About the service:

CL Lifestyles Night Care Support Somerset is a domiciliary care agency which provides overnight care to people in their own homes. The majority of the support provided is on a short-term basis to support people at the end of their lives and people leaving hospital. At the time of the inspection the agency was supporting 6 people on a long-term basis and additional people each night under the ‘HomeFirst’ scheme and people requiring end of life care. The number of people being supported changed on a daily basis in response to local need.

People’s experience of using this service:

Without exception, the feedback we received from people was very positive. Comments included; “I am very appreciative of this super service. Just can't fault it,” “It couldn't possibly be any better” and “Professional and respectful would describe them. I have complete confidence in them. It has been a huge help.”

People were supported by an agency which had excellent organisational and quality monitoring systems in place. This meant that the service responded to need at short notice and was able to provide high quality care and support.

People received their care safely because staff worked with other professionals to make sure risks to people were minimised. Staff were trained in how to recognise and report abuse which helped to keep people safe.

People were supported by staff who were skilled and experienced which meant they received care that was effective and responsive to the changing needs. Staff liaised with other professionals to make sure people’s health and well-being was monitored and they received the support they needed to meet their needs.

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 promoted people’s independence to help them to regain confidence and maintain their safety.

People could be confident they would receive care and support which met their needs and was provided by staff who were kind and caring. People who received long-term support from the agency told us they received care from a small team of staff who they had been able to form trusting relationships with.

People received compassionate and professional care at the end of their lives. Staff respected people’s wishes and their cultural and religious beliefs. People were fully involved in planning and reviewing their care and felt staff understood and would carry out their wishes.

Rating at last inspection: Good (Published 12/10/2016)

Why we inspected: This was a scheduled/planned inspection based on previous rating;

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

This inspection was announced and took place on 11 August 2016. We gave the provider short notice of the inspection as we needed to make sure we were able to access records and gain permission from people who used the agency to telephone them.

The last inspection of the service was carried out on 30 August 2013. No concerns were identified with the care being provided to people at that inspection.

CL Lifestyles provides personal care and support to people living in their own homes. At the time of this inspection the agency was providing support with personal care to 4 people. The service specialises in supporting and caring for people at the end of their life. Some people would have care for years whilst other people might have just one or two visits according to their needs and family circumstances.

CL Lifestyles had worked in partnership with the National Gold Standards Framework Centre for the End of Life Care to gain accreditation in 2014. The Gold Standards Framework for Domiciliary Care aims to improve care for people in their last years of life. Accreditation indicates the service is providing specialised care to a nationally recognised standard.

There is 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. The registered manager is also the sole provider.

People and their relatives were very complimentary about the quality of the service provided and of the management and staff team. They felt the care was very good. One relative told us “Overall they are the gold standard. The highest compliment I can pay them is that I trust them to care for (my relative) when I am away.” One person told us “I have been receiving support from CL Lifestyles now for almost a year, so far I have found very little to complain about. Overall, very pleased.”

A professional described the service as “Always reliable.” They said working with the service was “always a positive experience.”

There was other feedback that showed how well people had been supported when they had been ill. Relatives felt they had been exceptionally well supported when their relative had been at the end of their life.

People had consistent staff that they were able to build trusting relationships with. This ensured people received care from a small number of staff who they got to know well. This aspect of the service was very much valued by people.

Care was planned and delivered in a way that was personalised to each person. Staff monitored people’s healthcare needs and, where changes in needs were identified, care was adjusted to make sure people continued to receive care which met their needs and supported their dignity and independence.

Staff worked effectively with family members and other healthcare professionals to make sure people were fully supported.

The service had a robust recruitment procedure that ensured staff were thoroughly checked before they began work. Staff knew how to recognise signs of abuse and all said they were confident that any issues raised would be appropriately addressed by the registered manager. People felt safe with the staff who supported them.

There were systems in place to monitor the quality of the service and plan on-going improvements. People using the service and staff felt involved and able to make suggestions or raise concerns.