Community Careline Services

Updated 6 July 2022

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

Inspection team

One inspector, one medicines inspector and one Expert by Experience undertook the inspection. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided. At the time of our inspection there was not a registered manager in post. The manager told us they had commenced their application to be registered manager.

Notice of inspection

We gave the service short notice of the inspection. This was because we needed to be sure the provider or manager would be in the office to support the inspection.

Inspection activity started on 13 June 2022 and ended on 23 June 2022. We visited the service’s office on 13 June 2022.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from one professional who worked with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

With permission, we spoke with nine people who used the service and one relative over the telephone. We visited two people and one relative in their homes. We spoke with eight staff members. These included five care staff, the coordinator, the manager who took overall responsibility and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We also asked for feedback via email from all care staff. We looked at a number of records including, three people’s care records and associated documents. Medication administration records, training records, call monitoring, audits and monitoring relating to the operation and management of the service were also reviewed

After the inspection

We continued to receive information and evidence to support the inspection.

Updated 6 July 2022

About the service

Community Careline Services is a domiciliary care service, providing personal care to people in their own homes. At the time of our inspection there were 22 people using the service.

People’s experience of using this service and what we found

The service supported people with taking their medicines however the medicines were not always managed safely. Risk assessments were in place however, these were brief and lacked personalisation. Where risks required addressing, there was no record to confirm they had been undertaken. Staff were safely recruited. However, where gaps in the records were noted with long term staff, the manager told us they would develop a system to confirm these staff were suitable to work with vulnerable people . The provider was planning to introduce a new electronic system to monitor visits. We received some feedback that visits were occasionally missed or late and people felt the service would benefit from more staff. People told us they felt safe, a system had been developed for incident and accident recording, there was some evidence of lessons learned.

Training was being undertaken by staff. Staff told us there was sufficient training for them to undertake their role. People who used the service were confident in the skills of the staff team. Some staff fed back the training would be better spread over some time. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. Consent had been recorded in staff files and consent was sought by staff. People told us they had been involved in the development of the care plans but not always in reviews. Records contained information about their GP to enable staff to seek support and review if required.

People received good care and they were treated with dignity and respect. People provided positive feedback. Policies, guidance and training was available to support good care delivery to people. Care records had been developed however, they were brief and required details about individual needs. Records included information about supporting people with their communication, the service was in the process of introducing a new electronic system for care records. There was some evidence people were supported in activities of their choosing. A system had been developed to record complaints. The records would benefit from more detail in relation to the concerns and the actions taken as a result.

Where audits forms had been developed these had not always been commenced. These would have identified the shortfalls found at this inspection. Regional audits and monitoring had been undertaken however these did not identify the findings we found at the inspection. The call logging system was not being used to monitor the calls. Some people told us they knew who the manager was and was positive about the management of the service. However, others told us about difficulties communicating with the office and one said the service lacked consistency of management. The manager told us about the changes they had made and the improvements planned going forward. Questionnaires had been sent to people and the initial feedback from the manager was positive. There was good information on display in the office along with certificate of registration and employer liability insurance.

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

Rating at last inspection and update

The last rating for this service was inadequate (published 9 November 2021). The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found the provider remained in breach of regulations.

This service has been in Special Measures since 9 November 2021. During this inspection, the provider demonstrated that improvements had been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection.

We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Community Careline Services on our website at www.cqc.org.uk.

Enforcement and Recommendations

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to the safe management of risks, medicines management, and good governance at this inspection. We have made recommendations in relation to, staff deployment and ensuring care records are detailed and individualised.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.