Home Instead Lewes District and Uckfield

Not everyone using the service received a regulated activity. CQC only inspects the service 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 inspection, the service provided personal care support to 14 people.

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.

This was the first inspection of the service. The inspection was carried out on 14 and 18 December 2018 and was announced.

The organisation had identified problems in relation to recording errors around medicine management. Appropriate action had been taken to address these matters but further time was needed to determine if the measures taken had been effective. Record keeping in areas around complaints and some aspects of care plans lacked detail and we made a recommendation to improve record keeping in these areas.

There were effective systems to monitor and review the quality of the care provided. The owner was aware that as the service developed and increased in size, the systems to monitor and review the service would also need to be developed further. The technology to achieve this was being put in place.

People told us they had continuity of care givers. They said care givers always arrived on time and stayed for their allocated time. They told us care givers always completed the tasks required of them along with any additional requests.

People were supported by care givers who demonstrated kindness and had a caring approach. Care givers knew people well. They understood people's physical, social and emotional needs. We received numerous positive comments. One person said, "Yes, they are very good. They are very friendly. Whenever there are any issues they are straight on it. There is always someone on the end of a phone." Another person said, "The standard of the care is very high, they are really nice people. They don't rush, it's almost like having a friend in the house."

People knew how to complain but everyone said they had no need to. They said they would have no

hesitation in picking up the phone if needed as they were confident the office staff would address any issue brought to their attention. One person told us, "I wouldn't be concerned about ringing up the office, in fact they themselves are always encouraging me to ring up if I have any issues."

Care givers had a good understanding of safeguarding procedures and knew what actions to take if they believed people were at risk of abuse. There were thorough recruitment procedures that ensured as far as possible, care givers were suitable and safe to work with people. As part of the assessment process, risk assessments were carried out in relation to people's homes and to their individual needs. Where necessary, actions were taken to mitigate risks to reduce the risk of accidents or injuries.

There was information in care plans about how people liked to take their medicines. Care givers had received training on medicines and there were systems to monitor their competency in this area.

Spot checks were carried out at regular intervals to monitor care giver's performance. Care givers attended regular training to ensure they could meet people's needs. There was a thorough induction to the service and care givers felt confident to meet people's needs before they worked independently. People told us they valued the fact office staff came to check on care givers as this meant they cared about their staff.

The owner and staff had a good understanding of their responsibilities in relation to the Mental Capacity Act 2005 (MCA). The MCA are regulations that have to be followed to ensure people who cannot make decisions for themselves are protected. 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.

Care plans gave staff detailed advice and guidance on how to meet people's needs. People told us they had been involved as part of the process. If professional advice and support was sought then this was included within the documentation. People had the equipment they needed to keep them safe.

The owner worked hard to make the agency known within their local area. They ran a Saturday memory cafe twice a month. This provided a free afternoon of activities and social support for people living with dementia or other health care needs, within the community and their families/carers. They were also on numerous committees and groups that helped them to signpost people to gain support in a variety of different settings. This was particularly important as people generally lived in rural or semi-rural areas.

The five questions we ask about services and what we found