About the service: Home Instead Senior Care Rugby is a domiciliary care service that was providing personal care to 39 people aged 65 and over at the time of the inspection.

People’s experience of using this service:

¿People continued to benefit from an outstanding effective and well-led service providing outstanding care.

¿The feedback from people and their families was overwhelmingly positive with a consistent theme that people felt cared for and this was more than just a job to the staff.

¿People were at the heart of everything. Their packages of care were bespoke and staff went the ‘extra mile’ to ensure people remained safely in their own homes and in control of their lives.

¿People were treated as individuals and were valued and respected. The staff ensured that people’s privacy and dignity was protected and spent time getting to know people.

¿Staff received exceptional training and the provider continually looked at new and innovative training methods to support staff. The staff took part in regular supervision and were valued for their individuality and what they could bring to deliver high quality care.

¿The provider led by example and ensured staff appointed shared their ethos of providing good quality of care, passing the ‘mum test’; is the care given good enough for my relative? They actively sought feedback from people, their families and staff to continually look at ways to improve the service and were receptive to ideas and suggestions. The service had received recognition for their outstanding care.

¿The systems in place to monitor the quality and performance of the service were highly effective and the provider was quick to address any shortfalls identified.

¿People could be assured that they were cared for by a well-motivated staff team who were well managed.

More information in Detailed findings below.

Rating at last inspection: Outstanding (report published 28 July 2016)

Why we inspected: This was a planned inspection based on the rating at the last inspection. At our last inspection we rated the service Outstanding. At this inspection we found the service had remained overall outstanding improving its rating to outstanding in caring in addition to effective and well-led.

Follow up: We will continue to monitor the service through the information we receive until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

The inspection took place on 30 March 2016 and was announced. We gave the provider 48 hours’ notice because the service is a small home care agency and the registered manager is often out of the office supporting staff or providing care. We needed to be sure they would be in.

`Lutterworth and Rugby’ is a home care agency supporting people who live in their own homes in the Lutterworth and Rugby area. At the time of our inspection 43 people used the service. Of those 19 received personal care; the others received support which we do not regulate.

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 2008 and associated Regulations about how the service is run.

People were cared for and supported by staff who had excellent training and support to ensure that they understood their needs and how to meet them in the best ways. The training was innovative and staff were supported to put their training into practice. People using the service and their relatives spoke about the effectiveness of staff in consistently complimentary and positive terms. Staff were also supported through supervision and appraisal and they valued the support they received, including support to study for further qualifications.

The registered manager understood their responsibilities under the Mental Capacity Act (MCA) 2015. Staff had awareness of the MCA and understood they could provide care and support only if a person consented to it and if the proper safeguards were put in place to protect their rights.

Staff made special efforts to support people to have meals they enjoyed. They also supported people to access health services when they needed them. They had training about people's medical conditions and were able to recognise if a person's health deteriorated. When people needed it they took appropriate swift action to support the person to access health services. People and their relatives told us that they received care and support that had a significant positive impact on their lives.

People using the service and their relatives told us consistently that they held staff in high regard. The registered manager `matched' staff with people using the service which meant people were supported by staff who naturally empathised with them. Staff were caring and knowledgeable about people’s needs. People were consistently supported by the same staff who had developed caring relationships with them.

People were involved in decisions about their care and support. They received the information they needed about the service and about their care and support. They told us the information was clear and easy to understand.

People told us they were always treated with dignity and respect. The registered manager actively promoted values of compassion and kindness in the service.

People contributed to the assessment of their needs and to reviews of their care plans. Their care plans were centred on their individual needs. People knew how to raise concerns if they felt they had to and they were confident they would be taken seriously by the provider. People told us they had never had a reason to raise a concern. When people expressed preferences about their care and support these were acted upon by the service.

People who used the service were consistently safe. They were supported and cared for by staff who had been recruited under highly robust recruitment procedures that ensured only staff who were suited to work at the service were employed. The recruitment procedure placed great emphasis on kindness and compassion and people were not recruited unless they displayed those characteristics. Staff understood and discharged their responsibilities for protecting people from abuse and avoidable