This inspection took place on 05 and 06 September 2016. The provider was given 48 hours’ notice because the location provides a domiciliary care service and we needed to be sure the registered manager would be available for the inspection. It also allowed us to arrange to visit people receiving a service in their own homes.

Home Instead Senior Care provides personal care to people living in the areas of Taunton, Wellington, Wiveliscombe, Bridgwater and surrounding villages. At the time of this inspection they were providing personal care for 48 people. They also provided a domestic service to people living in their own homes.

The last inspection of the service was carried out in August 2014. No concerns were identified with the care being provided to people at that inspection. There is 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.

In this report we refer to care workers as CAREgivers as this is the title used by Home Instead Senior Care for their care staff.

People who received personal care and support from Home Instead Senior Care told us they were happy with the service provided. They said the registered manager and staff were open and approachable, cared about their personal preferences and kept them involved in decision making around their care. One person said, “The people in the office are extremely forthcoming. If I have any questions they will ring me. They are very proactive and care for you. They put themselves in your shoes. I am extremely happy. I have nothing but good to say about them.”

People were supported by sufficient numbers of staff who had a clear knowledge and understanding of their personal needs, likes and dislikes. We observed staff took time to talk with people during our home visits. One person said, “I have my regular team who I have got to know very well.” Another person said, “I know who is coming and when. I know them all like old friends now.”

People’s care needs were recorded and reviewed regularly with, senior CAREgivers and the person receiving the care or a relevant representative. All care plans included written consent to care. CAREgivers had comprehensive information and guidance in care plans to enable them to deliver consistent care the way people preferred. One person’s care plan clearly showed how they liked their care provided and the exact routine they liked to follow. The registered manager had also included picture guidance for things such as catheter care so staff could see what the specific catheter looked like.

People also experienced consistent care and support when moving between services. Assistance had been given to one person to ensure they received a care package without delay when they moved to another part of the country.

People were protected from abuse because the provider had systems in place to ensure checks of new staffs characters and suitability to work with vulnerable adults were carried out. Staff had also received training in protecting vulnerable people from abuse. People said they felt safe when being cared for; we observed people were happy and relaxed with care workers during our home visits.

Staff told us they received plenty of training, staff attended the organisations mandatory training which included regular updates of subjects such as, manual handling, dementia awareness, medication, safeguarding vulnerable adults, infection control, health and safety, food hygiene, first aid and nutrition. They also attended training in areas specific to people’s needs such as diabetes care, catheter care and awareness of Parkinson’s. Staff were also supported to attain a nationally recognised qualification such as an NVQ or diploma in he

Home Instead Senior Care provides personal care and support to people living in their own homes. During our inspection we visited four people using the service and spoke to another person who used the service. We spoke to two relatives, the registered manager, a director, the nominated person, and three members of staff.

Is the service safe?

People told us they felt safe receiving the service in their own homes. Safeguarding procedures were robust and staff understood how to safeguard people they supported.

People receiving the service spoke very positively about the services. One person told us they felt that since the service had provided their care the experience had been “Blissful, I now have no worries” People using the service felt the locality of the service was a great benefit, they were always cared for people “they knew and never a stranger”

Systems were in place to make sure that managers and staff would learn from any events that might occur, such as accidents and incidents, complaints, concerns, whistleblowing and investigations. This reduced the risks to people and ensured the service would continually improve.

The registered manager worked closely with staff, people using the service, relatives and other professionals ensuring people’s needs were taken into account. This ensured that people’s needs were always met.

We spoke to people who use the service who told us “The company was easy to contact, any problems were dealt with immediately”

We saw how staff received training, which reduced the risk of vulnerable people being abused and observed safe working practises during our visit.

Is the service effective?

People’s health and care needs were assessed with them and they were involved in writing their plans of care. We were told that care needs were constantly monitored and kept up to date, with changing care needs taken note of. People who use the service told us they “have plenty of time allocated to deliver care, never feel rushed at any time”

The manager told us their phone was manned 24hours a day and could respond to unexpected needs. People told us that out of hours care had been provided when needed.

Is the service caring?

People told us that they greatly appreciated the continuity of carers; they felt the carers really knew and understood them and their individual requirements; this enabled the carer to deliver their care to a very high standard.

We observed the interaction between carers and people receiving the care were respectful with a genuine concern for welfare. We were told that “nothing was too much trouble” People told us they felt very comfortable with the carers and could ask them about any concerns they may have.

Is the service responsive?

People knew how to make complaints if they were unhappy with any part of the service.

We were told the company was very easy to contact, with a quick response. One person told us that during a stressful time the carer stayed with them until the night carer arrived, ensuring they were not left alone.

People who used the service told us they felt the care given was exactly what they wanted, with any extra or new needs responded to very quickly.

Is the service well led?

The service has an effective quality assurance system in place.

The manager and staff worked together to identify any problems and improve the service provided. Staff told us they received strong and effective support from the management, with regular meetings and appraisals. Staff told us the management was very approachable and listened to any suggestions they may make. People told us they had total confidence in the staff and management.