The Home Service (Care Agency) Ltd

The Home Service [Care Agency] Ltd is a domiciliary care service that provides support to people in West Sussex, including in Midhurst, Petworth and Fernhurst. The service has been providing personal care to people since 2009. At the time of our visit the service provided personal care support to 42 people who were living with a range of care needs. This included support being provided to people living with dementia, physical disability, sensory loss, long term degenerative conditions and long term chronic illness.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission [CQC] 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.

At this inspection we found the evidence continued to support the rating of 'Good' overall and there was no evidence or information from our inspection or ongoing monitoring that demonstrated any serious risks or concerns regarding this service. Previously the Caring section of this report was rated as Outstanding. Following the previous report CQC's methods of inspection have changed and the areas that are now reviewed under the Responsive section. The report format is slightly shorter because the overall rating of the service is 'Good' overall.

People, without exception, all spoke very positively about the service they received from this agency and evidence showed that people received a service that met their needs which they were fully involved with. People were 'matched' to care staff who knew them well and exceptionally positive relationships were developed between the carers, the people and people's relatives. We observed that staff who provided care and support were very kind, compassionate, caring and respectful in their approach towards people and their relatives.

People received an exceptionally person-centred service which placed them at the centre of the care and support received. The staff and management team consistently went above and beyond to go 'the extra mile' to help and support people in many individual ways. This enabled people to be as independent as possible and to enjoy active participation in community activities. The wider community benefitted from the kindness of the registered manager with a donation of equipment that enabled people to bird (and squirrel) watch when they may have been unwell while staying in a local hospital. People told us that the support they received from the agency made a real difference to their everyday lives, with one person telling us that the agency had "saved" their life and enabled them to take pleasure in their lives again with strong relationships being developed between the dedicated staff team, people and their relatives. Relationships with external professionals were also very positive and people were supported by the agency to attend medical appointments and to access healthcare professional support when they needed it.

Care staff were well-trained and very well supported with evidence seen of regular supervisions, observations and 'spot checks' that took place to monitor that high standards of care were maintained for people.

Systems and processes, including safe recruitment practices ensured that people were safeguarded from abuse. People received their medicines safely. Care staff were aware of and practiced safe infection control, using the protective equipment that was provided to them appropriately. Staff understood how to support people with behaviours that may challenge at times and did this sensitively with support from the registered manager.

The service provided to people by this agency was extremely person-centred and driven by a passionate team of dedicated care and management staff. Examples were seen of exceptionally kind and caring actions taken by the provider to support not only those people who used the service, but also the wider community. The provider went above and beyond to support people whilst in a local community hospital with their compassionate generosity which enabled people to benefit from the positive effects of observing nature as they convalesced.

This agency was in the process of further developing their expertise in relation to the provision of compassionate end of life care for people who used the service. Health professionals told us that the agency offered a professional service and that the staff at the agency communicated well with professionals involved with people's healthcare needs. The agency provided opportunities for people to engage in coffee mornings and Christmas celebrations which were greatly enjoyed by those who attended.

People were listened to and were involved with their day to care decisions about the care they received. They were supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice. People and their relatives were asked for their views of the service which were included in the way the service was run and developed further.

The service was very well-led by a dedicated and extremely caring workforce. The registered manager was evidently passionate and motivated to provide a positive service for people with a caring approach. The registered manager was actively involved in the day to day running of the service and knew people and care staff very well which enabled them to 'match' people to their carers. People told us how much they enjoyed the positive relationships they had developed with the carers that worked with them.

Further information is provided in the detailed findings below.

The five questions we ask about services and what we found