The inspection was carried out on 22 November 2016. The inspection was announced. We carried out a follow up visit on the 24 March 2017 due to additional evidence sent to us by the provider as part of the factual accuracy process.

Home Instead Senior Care is registered as a domiciliary care agency, providing personal care and support to people in their own homes. The office is located in Tonbridge. The services provided include companionship services, home help services and personal care services. People can receive one visit or continued visits and overnight support can be provided when required. The service provides support for older people, some who are living with dementia, as well as people with physical or learning disabilities. The service is a privately owned franchise and the provider was involved in the day to day management of the service. At the time of the inspection the service was providing support to 23 people which included personal care being provided to three people. The care of these three people is the only part of the service that is registered with the Commission and as such our inspection focused on this aspect of the service only. Staff who work for the service and support people in their own home are called ‘Caregivers’, and these staff will be referred to as staff throughout the report.

There was a registered manager for the service, who was also the registered provider. 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 and associated Regulations about how the service is run. We refer to the provider and registered manager as the registered manager throughout this report.

The feedback about the service we received from people was positive. People using the service who received personal care expressed satisfaction and spoke highly of the staff. For example, one person said, “Yes, they (staff) are very helpful and caring”. A person’s relative told us, “We are very happy, they do a really exceptional job.”

People received personalised care that was delivered by staff that understood what was important to them. Staff were skilled in meeting their needs and were creative in tackling challenges. People received a responsive and consistent service from staff they had developed positive relationships with. People who used the service felt they were treated with kindness and told us their privacy and dignity was always respected. Staff understood the importance of promoting people’s independence and ensuring their retained their self-esteem.

The registered manager demonstrated an exceptional commitment to enabling people to live well with dementia. The registered manager had provided free training in dementia for families of the people the service supported. They gave examples of how this training had made a difference to the lives of the people they were supporting.

The service had suitable processes in place to safeguard people from the potential of different forms of abuse. Staff had been trained in safeguarding people and in the whistleblowing policy. The registered manager had carried out risk assessments which included an environmental assessment of people’s homes. Incidents and accidents were recorded and checked by the registered manager to see what steps could be taken to prevent these happening again. The registered manager ensured that they had planned for foreseeable emergencies, so that should they happen, people’s care needs would continue to be met.

The service had robust recruitment practices in place to ensure staff were safe and suitable to work with people. Comprehensive training was provided and training was refreshed at regular intervals. All staff received induction training and they worked alongside experienced staff when they first started employment. Staf

People experienced support and care provided by Home Instead Senior Care staff that met their personal, social and health care needs and ensured their safety and welfare. People were involved in developing their care plans which were tailored to their individual needs and preferences. A relative of a person who used the service told us “[My relative] likes to chat and [staff] always chat with them. It feels like an extended family”. A member of staff told us “I offer choice and encouragement to support people in doing what they want to do”. A relative of a person who used the service told us “The support we have got has exceeded our expectations”.

People were complimentary about the way the support and care was organised. People told us that support workers were reliable and always arrived on time and stayed for the length of time arranged. A relative of a person who used the service told us “[Staff] are always on time”. One person who used the service told us “They are flexible and respond to what we need”

People were protected from the risk of abuse. A relative of a person who used the service told us “I know that [my relative] will be safe when I go out for the day”. A member of staff told us “I am trained to recognise abuse yearly. If I saw anything, I would report it straight away to the manager” There was a system in place that supported people with monies handled by staff on their behalf. A person who used the service told us “[Staff] often do shopping and they complete detailed records”.

People who used the service were supported by trained and supervised staff who knew how to meet their needs. A relative of a person who used the service told us “The training is very good. [Staff] seem to be trained and skilled to do their jobs”. Staff told us “Induction training was very comprehensive” and “The manager does spot checks, I’ve had two” and “There is good support for staff. If you have a problem or something you’re worried about, even if it’s insignificant, you get a phone call immediately and it’s resolved. There is always someone there”.

There was a system in place to regularly assess and monitor the quality of service that people received. People were asked for their views about the service provided, which were acted upon. Relatives of people who used the service told us “[A senior member of staff] has come round about three times with a list of questions and asked how the service is and is everything OK and is there anything else we need” and “I have nothing but praise for Home Instead”.

Home Instead Senior Care was registered in November 2011 and this was the first inspection of the service. It was still a very small service delivering care and support to seven people. We spoke with two people who used the service, a relative, the provider and two staff.

People spoke very positively about the staff and felt that they fully supported their care needs. One person said, “they are very friendly. I look forward to their visits”.

People spoken with told us that their care was personalised to their needs. Comments included, “We’ve finally found a care provider who does what they say they will do. I can’t speak highly enough of them”.

People were aware of their care plan and had their own copy. They confirmed that they and sometimes their family had been involved in discussions about their care, when the service had first started.

People felt that staff had received training and had the necessary skills in order to meet their needs.

People told us that they felt safe when staff visited and if they had any concerns they would speak with the provider. One person said, “Staff have a relaxed attitude and they listen carefully to us”. People, who had used the service for sometime, confirmed they had been asked to give feedback on the service provided. One person said, “With Symone’s (the provider) leadership it’s 100% reliable and good quality”. Another person said, “I can honestly say Symone has not once let us down, I cannot praise them enough”.