Home Instead Cleveland

This service is a domiciliary care agency. It provides personal care to people living in their own homes in the community. It provides a service to older adults.

Not everyone using Cleveland Care at Home Limited t/a Home Instead Senior Care receives regulated activity; Care Quality Commission (CQC) only inspects the service being received by people provided with 'personal care'; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided. At the time of this inspection 28 people were receiving support which included personal care.

We previously inspected the service in March 2016 and rated the service as good overall. At this inspection we found that the service had improved. The service was found to be outstandingly caring and well led and as a result was rated outstanding overall.

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.

Cleveland Care at Home Limited t/a Home Instead Senior Care ensured people were at the heart of their care and support. People received a high standard of person centred care delivered by staff who were extremely well trained and supported.

People received care from staff who had developed their skills and knowledge through an excellent programme of training that was adapted to suit individual needs. In depth induction training was provided upon commencing employment. Ongoing refresher training was also provided and this was regularly updated to meet the changing needs of the people receiving care.

Staff received high levels of support to enable them to provide outstanding care including regular supervision, team meetings and appraisals.

Staff clearly knew the people they supported and they were carefully matched by considering things such as people's personality, likes, dislikes, hobbies and interests. The service ensured a small and consistent team worked with each person and it was evident that both staff and people using the service benefitted from this approach.

Care was delivered safely by staff who understood how to recognise and report abuse if necessary. People received their medicines as prescribed and clear accurate records were kept. Risks to people were assessed and minimised by careful care planning.

Staff supported some people with food preparation and at times went out of their way to ensure people's nutrition needs were met.

The provider had a strict recruitment process that ensured all necessary checks were conducted to minimise the risk of unsuitable people being employed.

Calls were carefully monitored by office staff and people were alerted if staff were going to be late. There had not been any missed calls.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

Staff ensured people had access to external health professionals and supported them to appointments.

People's care needs were reviewed regularly. Changes to people's needs were monitored by management and staff and calls changed accordingly. Temporary changes could be accommodated at short notice when necessary.

End of life care plans were put in place where appropriate. On one occasion the service was required to provide support at short notice and this was handled in a sensitive way that ensured continuity of care for the person and support for their family.

There was a complaints policy in place and people knew how to raise concerns but no complaints had been made about the service.

Staff members felt they were a highly valued part of the service and very much involved in feedback and decision making. Without exception staff told us they were proud and happy to work for Cleveland Care at Home Limited t/a Home Instead Senior Care.

The service continued to develop strong relationships with partners in the local community. A fraud prevention scheme that was in the early development stage during our last inspection had now been successfully implemented. Fraud prevention information and support was provided not just to people who used the service but also free of charge to the wider community. As a result of the scheme people had avoided falling victim to scams.

There was a very open culture that was driven by a very visible management team. The directors worked alongside the registered manager and office staff and provided hands on day to day support. The directors and registered manager spoke with passion about the service, what they had accomplished and how they wished to improve the existing high standards of care in the future.

The five questions we ask about services and what we found