Background to this inspection
Updated
11 October 2018
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
This inspection took place on 11 and 12 September 2018 and was announced. The provider was given short notice because the location provides a domiciliary care service and we needed to be sure that someone would be in. This was Home Instead Senior Care's first inspection since registering the new location with the Care Quality Commission. The inspection team consisted of an inspector and an expert by experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service. The expert by experience made calls to six people who used the service and two relatives.
Before the inspection, we reviewed the information we held about the service from the Provider Information Return (PIR). The PIR is a form in which we ask the provider to give us some key information about the service, what the service does well and any improvements they plan to make. We also reviewed other information we held about the service such as from notifications. A notification is information about important events which the service is required to send us by law.
During the inspection we spoke and sought feedback from three caregivers, and the registered manager. We reviewed information about people's care and how the service was managed. This included four people's care records and three people's medicine records, along with other records relating to the management of the service. This included training information, four caregiver’s employment records, quality assurance audits, minutes of team meetings and findings from questionnaires that the provider had sent to people. We also emailed health care professionals for feedback and received one reply.
Updated
11 October 2018
This inspection took place on 11 and 12 September 2018 and was announced. The provider was given short notice because the location provides a domiciliary care service and we needed to be sure that someone would be in.
This was Home Instead Senior Care's first inspection since registering at their new location with the Care Quality Commission. The last inspection at the previous location in May 2017 had found the provider had met all the standards inspected and was therefore rated as good.
Home Instead Senior Care is a domiciliary care provider based in Doncaster, South Yorkshire providing personal care and support to people in their own homes. Home Instead Senior Care is part of a franchise that delivers care to people in many areas of the United Kingdom. This service supports 69 people living in the Doncaster region. The service offered includes personal care such as assistance with bathing, dressing, eating and medicines. The service also offered home help covering all aspects of day-to-day housework, meal preparation and household duties; and companionship services such as spending time with people or supporting people on visits or appointments. Of those 69 people, 19 received personal care and the remainder receive help in their home or companionship. We only looked at the service for people receiving personal care as this is the activity that is registered with Care Quality Commission (CQC).
The staff who support people are known as 'caregivers,' we have called them this in the report. When we visited 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.
People felt safe and caregivers could demonstrate they had a good understanding of abuse and how recognise and report it. The safety of people who used the service was taken seriously and the registered manager and staff were aware of their responsibility to protect people's health and wellbeing. There were systems in place to ensure that risks to people's safety and wellbeing were identified, monitored and reduced. The service responded well, investigated and addressed any issues that arose in line with their policies and procedures.
The provider ensured caregivers knew people prior to supporting them. People received a timetable of who was visiting and had always been introduced to new caregivers before they received support from them. People received a personalised service that was based on their personal needs and wishes. Care plans were detailed and personalised. Caregivers felt they had enough information to meet people's needs, and get to know them.
Changes in people's needs were identified and their care packages were amended to meet their changing needs. The service was flexible and responded positively to people's requests where possible. People who used the service felt able to make requests and express their opinions and views.
Health and social care professionals were regularly involved, where needed, in people's care to ensure they received appropriate care.
People spoke highly of the quality of care provided by the caregivers. Nobody expressed any concerns about any of the care provided.
People received their medicines on time and in a safe way. More information needed to be put in place to instruct staff how to administer as and when required medicines to people.
People who used the service felt they were treated with dignity and respect. Everyone said their caregivers treated them respectfully and kindly and took extra time to make sure their needs were met.
Staff were supported and had opportunities for development. All caregivers said they were fully supported and valued by the registered manager, and the office team. There was a programme of training, clear career progression opportunities and one to one supervision that enabled caregivers to develop their skills and knowledge.
The service had robust recruitment procedures in place for recruiting staff. When selecting caregivers, the service placed a focus on the person's caring nature rather than whether they had previous experience of working in care.
There was good leadership from the registered manager who had the support of a well organised office team.
Caregivers had effective and extensive training and rewards which helped to ensure a stable and skilled staff team. Morale was very good and caregivers said they felt proud to work for Home Instead and they would recommend them and use then with their own relatives.
The provider was developing community connections. They had also worked closely with the fire service, local authority and solicitors to help to develop the service. The providers were very committed to continuous improvement.
All feedback from people, whether positive or negative, was used as an opportunity for improvement.
The providers had a good and effective quality assurance process in place. There were processes in place to monitor quality and understand the experiences of people who used the service.