Day and Nightcare Live-in care Ltd

This service is a domiciliary care agency. It provides 24-hour care to people living in their own houses and flats. The agency provides a service to older adults and younger disabled adults. Not everyone using this service receives regulated activity; the 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.

There was 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.

People were safe as staff had been suitably trained and knew how to support people in a way that protected them from danger, harm and abuse. Staff knew how to accommodate support delivered to people so that the risks of harm associated with people's care were minimised.

People were supported to take their medicines safely and in accordance with the prescribed instructions. There were infection control processes and procedures in place to reduce the risks of cross infection.

Most aspects of safe recruitment practices, such as police identity and character checks, were in place. However, the provider had failed to gather full employment history of some of their prospective staff members. The identified gaps in the employment history had not been fully examined and explained. However, this had no impact on the quality of care provided to people.

People received care from staff that had the skills and knowledge to meet their needs. New staff members received an induction to their role and were equipped with the skills they needed to work with people. Staff attended training that was relevant to those they supported and any additional training needed to meet people's requirements was provided.

The service was working within the principles of the Mental Capacity Act 2005. People's consent was sought

before any care was provided.

People had access to healthcare services when needed and staff responded to any changes in people's needs promptly and consistently. People were supported to eat and drink sufficient amounts to maintain good health.

People had positive relationships with the staff members who supported them. Staff were aware of people's likes and dislikes which enabled them to provide people with highly individualised care.

People told us that staff were respectful and caring. Care records guided staff in how people's privacy, dignity and independence should be promoted and respected. People were involved in making decisions about their care and support. People's views were valued and people were encouraged to voice their opinions on how their care was planned for and delivered. People told us they felt listened to.

People were given information in a way they could understand it. There was a complaints procedure in place and people knew how to raise a complaint about the service they were provided with.

There were policies and procedures in place in relation to end of life care. Whilst the service was not currently supporting anyone at the end of their life, staff had received relevant training and were knowledgeable and confident in this area.

Staff received support and guidance from the management team whom they found approachable. People and staff felt able to express their views and felt their opinions mattered.

There were effective quality assurance measures in place used to identify trends and drive improvements.

The service worked in co-operation with other organisations such as healthcare services to deliver effective care and support.

The five questions we ask about services and what we found