This inspection took place between 14 and 16 November 2017 and was announced. This service is a domiciliary care agency. It is registered to provide personal care to people living in their own houses and flats in the community. It provides a service to older people, people with a physical disability or sensory impairment, younger adults, people living with a mental health condition, dementia or sensory impairment.

At the time of our inspection there were 42 people using the service who lived in Peterborough, Oundle and the Deepings areas. The provider's head office is located on the outskirts of Peterborough.

Not everyone using Home Instead Senior Care - Peterborough, Oundle & The Deepings receives the regulated activity of personal care. 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 our last inspection on 8 December 2015 the service was rated ‘Good’. At this inspection we found the service remained ‘Good’.

A registered manager was in post at the time of the inspection. A registered manager is a person who has registered with the Care Quality Commission (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.

Staff knew what keeping people safe meant. They also knew how to report concerns and the organisations they could contact should they suspect or identify any risk to people's safety.

The registered manager had policies and procedures in place to respond to any accidents and incidents such medicines administration errors. These procedures were effective in driving improvements to help prevent any recurrences.

A robust recruitment process helped ensure that only staff who were deemed suitable due to their skills and suitable character were employed to work with people using the service.

Staff whose competence had been assessed to administer people's medicines did this in a safe way. Medicines were managed in line with current guidance.

Risks to people both in their home, and whilst out in the community had been assessed. These risks were then managed effectively to help ensure people continued to be as safe as they could possibly be. This was as well as any checks required on the equipment people used being completed to make sure it was safe to use, such as wheelchairs.

People continued to be cared for by staff who were supported, mentored, supervised and given the training and skills they needed to help each person live the life they wanted to. The support and care people received helped them to benefit by being enabled to remain as independent as possible.

People were effectively supported with their healthcare and nutritional needs. People were enabled access to healthcare support such as that from a GP in a prompt way.

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 were well looked after and cared for by staff who considered people's equality and any diverse needs. People rights, dignity and privacy was protected by staff.

People contributed to how the service was run, how the quality of care was maintained and how it was improved. This was by face to face meetings, observations of staff's care practises, quality assurance, audit and governance processes and staff's daily contact with people during the provision of their care. Any comments/concerns were acted upon swiftly and to the person's satisfaction.

The registered manager had created an inclusive atmosphere within the service and this had fostered an open and honest staff team culture. Staff were supported in a positive and

Home Instead Senior Care - Peterborough, Oundle and The Deepings is registered to provide personal care and this is for people who live at home. The people receiving the care live with a physical disability or mental health conditions. At the time of our inspection there were 32 people using the agency.

This comprehensive inspection took place on 8 December 2015 and was announced.

A registered manager was in post at the time of the inspection. They had been registered since 8 May 2015. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the agency. 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 agency is run.

People were kept safe and staff were knowledgeable about reporting any incident of harm. People were looked after by enough staff to support them with their individual needs. Pre-employment checks were completed on staff before they were assessed to be suitable to look after people who used the service. People were supported to take their medicines as prescribed.

People were supported to eat and drink sufficient amounts of food and drink. They were also supported to access health care services and their individual health needs were met.

The CQC is required by law to monitor the Mental Capacity Act 2005 (MCA 2005) and the Deprivation of Liberty Safeguards (DoLS) and to report on what we find. None of the people lacked capacity to make decisions about their care. However, the provider was aware of what they were required to do should any person lack mental capacity. This included following their policy and procedure in making sure that people were not unlawfully deprived of their liberty.

People were looked after by staff who were trained and supported to do their job.

People were treated by kind and respectful staff who they liked. They and their relatives were given opportunities to be involved in the review of people’s individual care plans.

People were supported to take part in their hobbies and interests, which included art, eating out, shopping and going for a walk. Care was provided based on people’s individual needs. There was a process in place so that people’s concerns and complaints were listened to and these were acted upon.

The registered manager was supported by a team of office based and care staff. Staff were supported and managed to look after people in a safe way. Staff, people and their relatives were able to make suggestions and actions were taken as a result. Quality monitoring procedures were in place and action had been taken where improvements were identified.

An adult social care inspector carried out this this inspection. The focus of the inspection was to answer five key questions; is the service safe, effective, caring, responsive and well-led?

As part of this inspection we spoke with five people who used the service, four relatives of people who used the service, the management team and four members of care staff. We also reviewed records relating to the management of the service which included five care plans, daily records, staff records and quality assurance monitoring records.

Below is a summary of what we found. The summary describes what people using the service, their relatives and the staff told us, and the records we looked at.

Is the service safe?

People who used the service indicated that their social and health care needs were met in a safe and appropriate way. People also felt safe because they had confidence in the staff members to arrive on time, and they also engaged well with them. Family members of people who used the service said that they felt their relative was kept safe because they were well looked after by the service.

Health and safety risk assessments had been carried out and measures were in place to minimise these, to safely keep people living at home.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards which applies to care services. While no applications had needed to be submitted, relevant staff had been trained to understand when an application should be made, and how to submit one. However, we have pointed out to the provider that members of staff had no access to Deprivation of Liberty Safeguards policy guidance. We expect the provider to take action to remedy this deficiency.

Equipment was available to support people’s individual needs. Members of staff were trained to safely support people with their walking aids and equipment around the home, where this was needed.

There was a sufficient number of trained and competent members of staff employed to provide people with safe and appropriate care, to meet their health and social care needs.

Is the service effective?

People’s choices and decisions about their support and care were respected and valued. People told us that they were actively consulted about their support and care. Changes were made, if needed, to effectively meet people’s choices.

The standard of support and care had enabled people to remain living independently at home. This was where people said they wanted to live. In addition, the support and care increased people’s level of confidence with their mobility.

Is the service caring?

People who we spoke with had many positive comments to make about how they were looked after. They also said that members of staff listened to what they wanted. People also considered that members of staff were well-matched to meet their individual health and social care needs.

Is the service responsive?

People’s individual needs, choices and personal preferences had been assessed and were kept under review.

Members of staff demonstrated to us how they respected people’s choices and decisions about their support and care.

The main aims of the service were to maintain and promote people’s independence and confidence. People who we spoke with and an examination of their care records, confirmed that members of staff supported people to achieve these aims.

Is the service well-led?

Members of staff told us that they had the training and support to safely do their job, which they said they enjoyed. They were trained and supervised so that people who used the service were kept safe and well-looked after.

People who used the service and members of staff, were provided with opportunities to make suggestions and comments to improve the quality of people’s support and care.

A manager’s application to voluntarily cancel their registration has been submitted for the Care Quality Commission to consider. Until this process is completed, the name of the former manager remains on our register. While a vacancy has arisen for a manager to be appointed, the service was being run by a management team. Active recruitment was in progress to fill the registered manager’s vacant position.