Archived: Cleeve Link Homecare

Updated 30 March 2015

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 12 and 16 February 2015 and was announced. The provider was given 48 hours notice because the location provides a domiciliary care service and we needed to be sure they would be available.

This inspection was carried out by two inspectors and an expert by experience. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service. The expert’s area of expertise was caring for older people. Prior to the inspection we looked at information we had about the service including notifications and feedback from the local authority commissioning team. Services tell us about important events relating to the service they provide using a notification. Before the inspection, the provider completed a provider information return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.

As part of this inspection we visited 10 people in their homes. We spoke with them and their relatives as well as the staff supporting them. We had telephone discussions with seven people who use the service and 11 relatives. We talked with the registered managers, senior management, six staff based in the office and five staff supporting people in their homes. Prior to the inspection we had feedback from Healthwatch and local commissioners of services. After the inspection we had feedback from social and health care professionals. We reviewed the care records for 10 people using the service, five staff files, quality assurance audits and policies and procedures.

Updated 30 March 2015

This was an announced inspection which included a visit to the offices of Cleeve Link Homecare on the 12 and 16 February 2015. This was followed up with visits to people in their own homes on 13 and 16 February 2015. This service moved offices in August 2014 and this is the first inspection of the service at this location.

Cleeve Link Homecare provides personal care to people living in their own homes in areas around Cheltenham, Tewkesbury, Evesham, Kidderminster and Worcester. Live in 24 is also based at this location and provides full time live in care for people living in England. At the time of our inspection personal care was being provided to over 500 people.

There are two registered managers, one for Cleeve Link Homecare and another for Live in 24. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 and associated Regulations about how the service is run. The registered managers were supported by another manager and senior supervisors.

The provider acknowledged the challenges facing them of delivering personal care to a large number of people across a large area. They had restructured the way the service was provided and staff were allocated to work in an area where a number of people used the service. This was providing greater consistency of care and improving the experience of people using the service and of staff. People commented, “for the last year things have been good”, “a lot better now” and “consistency is so important to me and they have it right”. Quality assurance processes involving feedback from people and staff were used to improve the service and people’s experience.

People raised concerns with us about getting through to the office when using the telephone, the impact of travelling time on people’s visits and understanding staff whose first language was not English. The provider was aware of these issues and had plans in place to improve telephone systems in the office and to tackle the problems of travelling times between visits. They assessed the competency of new staff to speak and write English as well as providing English lessons.

People were kept safe from potential harm and said having a consistent staff team helped them to feel safe. People were protected against hazards and the risk of accidents. Staff were provided with guidance about how to reduce risks to people and how to keep them safe. Staff knew how to keep people safe whether by providing appropriate personal care such as monitoring people’s skin condition to raising concerns about suspected abuse. People knew how to raise concerns. People’s view of the handling of their complaints varied according to their individual experience ranging from satisfied to frustrated with the response to their concerns.

People’s needs were assessed and their care plans provided an individualised account of how they wished to be supported. There were inconsistencies in the quality of records kept in people’s homes. People’s background, routines and preferences were reflected in the delivery of their care and support. There were sufficient staff to meet people’s needs. Arrangements were made to cover in an emergency and support for staff out of normal working hours. Staff were supported to develop in their roles and had access to a range of training. Robust recruitment and selection procedures were followed before staff were appointed.

People were treated respectfully and with kindness. They were asked for their consent before personal care was provided. They were offered choices and discussed with staff how they wished to be supported and cared for. People’s health and wellbeing was monitored and any changes were reported to managers or to health care professionals.