The inspection took place on 15 August 2017. The provider was given short notice of our inspection in line with our current methodology for inspecting domiciliary care services. At the time of our inspection there were approximately 70 people using the service.

Lifetime Home Care Limited provides personal care and support to people living in their own homes. Care and support is co-ordinated from the main office which is based in the village of Harthill. The agency also provides befriending and domestic services.

Our last inspection took place in April 2015 when the service was rated Good. At this inspection we found the service remained Good.

The provider 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 was safe. People were protected from the risk of abuse and staff received training and were aware of the procedure to follow if they suspected abuse. People’s medicines were managed in a safe way so that people were supported to take their medicines as prescribed. Care records contained information about risks associated with people’s care. Clear guidance was available to ensure any hazards were reduced. Staff told us there were enough staff working with them to support people’s needs. The provider had a recruitment procedure which helped them to employ suitable people.

The service was effective. Staff received training to do their job and felt the support they received was beneficial. Staff understood the principles of the Mental Capacity Act 2005 and involved people in their care and support. Some people required assistance to prepare a meal and this was provided. Care workers also left drinks and snack in easy reach for people. Health care professionals were involved when required.

The service was caring. Staff understood people’s likes and dislikes and provided support in line with their preferences. Staff explained that they respected people’s privacy and dignity by ensuring they knocked on the door when entering their home, and closing curtains when attending to personal care tasks.

The service was responsive. Care plans were person centred and staff ensured that people were involved in their care at all times. The provider had a complaints procedure and people felt able to complain if they needed to. People had confidence that any concerns would be addressed.

The service was well led. People who used the service, their relatives and staff, spoke highly of the management team. We saw systems were in place to ensure people received a good quality service. People had the opportunity to comment about the service.

Further information is in the detailed findings below.

The inspection took place on 15 April 2015 with the provider being given short notice of the visit to the office in line with our current methodology for inspecting domiciliary care agencies. The service was previously inspected on 19 August 2013, when no breaches of legal requirements were identified.

Lifetime Healthcare provides personal care and support to people living in the community. It supports people whose main needs are those associated with older people, including dementia, learning disabilities and physical disabilities, as well as younger people with these conditions. Care and support was co-ordinated from the services office which is based in the village of Harthill. The agency also provides befriending and domestic services.

The service had a registered manager in post at the time of our inspection. 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 and associated Regulations about how the service is run.

At the time of our inspection there were 46 people receiving support with their personal care. We spoke with ten people who used the service and seven relatives about their experiences of using the agency. All the people we spoke with told us they were very happy with the service provided.

People’s needs had been assessed before their care package commenced and they told us they had been involved in formulating and updating their care plans. The information contained in the care records we sampled was individualised and clearly identified people’s needs and preferences, as well as any risks associated with their care and the environment they lived in.

We found people received a service that was based on their personal needs and wishes. We saw changes in people’s needs were quickly identified and their care package amended to meet the changes. Where people needed assistance taking their medication this was administered in a timely way by staff who had been trained to carry out this role.

Policies and procedures were in place covering the requirements of the Mental Capacity Act 2005 (MCA), which aims to protect people who may not have the capacity to make decisions for themselves. The Mental Capacity Act 2005 sets out what must be done to make sure that the human rights of people who may lack mental capacity to make decisions are protected, including balancing autonomy and protection in relation to consent or refusal of care or treatment.

We found the service employed enough staff to meet the needs of the people being supported. We saw people mainly had a team of care staff who visited them on a regular basis. People who used the service praised the staff who supported them and raised no concerns about how their care was delivered.

There was a recruitment system in place that helped the employer make safer recruitment decisions when employing new staff. We saw new staff had received a structured induction and essential training at the beginning of their employment. This had been followed by refresher training to update their knowledge and skills. Staff told us they felt very well supported by the management team.

The company had a complaints policy, which was provided to each person in an information pack given to them at the start of their care package. When concerns had been raised we saw the correct procedure had been used to investigate and resolve issues.

The provider had systems in place to enable people to share their opinion of the service provided and check staff were following company polices.

People we spoke with said they were happy with the care and support received and felt it was delivered in a safe way. One person who used the service said, “They are perfect, I am very happy.” A relative told us, “They were good, I told them what I wanted and they did it.”

Before people received care or treatment they were asked for their consent and the provider acted in accordance with their wishes.

We saw each person had a care file which identified their needs as well as their preferences and any risks associated with their care. People told us they had been involved in planning their care and felt staff respected their opinions and decisions.

People were provided with a choice of suitable and nutritious food and drink. We saw where people needed support in this area it was clearly reflected in their care plan.

There were effective systems in place to reduce the risk and spread of infection. This included staff receiving training in this subject and the provision of protective clothing.

Background checks had been carried out on staff before they started to work at the agency to make sure they were suitable to work with vulnerable people.

People were made aware of the complaints system. People told us information about how to make a complaint was given to them when their care package started. The people we spoke with confirmed that when they had raised any concerns these had been acted on to their satisfaction.

This inspection was to check if the agency had taken action to address the shortfalls we found in records when we carried out our last inspection on 24 July 2012.

We did not speak to people who used the service on this occasion however their experiences were captured through checking records and considering other information we received from the provider.

We found that assessment information had been incorporated into people’s care plans in more detail than at our previous inspection. We also saw the records were more individualised. This meant that staff had access to more detailed information about what support people needed and how they preferred their care delivering.

The people we spoke with said they were very happy with the care and support they received and felt it was delivered in a safe way. They told us staff offered them choice and respected their opinions while helping them to be as independent as possible.

People told us their needs were being met by staff who were competent, reliable and caring. One person said, “They (care workers) know exactly what they are doing.”

The people we spoke with told us they had no complaints about the way they were cared for and supported. They said they had never made any complaints but would feel confident raising any concerns they might have with the care workers or the manager.

When we asked people if there was anything they would like to improve they told us there was nothing and said they were very happy with the care provided. One person told us, “They are better than any other agency that has come to me.” Another person said, “They are brilliant, the best, just amazing.”

One of the four relatives we spoke with told us, “We have no problems whatsoever, we are very satisfied, they are flexible and supportive.” Another relative said, “What they do they do well.”