Home Instead Bath and West Wilts

People's needs were assessed before the service agreed to deliver personal care. Care plans were individualised with people's background information and their preferences. Their abilities to manage their care and how staff delivered personal care was part of the care plan. However, the priorities of care and wishes were not consolidated for one person receiving end of life care. We recommend the provider introduce end of life care plans for people receiving palliative care.

People told us they felt safe with the staff. Safeguarding information and procedures were on display in the office and staff room. Safeguarding referrals were made appropriately.

Systems were in place to manage risk. Where risks were identified individual risk assessments action plans were in place on how to minimise the risk. People's environment was assessed to ensure the safety of people and others.

There was an online system of recording accidents and incident. Reports were reviewed and the follow-up action to prevent any further reoccurrences was detailed They were also analysed to identify patterns and trends such as persistent medicine errors

Staffing levels were determined by the needs of people.

New staff had an induction when they started work for the service. The staff attended the training that ensured people's needs were met and were supported with their performance and development. Performance was monitored through one to one supervision, observations and annual appraisals.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way. People had capacity to consent to their care and treatment. Some people had nominated Lasting Power of Attorney and the provider had checked the status of the legal document with the office of the public guardian. Where people had capacity and deferred consent to their relatives this

needed to be made clear in the documents.

People managed their healthcare. The staff reported concerns about people's healthcare. There were electronic records of health care visits which included the nature of the visits and the outcome.

People and relatives were complimentary about the service. They told us the staff were kind, caring and they would recommend them. They told us their personal care was delivered by staff that knew their preferences and the matching of people to staff ensured relationships were built." We saw photos of when the staff were caring towards people. The staff told us there was always time during their visits to sit and chat with people. The deputy manager told us they ensured the staff employed were caring and compassionate.

Complaints were investigated and resolved. People told us their concerns were resolved whenever they raised concerns.

Quality assurance systems were effective. The national office completed audits of outcomes and the providers developed improvement plans on how to meet shortfalls identified. The views of people and staff about the agency was gathered through questionnaires. Actions were added to the improvement plan from feedback received through surveys.