Home Instead Senior Care Reigate & Tandridge

There was a registered manager in post at the time of the inspection. 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. We were supported on the inspection by the registered manager and the senior management team.

At the last inspection, the service was rated Good. At this inspection we found the service had improved in the Caring and Well Led domains. We have rated Reigate Senior Care Ltd 'Outstanding' overall.

Staff found ways to make sure that every person using the service were at the heart of the care they provided. The service was a family run business and people and staff felt that they were part of the provider's family. People were treated as individuals whose life and experiences mattered to the staff. The manager and staff went out of their way to ensure that people and their relatives were comforted and looked after in a kind and compassionate manner and treated with dignity and respect. One member of staff said, "It's important to listen to people and be part of their world." People and relatives were at the centre of decision making about their care.

People and their relatives placed great value on the friendships that they developed with staff. They felt that staff went beyond all expectations in the care that staff provided. Staff would often visit people on their day off to say hello and to spend social time with them. Relatives fed back that using the services had a huge positive impact on theirs and their family member's lives.

The service had a strong, visible person centred culture and was exceptional at helping people to live their lives to the fullest. People, their relatives and staff told us the registered manager and all of the senior staff were caring, friendly and approachable. The registered manager and senior management took a personal interest in people and knew them well. The registered manager worked in partnership with people's families and outside organisations to improve the care and support people received. The registered manager had systems in place which monitored health and safety and the quality of people's support. The systems were responsive and had led to changes being made. The registered manager was proactive with regard to how people's support could be improved.

People told us that they felt safe with staff. Staff understood risks to people's care and what they needed to

do to reduce the risks of injuries to people. Staff had received training in how to safeguard people and what they needed to do if they suspected abuse. Before staff started work checks were undertaken to ensure that they were suitable.

There were sufficient numbers of staff employed at the service and systems were in place to ensure that there were no missed calls to people. People's medicines were managed in a safe way by staff. Staff followed best practice with regards to infection control.

In the event of an emergency such as bad weather there were plans in place to ensure that people's care was prioritised. Accidents and incidents were recorded and actions were taken to reduce the risk of these re- occurring.

Before staff started work they received a detailed induction. Staff told us that they felt supported and that training at the service was effective. People told us that staff knew how to provide care and understood their needs. Training was continuous and staff competencies were reviewed regularly through spot checks and one to one meetings with their manager.

People's opinions were sought in relation to how they wanted their care to be delivered. Staff treated people with kindness, consideration and respect.

People were supported with the meals that that they liked and in line with their dietary needs. Staff monitored people's health and liaised with relevant health care professionals to ensure people received the care and treatment they required. Staff worked within health care social care guidance.

Staff understood the principles of the MCA and what they needed to do if they suspected a person lacked capacity. People received personalised care that reflected their needs, interests and preferences. Regular reviews were undertaken and any changes to people's needs were actioned by staff. The provider had a clear and accessible complaints procedure.

Services that provide health and social care to people are required to inform the Care Quality Commission (CQC) of important events that happen in the service. The registered manager had informed the CQC of significant events including significant incidents and safeguarding concerns.

Further information is in the detailed findings below

The five questions we ask about services and what we found