This inspection was unannounced and took place on 30 July and 1 August 2018.

Live in Care is a care service registered to provide personal care to people in their own homes (domiciliary care). The service specialises in providing live in care and support for people in the community. They cover a wide area across the country. Not everyone using the service receives a regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

This was the first inspection since the provider registered the service in August 2017. The service does not directly employ staff. They interview staff and create personal profiles to present to prospective clients who decide on the staff member they prefer. The client then pays the staff member as their employer. The service does maintain an overview of the clients care plans and staff training which is why they are registered with the Care Quality Commission (CQC).

There was a new manager recently employed. The new manager was in the process of registering with CQC. 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.

Previous systems had not been effective in monitoring the quality of the service. The new manager had introduced a system which they had started to use and we saw that action plans were in place and some actions had already been completed. This meant the ongoing improvement of the organisation would be overseen by a system that would be robust in highlighting and managing shortfalls in the future. However, the system was new and had not been used long enough to evidence sustainability. This would be assessed at the next inspection.

People told us they felt safe with the care provided and care workers who lived in their homes. People were protected from harm because the provider had a robust recruitment process and staff received training in how to recognise and report abuse. The new manager had developed an information poster to include in people’s care plans. This gave them the contact details for their local safeguarding teams and other agencies they could seek support and advocacy from. We discussed the need for care workers to have a risk assessment if issues were raised during the recruitment process. This was completed immediately.

There were sufficient staff to meet the needs of people and an ongoing recruitment programme was in place. This meant the staff profiles were available for people to look at and choose from. This enabled people to maintain choice and control over the care package and who they wanted to provide that care.

People were supported by staff who knew their needs and understood the importance of delivering effective care and support. Records showed all staff completed the organisations mandatory training and training relevant to the needs of the people they provided care and support for. Plans were in place to ensure all staff received one to one supervision. Spot checks had been carried out however, this had not been formalised. The new manager explained they had introduced a system when staff would be met regularly and given the chance to discuss their performance through an annual appraisal.

People were supported by staff who were kind and caring. People said, “The carers were very caring and respectful.” And, “My [relative] was cared for with upmost respect and understanding.”

People received care and support that was responsive to their changing needs. Staff had a clear understanding of people’s needs and how to meet them effectively. People were involved in discussing and setting up their care pla