relatives were able to provide feedback about their care to help the service make improvements where required.

Quality monitoring systems and processes were in place and audits were taking place within the service to identify where improvements could be made. The provider needs to ensure th

The inspection was announced and took place on the 28 July. We spoke on the telephone to people who used the service and relatives on the 29 July and 1 August 2016.

Home Instead Senior Care Milton Keynes is a domiciliary care agency providing personal care, support and companionship to people in their own homes. At the time of our inspection the service was providing personal care to 40 people. In addition a further 80 people were being provided with companionship support. The frequency of visits ranged from one visit per week to four visits per day depending on people’s individual needs.

The service had a 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 and associated Regulations about how the service is run.

People felt safe. Staff had been provided with safeguarding training to enable them to recognise signs and symptoms of abuse and how to report them. There were risk management plans in place to protect and promote people’s safety. Staffing numbers were appropriate to keep people safe. There were safe recruitment practices in place and these were being followed to ensure staff employed were suitable for their role. People’s medicines were managed safely and in line with best practice guidelines.

Staff received regular training which provided them with the knowledge and skills to meet people’s needs. They were well supported by the registered manager and had regular one to one supervision and annual appraisals.

People were matched with staff who were aware of their care needs. Staff sought people’s consent before providing any care and support. They were knowledgeable about the requirements of the Mental Capacity Act (MCA) 2005 legislation.

Where the service was responsible people were supported by staff to access food and drink of their choice to promote healthy eating. If required, staff supported people to access healthcare services.

People were treated with kindness and compassion by staff; and had established positive and caring relationships with them. People were able to express their views and to be involved in making decisions in relation to their care and support needs. Staff ensured people’s privacy and dignity was promoted.

People’s needs were assessed prior to them receiving a service. This ensured the care provided would be responsive to their needs. People’s care plans were updated on a regular basis or when there was a change to their care needs. The service had a complaints procedure to enable people to raise a complaint if the need arose.

There was a culture of openness and inclusion at the service. Staff felt that the management team led by example and this inspired them to deliver a quality service. The service had quality assurance systems in place, which were used to good effect and to continuously improve on the quality of the care provided.