This was an announced inspection which took place on 13 March 2018.

Home Instead Senior Care- Reading is a domiciliary care agency. It provides care to people living in their own homes. Not everyone using the service receives a regulated activity. Approximately 48 of 70 people receive a regulated activity. The Care Quality Commission only inspects the service being received by people provided with personal care, help with tasks related to personal hygiene and eating. The agency provides a service to older adults.

At the last inspection, on 16 February 2016, the service was rated as good in all domains and therefore overall good. At this inspection we found the service was still rated as overall good but the responsive domain was rated as outstanding.

There was a registered manager running the service. 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.

People, staff and visitors were protected from harm by staff who had been trained in safeguarding vulnerable adults and health and safety policies and procedures. Staff understood how to protect the people in their care and knew what action to take if they identified any concerns. General risks and risks to individuals were identified and appropriate action was taken to reduce them, as far as possible.

Care staff followed the medication procedure, completed medicine care plans and recorded medicine administration as safely as they could. People benefitted from adequate staffing because the service did not accept a package of care unless they were able to provide staffing to meet the individual’s needs safely. The service followed a robust recruitment process.

People were supported staff who were appropriately trained and well supported to make sure they could meet people’s varied needs. Care staff were effective in meeting people’s needs as described in plans of care. The service worked closely with health and other professionals to ensure they were able to meet people’s needs, as appropriate.

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

People were supported by a highly committed staff team who delivered care with kindness, respect and understanding. They built caring relationships with people to enable them to meet their needs more sensitively. The service and care staff were aware of people’s equality and diversity needs and endeavoured to meet them.

The service was person centred and exceptionally responsive to people’s individual’s needs. It adapted and changed care packages in response to people’s choices and specific needs. People’s needs were regularly reviewed to ensure the care provided was up-to-date. Care plans included information to ensure people’s communication needs were understood.

The registered manager and the management team ensured the service was very well-led. The provider, registered manager, management team and office staff were described by staff as amazingly supportive, open and approachable. The registered manager and her team were totally committed to ensuring there was no discrimination relating to staff or people in the service. The quality of care the service provided was continually assessed, reviewed and improved.

This was an announced inspection which took place on 16 February 2016. Home Instead (Reading) is a domiciliary care service which is registered to provide personal care to people living in their own homes. The service currently provides personal care to 26 people who live in the Reading and West Berkshire area. The agency, mainly, offers care to people who pay for their own care or who have a personalised budget.

There is a registered manager running the service. 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.

People were safe when using the service because staff had been trained and knew how to protect people in their care. Care staff (called ‘caregivers’) had been recruited, using a robust recruitment process, to check they were suitable and safe to work in people’s homes. Risks were identified, recorded and managed to make sure that people and staff were kept as safe as possible.

People were always asked for consent prior to care being undertaken. They were encouraged to make as many choices and decisions for themselves as they could. Staff understood and protected people’s human and civil rights.

Staff were trained, well supported and had the knowledge and skills required to ensure people’s health and well-being needs were met. The service respected people and staff’s diversity by developing individualised care plans and appointing care staff who were able to meet any specific needs people had. The management team and care staff were committed to the people they cared for and often gave care over and above what was in the care contract or was expected from the service.

Staff and people described the registered manager as very supportive and approachable. Staff told us they could approach any of the management team, including the director, who were open and responsive, at any time. The quality of care provided was continually reviewed by the service and people who use it. Developments or improvements were made, as appropriate.

At the time of the visit the provider was supporting around 30 people in their own homes. We spoke with people who used the service; relatives; staff and managers.

People were complimentary about the service, describing staff as "excellent". They felt staff treated them with respect and showed regard for their privacy and dignity. One relative said that staff "went the extra mile" when delivering care. People felt involved in their care and staff felt supported and said they had enough time to carry out their roles.

Staff demonstrated a good understanding of their responsibilities in respect of safeguarding and also felt safe when carrying out their duties.

There were effective mechanisms to monitor quality and to evaluate people's care needs. People using the service and staff were supported in providing feedback on the quality of care provided.

We spoke with people who use the service. One person told us they received a "wonderful service" and they were "very pleased" with the care they received. Another person told us the staff were "polite and friendly" and "very approachable".

Care was planned with the involvement of the people who use the service and reflected individual people's needs.

There were arrangements in place to support workers. Staff received appropriate training and supervision. One member of staff told us the training they received was "very informative and useful".

There were systems in place for the provider to monitor the quality of the service provided and for recording complaints. The people we spoke with were aware of who they would speak to if they had any complaints.