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Inspection Summary


Overall summary & rating

Good

Updated 22 February 2016

We inspected Live-in Comfort on the 17 December 2015 and this was announced. The provider was given 48 hours’ notice because the location provides a domiciliary care service. We wanted to be sure that people would be in the office that we needed to speak with. Live-in comfort supports people in their own home, including those with dementia type illness, physical disabilities, sensory impairment and / or medical (including terminal) illness. They provide staff who live with people to provide regular and consistent care and support to people who wish to retain their independence

and continue living in their own home. On the day of our inspection there were four people receiving support from Live-in Comfort.

The service had a registered manager. 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 considered peoples capacity using the Mental Capacity Act 2005 (MCA) as guidance. People’s capacity to make decisions had been assessed. Staff observed the key principles in their day to day work checking with people that they were happy for them to undertake care

tasks before they proceeded. However there was no formal specific recording where someone may lack capacity to make day to day decisions regarding their care and support. This is an area that needs improvement.

Staff felt supported to carry out their roles and were in regular contact with the registered manager. Staff had received training relevant to the care and support they provided but some of this was not current and needed to be updated. We identified this as an area that needs improvement.

People were supported to have their nutritional needs met and there was detailed guidance in care records as to how to meet these. People were supported to access support from the appropriate health professionals.

Risks to people were assessed and monitored to ensure action was taken to avoid accidents and the deterioration of people’s health. The service had recruited a sufficient number of suitably qualified staff to meet people’s needs. Recruitment practice was robust and protected people

from the risk of receiving support from staff who were unsuitable.

The provider had arrangements in place for the safe administration of medicines. People were supported to receive their medicine when they needed it. People were supported to maintain good health and had assistance to access to health care services when needed.

Staff had a very good understanding of respecting people within their own home and providing them with choice and control. The service had identified people’s needs and preferences in order to plan and deliver their care. People told us staff were kind and caring. One person said I’m very well looked after”.

There were clear lines of accountability. The agency had good leadership and direction from the registered manager. Feedback was sought by the provider. Survey results were positive and any issues identified acted upon. People and relatives we spoke with were aware of how to make a

complaint and felt they would have no problem raising any issues. In respect to the registered manager one relative told us they were “On the ball and has been a great help and guide”.

Inspection areas

Safe

Good

Updated 22 February 2016

The service was safe.

There were processes in place to ensure people were protected from the risk of abuse and staff were aware of safeguarding procedures.

Assessments were undertaken of risks to people who used the service and staff. There were processes for recording accidents and incidents. We saw that appropriate action was taken in response to incidents to maintain the safety of people who used the service.

People were supported to receive their medicines safely. There were appropriate staffing levels to meet the needs of people who used the service.

Effective

Requires improvement

Updated 22 February 2016

The service was not consistently effective.

Staff had an understanding of and acted in line with the principles of the Mental Capacity Act 2005. However capacity assessments were not recorded in people’s care records. This is an area that needs improvement.

Staff had the skills and knowledge to meet people’s needs. Staff received an induction. Some training was not current and needed updating. This is an area that needs improvement.

People were supported at mealtimes to access food and drink of their choice in their homes and assisted where needed to access healthcare services.

Caring

Good

Updated 22 February 2016

The service was caring.

People told us the care staff were caring and friendly.

People’s privacy and dignity were respected and their independence was promoted.

People were involved in making decisions about their care and the support they received.

Responsive

Good

Updated 22 February 2016

The service was responsive.

Assessments were undertaken and care plans developed to identify people’s health and support needs.

There was a system in place to manage complaints and comments. People felt able to make a complaint and were confident that complaints would be listened to and acted on.

Staff were aware of people’s preferences and how best to meet those needs.

Well-led

Good

Updated 22 February 2016

The service was well led.

Staff were supported by the registered manager. There was open communication within the staff team and staff felt comfortable discussing any concerns with their manager.

People we spoke with felt the registered manager was approachable and supportive.

The registered manager carried out regular audits to monitor the quality of the service and drive improvements.