About the service: Inspiratus Senior Care Limited is a domiciliary care service supporting mainly older people in their own homes. At the time of our announced inspection the service supported 37 people.

People’s experience of using this service:

We found overwhelming evidence that people using this service received exceptional care from staff who were exceedingly caring and passionate about providing a high quality service. Everyone we spoke with was extremely complimentary about the way the care was delivered. The feedback we had reflected the service provision had a positive impact not only on people but also on people’s relatives. This was due to people receiving excellent care from a very reliable service. This can be summarised by a relative commenting on the staff team, “I think care is the wrong word it is more than that, it is looking after someone with the same love and genuine desire to do their best that a relative would give.”

The culture of the service was one of building positive and consistent relationships with people and their relatives. This included offering people a regular service from staff who were very well trained and supported. People’s rights were respected and they were encouraged to give their views on the service to ensure improvements were made.

The positive feedback from staff in various roles confirmed they were fully involved, felt valued and there was a strong feeling of pride working for the service. To sum up all the good feedback we received from staff. One staff member told us, “I feel privileged to be part of this team.”

Respect for privacy and dignity was at the heart of the service's culture and values. Time was taken to get to know people and the type of support they wanted and needed. Each visit to people was at least one hour and this enabled people to feel cared for in an unhurried way. The caring approach was demonstrated at every level of the organisation. Staff referred to and treated people with dignity and respect. People were supported to remain independent and do as much as they could for themselves.

The staff team responded exceptionally well to people's needs and preferences. Staff supported people to access community places to minimise people feeling isolated. They built trusting and caring relationships with people as staff worked with the same people and could spend time developing meaningful relationships.

The service was exceedingly well run. The provider demonstrated strong values and successfully created a service that put people first and supported staff. There was a person-centred culture amongst the staff team. All staff we met and received feedback from were clear about their roles and knew offering a good service for people was of the upmost importance. The registered manager and care manager worked well together to ensure they knew people’s needs and could offer an excellent service to people. They kept up to date with current good practice and shared this with staff and people using the service.

The provider reflected how the service could be improved and took appropriate action when needed. New electronic systems were in place and these helped staff ensure people received a high quality service. There were excellent systems to assess the quality of the service provided. Regular effective checks on staff and their ability to do their jobs in a safe and caring way meant people could be reassured they were receiving excellent care.

People's support plans and risk assessments were individual and described their needs and preferences. These records were person centred and described ways staff could support people effectively and safely.

People were supported to access health professionals and maintain good diet and nutrition. The provider worked exceedingly well with other health and social care professionals to help people receive coordinated support.

People were supported to have maximum choice and control of their lives and staff supported

We carried out an announced comprehensive inspection of this service on 1 August 2016. A breach of legal requirements was found. After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to a breach of Regulation 12 of the Health and Social care Act 2008 (Regulated Activities) Regulations 2014.

We undertook this focused inspection to check that they had followed their plan and to confirm that they now met legal requirements. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Home Instead Senior Care on our website at www.cqc.org.uk. At this announced inspection on 12 October 2017 we found improvements had been made.

Home Instead provides a range of services to people in their own home including personal care, companionship and shopping in Swindon and the surrounding areas. At the time of inspection there were 55 receiving care under the regulated activity of personal care.

There was not 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. The current manager was registering with the Care Quality Commission to become the registered manager.

People received their medicines as prescribed. Medicine administration records were accurately maintained by staff trained in administering medicines and staffs’ competency to administer medicine was regularly checked and documented. A senior staff member had been appointed as ‘Medicines lead’ who managed all aspects of medicine management.

We were greeted warmly by staff at the service who seemed genuinely pleased to see us and were keen to show us the improvements they had made.

People told us they benefitted from caring relationships with the staff. There were sufficient staff deployed to meet people’s needs and people received their care when they expected. The service had safe, robust recruitment processes in place.

People were safe. Staff understood their responsibilities in relation to safeguarding. Staff had received regular training to make sure they stayed up to date with recognising and reporting safety concerns. The service had systems in place to notify the appropriate authorities where concerns were identified.

Where risks to people had been identified risk assessments were in place and action had been taken to reduce the risks. Staff were aware of people’s needs and followed guidance to keep them safe.

Staff visits were punctual and people told us there were no missed visits. People, staff and records confirmed this.

We carried out an inspection of Home Instead Swindon and Vale on 1st and 2nd August 2016. This was an announced inspection where we gave the provider 48 hours’ notice. This was because the location provides a domiciliary care service and we wanted to make sure the manager would be available to support our inspection, or someone who could act on their behalf.

Home Instead provides a range of services to people in their own home including personal care, companionship and shopping in Swindon and the surrounding areas. At the time of inspection there were 110 clients using the service; 40 of whom were receiving care under the regulated activity of personal care.

A registered manager was in place and available throughout the inspection. 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 and their relatives spoke highly of the staff and said they always treated them with consideration and respect. Staff spoke about how they helped people retain their independence and encouraged them to be in control of their decision making and choices. People said they were cared for in a person centred way and were able to contribute meaningfully in day to day decisions about how their care was provided. Staff spoke fondly about the people they supported and gave good examples of how they developed positive relationships with people using the service. People, their relatives and staff all gave examples of when staff had gone the ‘extra mile’ to help and support people.

People who used the service told us they felt safe. Staff had received training about safeguarding and knew how to respond to any allegation of abuse. Staff were aware of the whistleblowing procedure which was in place to report concerns and poor practice.

There were sufficient staff employed to provide consistent and safe care to people. People said they had regular staff who knew them well and there were suitable arrangements in place to cover any staff sickness.

People said they were satisfied with the support they received with regards to their medicines however; medicines were not always managed safely. The Medicines Administration Records (MAR) did not always provide sufficient information to enable the safe administration of medicines and documentation of medicines administered was not consistently completed. This meant people were at risk of not receiving their medicine as prescribed and according to the labelling. The registered manager told us during the inspection they had recently identified some of the issues in the way medicines were being managed and they were in the process of addressing and rectifying this.

Effective systems were in place to manage risk and ensure people were cared for in a safe way. Risk assessments had been completed and actions recorded to manage identified hazards and concerns.

Staff completed competency assessments as part of their induction followed by regular supervisions and training. Staff were knowledgeable about people’s needs and said they received the necessary training to equip them with the skills they needed to provide the care people required.

Staff had received training around the Mental Capacity Act 2005. Staff explained they understood the importance of ensuring people agreed to the support they provided. Consent forms were filed in people’s care plans, some signed by people receiving care. However, some consent forms had been signed by a next of kin or relative. In some cases, there was a record that the person had a legal right to do this on a person’s behalf but this was not consistent in all care files.

Staff helped ensure people who used the service had sufficient food and drink to meet their needs. Some people wer