This inspection took place on 27 and 28 November 2017 and was announced 48 hours in advance in accordance with the Care Quality Commission's current procedures for inspecting domiciliary care services.

The service was last inspected in October 2016, when it was rated as Requires Improvement. This was due to concerns about the safety of the service due to an inconsistent system for ensuring that all commissioned calls had taken place. At this inspection we found the provider had addressed the issue by implementing a new call tracking system which automatically made an alert if a scheduled call was not registered as having taken place within a set time scale. The provider told us, “The new tracking system has been great. It has safeguarded everything we do and is a safety net against missed and late calls. It’s our safety alert that everyone has had their visit.”

Live Life Care is a domiciliary care agency that provides care and support to adults, of all ages, in their own homes. The service provides help to people with physical disabilities and dementia care needs in central and west Cornwall. The service mainly provides personal care for people in short visits at key times of the day to help people safely maintain their independence to live in their homes.

At the time of our inspection 115 people were receiving a personal care service. The services were funded either privately or through Cornwall Council or NHS funding. The service employed 67 staff including management.

The service had 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’s feedback about their experience of the service was positive. People said staff treated them respectfully and asked them how they wanted their care and support to be provided. People told us they had their care visits as planned. Staff arrived on time and stayed for the allotted time. Nobody reported any missed visits.

People confirmed there was a stable staff team and that care was provided by familiar faces. Staff told us that travel times were sufficient, so they were not rushed. People’s comments included, "I get to see the same face; that makes me feel safe”; "They make sure I have something to drink and prepare my meals for the day” and, a relative commented, "They are always on time and they stay their time as well."

Staff were knowledgeable about the people they cared for and responded appropriately as people's needs changed. Staff spoke positively about the people they supported and were motivated to provide an individualised service in line with people's needs and goals. Comments from staff included, "I have worked here for a long time; that says it all for me. I wouldn’t stay if I didn’t think they were a good employer and providing a good service to people we support.”

People had a care plan that provided staff with direction and guidance about how to meet people’s individual needs and wishes. Care plans were regularly reviewed and any changes in people’s needs were communicated to staff. Assessments were carried out to identify any risks to the person using the service and to the staff supporting them. This included any environmental risks in people’s homes and any risks in relation to the care and support needs of the person. People told us they were involved in decisions about their care and were aware of their care plans.

Daily care records were kept; these were predominantly task focused and did not provide adequate detail of the person-centred care and support provided to people. We have made a recommendation about this in the report.

The service worked successfully with healthcare services to ensure people's health care needs were met and had sup

We carried out this inspection 5 and 6 October 2016 and it was announced 48 hours in advance in accordance with the Care Quality Commission's current procedures for inspecting domiciliary care services. The service was last inspected in February 2014; we had no concerns at that time.

Live Life Care Ltd is a domiciliary care agency that provides care and support to adults, of all ages, in their own homes. The service provides help to people with physical disabilities and dementia care needs in Camborne, Redruth and Truro and surrounding areas. The service mainly provides personal care for people in short visits at key times of the day to help people get up in the morning, go to bed at night and support with meals.

At the time of our inspection 131 people were receiving a personal care service. The services were funded either privately or through Cornwall Council or NHS funding. The service employed 53 staff including management.

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.

We had some concerns about the safety of the service. This was because there had been 16 missed calls over the previous six months. People who used the service and families told us they had experienced missed calls and the timing of calls was variable and inconsistent.

People told us they did not always receive care from the same care worker or team of care workers. Some people had spoken with the service management about this issue and wherever possible the service had attempted to rectify this. However, we found continued issues with how the staffing rotas were operating. This had resulted in a number of missed visits, significant time variations between pre-arranged calls and calls where two staff members were required and one staff member undertook the call alone. People who used the service told us, “The main difficulty with the service is the uncertainty about the time of the carer’s arrival. It is difficult to plan your day when the carer can arrive anytime between 8:15am and 10:15am for a nominal 9 am appointment” and “We never know which carer is scheduled to come. I appreciate we can’t expect a seven day service from the same person, but it would be good if we had fewer carers” and “The same faults occur regularly. Arriving later than agreed time schedule, as it means I am then late for agreed appointments” and “At one time I had the same care workers regularly but for many months there has always been someone new.”

People who used the service commented favourably about the quality of care provided by staff saying, “The carers they supply are kind and considerate” and “I am very happy with my care. Any concerns raised by my family were dealt with effectively”

The service had a contingency plan in place to manage any emergencies. Risks to people, in the event of an emergency, had been assessed and rated, in order to identify who would be at the highest risk. There was 24 hour telephone contact available to people to be able to contact staff in an emergency. This demonstrated the provider had prioritised people's care provision during such an event. People were protected as robust processes were in place to manage emergencies.

Staff were recruited safely, which helped ensure they were suitable to work with vulnerable people. Staff had received training in how to recognise and report abuse. All were clear about how to report any concerns and were confident that any allegations made would be fully investigated to help ensure people were protected.

Staff received appropriate training and supervision. New staff received an induction, which incorporated the care certificate. All staff received an appraisal of their work.

We found that since our last visit to Live Life care Limited in September 2013, there had been improvements in the areas of safeguarding, supporting workers and record keeping.

We reviewed 27 questionnaires that the agency had recently received from people who used the service or their representative in respect of how they saw the service they received from Live Life care. The comments received in the questionnaires were all positive. Comments included; “I am very pleased with the care”, “keep up the good work”, “brilliant”, “complete satisfaction” and “carers are all friendly, helpful, couldn’t wish for better”. The registered manager confirmed they had not received any concerns or complaints since our last visit. At the time of our inspection, there was a tendering process taking place with the local council. We were told this had caused anxiety for some people who used the service. As we had received positive comments from people who used the service on our last inspection and viewed the recent positive questionnaires , we did not contact people who used the service directly on this visit.

People who use the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.

People were cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard.

People were protected from the risks of unsafe or inappropriate care and treatment because accurate and appropriate records were maintained.

We visited and spoke to four people who received care from Live Life Care. Everyone we spoke to was very positive about the care they received and told us the staff were “very good” and one person said “could not wish for better people”.

The care plans we looked at directed and informed staff as to how the care was to be provided. They included “offering [the person] a choice of clothes” and “greeting [the person] with their preferred name”

The recruitment process was robust and training was provided frequently.

A newsletter was produced by the service and posted to the peoples homes. We were shown a copy which contained information about the service, advice for individuals concerning benefits and details regarding a dental service. There was a competition included and we saw three entries from people who received care from the service.

We reviewed all the information we hold about this provider, carried out a visit on 19 March 2012, talked with people who use services, talked with staff, checked the provider’s records, and looked at records of people who use services.

People told us that the staff that visit them are usually good timekeepers, and they were positive about the carers themselves saying that they had no complaint about them as individuals or the care provided.

We spoke with four people who received care from Live Life Care. Everyone said they were treated respectfully and received the care and support they expected. People were satisfied they received continuity of care because they usually saw the same care workers.

Care plans recorded peoples' preferences and choices regarding their personal care and support needs. However old information in people's care plans was not always removed which could cause confusion. Risk assessments did not always guide staff on how to manage identified risks.

There were not adequate systems in place to enable staff to fully protect people from the risk of abuse.

Live Life Care operated a consistently effective recruitment procedure in order to ensure that the people they employed were of good character, suitably qualified, skilled and experienced.

Staff were not appropriately supported to enable them to deliver care and treatment to people who used the service safely and to an appropriate standard.