The service was exceptionally caring. Based on companionship led care, the Home Instead model of care has recently won a national award for innovation. The service places a high importance on the building of genuine positive relationships between compatible people and staff, with a clear recognition of the continuing need for professional boundaries. Without exception, people and their relatives said that management and staff were kind and compassionate. One person said, "Lovely. All lovely." A relative said, "They are absolutely brilliant. We could not find anything suitable to meet my relative's needs and then I found out about them. They came to see us both and found out more about what was needed. They then came back with staff name and introduced us. My relative got on with staff name straight away and it went from there. It's such a relief. It really saved my life too." Another relative said," They have been excellent. They just take more care. It's like added TLC (tender loving care). I trust them that relative is receiving proper attention from someone who really cares about them." Staff spoke with passion about their work and talked warmly about the people they supported. One member of staff said, "All the people I support are over 90. I love learning about people's lives and the things they have done. I learn a lot from them you know. It becomes more like a friendship and is enjoyed by both of us." They went on to say, "I go home happy that I have done a good job and I have left my client happy, safe and well." People received care and support from staff that had got to know them well. The relationships between staff and people receiving support demonstrated that dignity and respect was promoted at all times. Supporting people to maintain their independence and control over their own life was key. Several staff told us that due to all visits being a minimum of one hour, they felt able to provide good quality and compassionate support to people because they had the time allocated to do so. They said they never felt they were just there to complete a task and leave. One member of staff said, "I have the same three clients all week and they have just me and another carer. We cover for each other to keep the continuity. We don't have to rush around and there is time to spend with the clients. That is important to people." A relative said, "We only have two carers and they are both excellent. They never let me down and they are always on time." Staff were aware of, and understood each person's diverse cultural, gender and spiritual needs in a caring and compassionate way. Staff told us it was important to treat people differently because they were individuals. We found they took care to consider people's needs in relation to accessible information. For example, one member of staff told us about the support offered to one person. They said, "This person is living with dementia and could not always remember people with confidence. To help them feel at ease, we put a photograph of their two carers up by the front door. Then they could recognise who was at the door and not just let anyone in." The provider demonstrated a strong empathy for people and spoke of the need to understand what is really important to the person receiving support. They told us about the support received by one person to attend Outstanding 11 Home Instead Senior Care Inspection report 17 March 2017 their daughter's graduation. A member of staff also told us about this, and said, "Provider's name really goes out of his way to care. One time he supported a person with a significant physical disability to go to their daughter's graduation in Dorset. He worked out the route, including suitably accessible meal and toilet breaks and took the person himself. This was really important to the person and there was no one else who could take them. That's an example of how they go out of their way to do good things for people." Staff spoke about the importance of family relationships and their role in enabling people to maintain links with those who were important to them. A member of staff said. "The relative of person was in overseas country for a month. In that time, I went in to see them every day to cook a meal and spend time with them. I sent photos to the relative while they were away and arranged for person to face time video link with them so they could keep in touch." The provider told us about efforts that had been made to support a person to reunite with family members they had not seen since the second World War. At the time of the inspection arrangements were being made for the person to connect with their relative via a video link. Another member of staff spoke about the importance of building trust and engaging with family members. They said, "I love seeing my work progress and making a difference in people's lives. For instance, the person I am working with today, we have now built up such a good rapport that their relative has felt able to go out for the first time in a really long time today. That feels great!" Staff wore their own clothes rather than uniforms. The registered manager told us this was because uniforms could create a barrier and make people feel uncomfortable. This put people and staff on a more equal footing. It also upheld their dignity when out in public places as it was not obvious to onlookers that the person was accompanied by staff. Staff were expected to dress appropriately and to carry a company identification badge so that people could easily check their identity.