Live Life Care Limited

Updated 17 January 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 27 and 28 November 2017 and was announced 48 hours in advance in accordance with the Care Quality Commission's current procedures for inspecting domiciliary care services.

The inspection was undertaken by one adult social care inspector and an expert by experience. An expert by experience is a person who has experience of using or caring for someone who uses this type of service.

Before the inspection we reviewed information we kept about the service and previous inspection reports. This included notifications of incidents. A notification is information about important events which the service is required to send us by law. This enabled us to ensure we were addressing potential areas of concern. We reviewed the Provider Information Record (PIR). The PIR provides key information about the service, what the service does well and the improvements the provider plans to make.

During the inspection we used a range of methods to help us make our judgements. This included talking to six people that used the service and six relatives, interviewing four staff, pathway tracking (reading people’s care plans, and other records kept about them) and we reviewed other records about how the service was managed.

We looked at a range of records including four care plans, records about the operation of the medicines system, three staff personnel files, and other records about the management of the service. After the inspection we contacted three professionals who were external to the service for their feedback.

Updated 17 January 2018

This inspection took place on 27 and 28 November 2017 and was announced 48 hours in advance in accordance with the Care Quality Commission's current procedures for inspecting domiciliary care services.

The service was last inspected in October 2016, when it was rated as Requires Improvement. This was due to concerns about the safety of the service due to an inconsistent system for ensuring that all commissioned calls had taken place. At this inspection we found the provider had addressed the issue by implementing a new call tracking system which automatically made an alert if a scheduled call was not registered as having taken place within a set time scale. The provider told us, “The new tracking system has been great. It has safeguarded everything we do and is a safety net against missed and late calls. It’s our safety alert that everyone has had their visit.”

Live Life Care is a domiciliary care agency that provides care and support to adults, of all ages, in their own homes. The service provides help to people with physical disabilities and dementia care needs in central and west Cornwall. The service mainly provides personal care for people in short visits at key times of the day to help people safely maintain their independence to live in their homes.

At the time of our inspection 115 people were receiving a personal care service. The services were funded either privately or through Cornwall Council or NHS funding. The service employed 67 staff including management.

The service had 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.

People’s feedback about their experience of the service was positive. People said staff treated them respectfully and asked them how they wanted their care and support to be provided. People told us they had their care visits as planned. Staff arrived on time and stayed for the allotted time. Nobody reported any missed visits.

People confirmed there was a stable staff team and that care was provided by familiar faces. Staff told us that travel times were sufficient, so they were not rushed. People’s comments included, "I get to see the same face; that makes me feel safe”; "They make sure I have something to drink and prepare my meals for the day” and, a relative commented, "They are always on time and they stay their time as well."

Staff were knowledgeable about the people they cared for and responded appropriately as people's needs changed. Staff spoke positively about the people they supported and were motivated to provide an individualised service in line with people's needs and goals. Comments from staff included, "I have worked here for a long time; that says it all for me. I wouldn’t stay if I didn’t think they were a good employer and providing a good service to people we support.”

People had a care plan that provided staff with direction and guidance about how to meet people’s individual needs and wishes. Care plans were regularly reviewed and any changes in people’s needs were communicated to staff. Assessments were carried out to identify any risks to the person using the service and to the staff supporting them. This included any environmental risks in people’s homes and any risks in relation to the care and support needs of the person. People told us they were involved in decisions about their care and were aware of their care plans.

Daily care records were kept; these were predominantly task focused and did not provide adequate detail of the person-centred care and support provided to people. We have made a recommendation about this in the report.

The service worked successfully with healthcare services to ensure people's health care needs were met and had supported people to access services from a variety of healthcare professionals including GPs, occupational therapists and district nurses to provide additional support when required. One healthcare professional told us, “I have always found the service good to work with from the point of view of keeping us aware of any issues with clients. No-one I have assessed has complained about the service.”

Staff were recruited safely, which helped ensure they were suitable to work with vulnerable people. Staff had received training in how to recognise and report abuse. All were clear about how to report any concerns and were confident that any allegations made would be fully investigated to help ensure people were protected.

Staff received appropriate training and supervision. New staff received an induction, which incorporated the care certificate. All staff received an appraisal of their work. Staff comments included, "I think the training is very good. We are always doing refresher training and there are opportunities to do further training in areas like dementia care.”

Accidents and incidents were accurately recorded and reported and any lessons learned were shared with staff. The service learned from any mistakes and used these as an opportunity to raise standards. There was a culture of openness and honesty and staff felt able to raise concerns or suggestions.

People’s rights were protected by staff who under stood the Mental Capacity Act and how this applied to their role. Nobody we spoke with said they felt they had been subject to any discriminatory practice for example on the grounds of their gender, race, sexuality, disability or age.

The service had a contingency plan in place to manage emergencies. Risks to people, in the event of an emergency, had been assessed and rated, in order to identify who would be at the highest risk. There was an out of hours telephone contact service available to people so they could contact staff in an emergency. This demonstrated the provider had prioritised people's care provision during such an event. People were protected as robust processes were in place to manage emergencies.

There was a positive culture within the staff team and staff spoke positively about their work. Staff were complimentary about the management team and how they were supported to carry out their work. The provider and registered manager were clearly committed to providing a quality service to people and aimed to provide leadership by example. For example, the provider herself would undertake caring shifts in the community when needed and told us, “Our vision for Live Life Care is to provide high quality care for people in their local community; as much as possible to ensure people feel part of their community, aren’t lonely and feel valued.”

The provider was keen to provide additional community based services for people experiencing a degree of memory problems. Under the banner of Live Life Care, the provider had established different community groups as a service to people living with dementia. These included social groups to support people to make and keep social connections within their local community.

There were quality assurance systems in place to make sure that areas for improvement were identified and addressed. The service sought the views and experiences of people, their families and the staff in order to continually improve the service. People who used the service and their families told us they felt the service was well led and they felt actively involved in arrangements for their support package.