Archived: Live In Care Ltd

At this inspection we found the evidence continued to support the overall rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

At our last inspection we rated the service good overall but requires improvement in the key area of well-led, where we found one breach of the regulations. At this inspection we found legal requirements had been met and there were robust processes in place to monitor the quality of the service provided and to drive service improvements.

Systems, processes and practices were in place to protect people from the risk of abuse. Risks to people had been assessed and their on-going safety was monitored. People received their medicines safely from trained staff. People were protected from the risk of infection.

The provider had completed relevant checks upon staff’s suitability to be registered and placed in people’s homes on assignment. One of the registered managers took prompt action in relation to one care staff’s file we reviewed to ensure all the required information was available. There were sufficient staff to provide people’s care. The registered managers ensured care staff had the skills, knowledge and support required to provide people’s care.

The provision of people’s care was based on their assessment and legal requirements. 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 supported people to eat and drink sufficient to maintain a balanced diet.

Staff worked together to ensure they delivered effective care, support and treatment. The registered managers also worked in partnership with key organisations in the provision of people’s care as required. This included working with a variety of health care professionals. Arrangements were underway to ensure people could be appropriately supported as they reached the end of their lives.

People and their relatives told us staff were kind and caring. People received their care in an unrushed manner and staff had the time to spend with them. They were involved in decisions about their care. People’s privacy and dignity were upheld, and their independence was promoted during the provision of their care.

People received individualised care that was responsive to their needs. They and their representatives contributed to their care planning and reviews of their care. Staff supported them to maintain relationships that were of importance to them and to pursue their interests. Their views on the service were sought both through regular reviews of their care and independent surveys.

The provision of people’s care was underpinned by a clear set of values, which had recently been reviewed. These included respect, reliance and kindness Day to day management of the service was undertaken by the provider’s two registered managers, who were in turn supported by members of the senior management team. Processes were in place to investigate and action any complaints received or incidents.

The registered manager was also the registered provider. 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.

The service provided bespoke care to people living in their homes. Due to the nature of the support provided, the process of matching people to care workers was integral to the success of any care package provided. We found in many cases that this process had worked well and people received a good level of care from the care worker who lived with them. For these people, the feedback we received included comments such as “The support and care I receive enables me to stay comfortably in my own home.” For other people however, the relationship between themselves and their allocated care worker had either not worked or had subsequently broken down.

Where people had experienced care services from someone who they did not believe was suitably matched, they did not feel that staff had the necessary skills and experience to meet their needs and preferences. In most cases however, where a care worker had not been appropriate, people felt their complaints had been listened to and the situation resolved satisfactorily with the service providing a different care worker.

The service had an on-going programme of training and staff told us that they had the training and support to undertake their roles. Staff demonstrated to us that they were aware of their responsibilities and knew how to undertake their roles. It was however noticed that where staff joined the agency with recent training from another provider, the practical training, such as manual handling had not always been updated until the expiration of the certificate. Consequently this meant that the service had not fully competency checked the skills of these people.

The agency’s office was well organised, but people felt that greater management visibility and closer monitoring of care staff was needed to secure consistently good outcomes.

All people and their relatives felt that they were physically safe from harm. We found that the service had appropriate systems to safeguard people from the risk of harm or abuse and staff were knowledgeable about how to protect people and keep them safe. Robust recruitment procedures helped to ensure that only suitable staff were employed. Detailed risk assessments were undertaken at the commencement of a care package to ensure the safety of both people and the live-in care worker.

Where people were supported with their medicines, this was done safely and appropriately. Staff understood the implications of the Mental Capacity Act and the importance of gaining valid consent from people in relation to the support provided.

The service was responsive to changes in people’s needs people were involved in the planning and reviewing of their care. Each person had a personalised plan of care that reflected their individual needs and preferences. People were assisted to maintain good health and supported to access appropriate healthcare services.

Most people described their live-in care worker as “Kind” and “Compassionate”. Staff demonstrated that they supported people to be as independent as possible and took appropriate steps to ensure they respected people’s privacy and dignity.

We found one of breach of regulations. You can see what action we asked the provider to take at the back of this report