The inspection took place on 20 October 2017 and was announced.

Home Instead Senior Care provides care and support to people in their own homes in the Guildford and Woking areas. The agency provides a range of services to people, including companionship, home help and personal care. This report focuses on the experiences of people who received personal care as part of their support package. Most of the people who use the service are older people, some of whom are living with dementia. The agency also provides services to younger adults who may have learning disabilities, mental health issues, sensory impairment or physical disability. The agency provided services to 102 people at the time of our inspection, 48 of whom received personal care.

There was no registered manager in place at the time of our inspection. Like registered providers, registered managers 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. The agency’s care manager had submitted an application for registration with the Care Quality Commission which was being processed at the time of our inspection. Sarah Daly is the agency’s managing director and the Nominated Individual for the provision of personal care.

The agency adopted a proactive approach to keeping people safe. Staff had implemented measures to reduce not only any risks involved in providing people’s care but also to improve their general safety and security. The measures that had been put in place ensured people were as safe as they could be in their own homes. In several instances staff had taken swift action to protect people from financial abuse or fraud. As a result of the risk many older people faced from financial abuse, the managing director had introduced advice sessions for people about how to avoid becoming a victim of fraud.

People told us they trusted their care workers and felt reassured by their presence. They said they could rely on their care workers and felt safe when staff provided their care. Relatives told us care workers consistently considered how best to keep their family members safe when receiving their care and in their day to day lives.

The agency employed enough staff to ensure that all care visits were covered. People said their care workers had never missed a visit. The managing director told us that the availability of staff to cover visits was always considered before a new care package was agreed. The management team had developed plans to ensure people’s care would not be interrupted in the event of an emergency.

People were protected by the agency’s recruitment procedures. Prospective staff were required to submit an application form and to attend an interview where their suitability for the role was assessed. Applicants also had to provide details of four referees and to produce proof of identity, proof of address and eligibility to work in the UK. The agency had obtained satisfactory references and a Disclosure and Barring Service (DBS) certificate for all staff employed.

Staff understood the responsibility they had to keep people safe. They had attended safeguarding training during their induction and were knowledgeable about the potential signs of abuse. Staff knew how to report any concerns they had about people’s safety or well-being, including outside the agency if necessary.

If an incident or accident occurred, staff recorded the event and the action they had taken in detail. Accident and incident records were reviewed by the management team to ensure that the actions taken were appropriate and to identify any learning points from the event.

Where people’s care involved support with medicines, this was managed safely. Staff had been trained in the safe management of medicines and their competency in this area had been assessed. Staff maintained medicines administration records in people’s homes, which wer