About the service: Livingwell Care - 301 Vicarage Road is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to adults and children. At the time of the inspection 27 people received personal care support from the service. The office is based in Kings Heath Birmingham. The service provides care and support varying from short visits to 24 hours a day support.

People’s experience of using this service:

People told us they felt safe being supported by Livingwell Care - 301 Vicarage Road. People told us they were made safe by the care they received. Staff told us they had appropriate training, knowledge and support to keep people safe. Staff could tell us how they managed risk and behaviours that challenge that respected the person and supported their dignity.

People and their relatives we spoke with felt confident in the management. They told us there was a caring culture within the service and staffing levels were appropriate.

We looked at how the management team planned their rotas. Staff were given travelling time between each person they visited. People told us they always received their full allocated visit times.

Staff told us they had regular clients and positive relationships had been built. One staff member told us, “When [person] is living in the moment and remembers me, it makes my day.”

It was clear staff morale was good and everyone was committed to ensuring people received care and support based on their preferences and life choices. The registered manager told us the low staff turnover allowed positive relationships to be built with people receiving support and strong teamwork to develop. People who used the service expressed positive views on how they were treated by staff.

Care plans had been developed with people and their relatives being involved throughout the process. These were regularly reviewed to reflect people’s current needs. The management of risk was included within the care plan to minimise the likelihood of preventable harm occurring.

Staff files we looked at evidenced the registered manager used the same safe recruitment procedures we found at our last inspection. Staff told us training was ongoing and they were supported to gain vocational qualifications in health and social care.

There was a complaints procedure which was made available to people and their family. People we spoke with told us they were happy with the support they received.

The service continued to have good oversight of relevant procedures through monitoring and auditing to ensure people received effective support and the service was well led.

The registered manager used a variety of methods to assess and monitor the quality of the service. These included questionnaires to seek their views about the service provided. We noted activities were provided as part of the care people received. Staff told us they supported people to activities that enhanced their physical and mental wellbeing.

The service engaged with outside agencies to ensure people received timely healthcare support. The management team engaged with other agencies to gain updates on legislation, best practice and learn from other providers experiences.

More information in the full report.

Rating at last inspection:

Good (Report published 16 April 2016)

Why we inspected:

This was a planned inspection based on the rating at the last inspection.

Follow up:

We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme or if any issues or concerns are identified.

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

This inspection took place on 22 March 2016 and was announced. We gave the provider 48 hours’ notice of our visit because the location provides a domiciliary care service; we needed to make sure that there would be someone in the office at the time of our visit.

We last inspected this service in November 2013. At that time they were meeting the requirements of the law and the people they were supporting.

Livingwell is registered to deliver personal care. They provide care to people who live in their own homes within the community. There were 34 people using this service at the time of our inspection.

The registered manager was present during 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 2008 and associated Regulations about how the service is run.

People and their relatives told us that the service provided to them was safe. Staff had been provided with knowledge to protect people from harm and knew what actions to take in line with safeguarding procedures.

Staff told us they had access to a range of training opportunities to provide them with knowledge and skills to fulfil their role. Staff told us they felt supported and received regular supervision.

People told us that staff supported them with the preparation of meals which they enjoyed.

People told us they had access to health care professionals when necessary to maintain their health.

Staff maintained people’s privacy and dignity whilst encouraging them to be as independent as possible. People told us they were involved in making decisions about their own care needs.

People and their relatives told us they were involved in the planning of their care. Care plans contained individual information about people's preferences and support needs.

Systems were in place for people to make a complaint.

People and staff we spoke with spoke positively about the registered manager. The service actively sought feedback from people and those that mattered to them through questionnaires, home visits and phone contacts about the quality of the service.

The registered manager undertook regular checks on the quality and safety of the service.

People were supported to give consent to the care that they received and we found that staff had a good understanding of the principles of 'person centred' care. People benefited from appropriate arrangements to assess their needs and plan, provide and regularly review care that met their needs and protected their rights. We found that each person had an assessment of their needs that was reviewed regularly and that care plans individual to them to meet those needs were in place. Risks presented by people's complex needs and conditions were assessed and managed to support their safety and independence. One person told us "The service is flexible and the carers are fantastic. I know I can trust them."

Action is taken to identify and prevent abuse from happening in the service. Staff that we spoke to were clear about their responsibility to report concerns that they had about people's welfare, in line with the provider's policy. They were confident that the manager would listen and take appropriate action. People who used the service told us that they had easy access to office staff and regular contact with the manager. One person said "If I had any concerns I would talk to [the manager], she would understand."

We found effective recruitment and selection processes in place which meant that people's health and welfare needs were met by staff who were fit to do their job. People told us that they had confidence in the staff that cared for them or their relative.

The people we spoke with who received personal care from the agency and their relatives were happy with the quality of care provided. One person told us the staff said “If you want me to do anything differently, just tell me.”

People and relatives told us that the agency had carried out an assessment before the service started and that they had a copy of the care plan in their home.

People told us they were happy with the support they received and that it met their needs. People told us that they were treated with respect and that staff helped them to be as independent as possible. They told us that staff completed the care and support required.

People and relatives we spoke with said they could raise concerns if they were not happy with the care being provided and they were confident they would be taken seriously.

We found that people who used the service and paid the provider for the services they received, knew how much they were expected to pay, when and how. People were given reasonable notice in writing of any increase in fees. People were billed in a timely manner for the services they received and the agency had a proper system for managing fees.

People’s needs were assessed and care was planned and delivered in line with their individual care plan. Care plans were in place for a range of the person's needs and were regularly reviewed and updated. Risks presented by people's needs or condition were assessed and managed to achieve a balance of safety and independence.

People were very positive about the service they received: "They are first class, I've been with them for five years"; "They have never let me down."; "All the carers are great with him. My [relative] is very comfortable to ask them to help him".

We found that the service had an updated statement of purpose to inform people of the services that it offered. The service was well led and managers were accessible to people and to the staff. Staff were highly motivated, had time to spend and talk with people they looked after and undertook regular training to meet people's needs.