This announced comprehensive inspection took place on 25 and 26 July 2018. This was the first inspection since the service was registered in July 2017.

Home Instead Senior Care North Devon and Exmoor is registered with the Care Quality Commission (CQC) as a domiciliary care agency. It provides personal care to people living in their own houses and flats.

Not everyone using Home Instead receives 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 time of inspection, there were 14 people who received a regulated activity. The frequency of visits ranged from one a fortnight to two a day. The length of visits ranged from one hour to two hours.

There was a registered manager in post. 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. The registered manager had been in post since the service commenced in July 2017.

People received outstanding individualised care and support from the management team and caregivers. People were put at the heart of the service and their wishes and choices were always respected. Caregivers were dedicated, extremely kind and very caring. They had developed strong, trusting and respectful relationships with people. There was a strong work ethos and staff were extremely dedicated, enthusiastic and proud of their jobs. People told us of staff going the extra mile to support them and examples were given on when this was done. One caregiver said, “We have caregivers I trust to look after my mother and that says a lot.”

People were well respected and valued as individuals. There was a strong, visible person-centred culture. Management and caregivers were highly motivated and offered care and support that was exceptionally compassionate and individual. They demonstrated a real empathy for the people they supported. Respect for privacy and dignity was at the heart of the service’s culture and values.

Caregivers involved people’s families, friends and pets in their care. Relatives felt they were also cared for and supported by staff. A relative commented, “Finding them (Home Instead) was a Godsend … light is now coming from within again which gives me such hope for the future … (family member) is achieving, improving and motivated. We are supported, empowered and listened to.”

There was a strong and knowledgeable management team in place who treated caregivers with the same care as people who used the service. The registered manager employed staff based on whether they would want them to look after their own family member. Staff praised the management team and spoke very highly about them. They felt valued, included and that their opinions mattered. One caregiver said, “From my first point of contact, I knew I was in the right place. A very professional, accommodating and most of all caring organisation to work for. Best care company I have had the pleasure of working with.”

Caregivers undertook a bespoke training package to ensure they were prepared for their care roles. Caregivers were carefully matched with people with the same interests, hobbies and attitudes. People and relatives told us they felt part of a family and safe with the caregivers who supported them.

Strong community links were fostered by the provider who was part of several organisations, particularly related to dementia. Good practice and innovations in practice were introduced into the service where possible. The service had robust quality assurance systems in place and the management team used this information to develop and improve the service. There was a complaints policy in place w