This announced inspection was undertaken on Tuesday 05 September 2017.

Home Instead Senior Care is a domiciliary care agency based in Salford and provides personal care and support to people in their own homes. At the time of our inspection, there were 32 people using the service. Additional services available include home and dementia care support.

Employees within the service are referred to as ‘Caregivers’, as opposed to staff and we have referred to them in this way throughout the report.

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.

We found there was an exceptional culture within the service. Staff were passionate about ensuring people received a high level of care and support, creating a caring and personalised service. The company had been co-founded by two directors, one of whom wanted to set up the service due to having previous difficulty finding a high quality service for a family member. Both the directors and registered manager had been involved in fund raising events to raise funds for people who had previously used the service and had now passed away. This was being done in memory of the person which demonstrated the caring nature of the service. This included events such as a sponsored walk and a sky dive. In honour of the person and to keep their memory alive, the service had devised ‘The Marshall award’ which would be awarded to caregivers for their continuous hard work and to help them remember the person specifically.

People who used the service and their relatives told us the level of care provided was excellent. We saw numerous examples of where both caregivers and the management team had gone ‘above and beyond’ to meet people’s care needs, requests and personal preferences. A ‘Matching process’ was used and this enabled people who used the service to receive care and support from caregivers who had similar personalities, hobbies and things in common. The service provided a minimum call time of one hour, with some lasting up to four hours and this allowed for genuine, friendly and caring relationships to develop.

The service excelled in areas such as community engagement and partnership working to ensure people were not placed at risk of social isolation and could enjoy their favorite pastimes with support from their caregivers. One of the directors had personally visited numerous facilities within the local area in order to create the WOW (What’s on where guide) so that people had access details and information about any activities and social events they may want to participate in. Other strong links within the community included Trading Standards and Marks and Spencer’s.

The registered manager had also been extremely proactive in raising awareness and sourcing training relating to specific conditions affecting people who used the service such as bowel cancel and Parkinson’s disease. The registered manager had also made arrangements for people to be interviewed via television and radio to share their views and experiences of care in Salford on the back of recent media interest. People had felt valued in having their say and wanted to share a ‘Good news story’ about their positive experience of using Home Instead.

The people we spoke with told us they felt safe. The caregivers we spoke with had a good understanding about safeguarding and whistleblowing procedures and told us they wouldn’t hesitate to report concerns if it may impact on people’s safety.

We looked at how medication was handled at two of the houses we visited and also reviewed MAR charts in the office. We found Medication Administration Records (MARs) were signed by caregivers when medication had been admi