Community Careline

Updated 28 July 2021

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 Care Act 2014.

Inspection team

The inspection team consisted of two inspectors and one Expert by Experience who spoke to people on the telephone. 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.

The service had a manager registered with the Care Quality Commission. 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.

Notice of inspection

We gave a short period notice of the inspection. We needed to be sure the provider or manager would be in the office to support the inspection. We also needed to arrange to speak with people and for documents to be sent to us.

Inspection activity started on 17 May 2021 and ended on 26 May 2021. We visited the office location on 19 May 2021.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all of this information to plan our inspection.

During the inspection

We spoke with seven people and five relatives about their experience of the care provided. We spoke with eight members of staff including the provider, the registered manager, senior care workers and care workers.

We reviewed a range of records. This included five people’s care records and reviewed multiple medication records. We looked at five staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at further medicine records and quality documentation. We looked at updated information sent to us by the service such as the updated training matrix and new competency forms.

Updated 28 July 2021

About the service

Community Careline is a domiciliary care agency providing personal care to people living in their own homes. At the time of the inspection 38 people were accessing the service. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided.

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

People and their relatives were positive about the support they received from the service. Comments included, “They can't do enough, they are friendly amazing people.” And, “I always felt good knowing that [my relative] was in safe hands.”

However, at the last inspection we identified a number of concerns about how safe, effective and well-led the service was. At this inspection the majority concerns had not been addressed and a number of improvements were still needed.

Quality assurance systems were not robust enough to drive forward improvement. Audits of records and people’s care had not always identified the concerns we found at the inspection. Where issues had been identified these had not always been addressed. The registered manager and provider continued to have regular meetings. However, these meetings had not sufficiently focused on improving quality and actions had not been taken in a timely way.

Staff did not to always have the information they needed to reduce risks to people’s health and wellbeing. Risk assessments were not to always be in place. Some risk assessments continued to be missing important information. The management of people’s medicines continued to need improvement to ensure they were always administered as prescribed. Improvements were needed to infection prevention and control policies and practices. Essential recruitment checks had not always been carried out.

People’s needs were assessed. However, there continued to be limited information for staff in relation to people’s health needs. Staff had not undertaken training in some areas such as epilepsy and diabetes but supported people with these needs. Staff were also not up to date with their refresher training.

People were supported to eat and drink safely. Where people needed support to access health care this was in place. 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. However, the policies and systems in the service did not always support this practice as the registered manager had not checked to ensure relatives had power of attorney in place.

Staff knew how to identify and report abuse. Staff were confident the registered manager would report on concerns raised. Incidents were recorded and actions were taken to reduce re-occurrence. However, there continued to be no systems in place to monitor trends and patterns. There were enough staff to support people.

Staff were positive about the support they received and were regularly supervised and felt listened to. There had been surveys for people and their relatives and staff to seek their opinion on the service. The service continued to work in partnership with healthcare professionals.

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 Requires Improvement (Published on 11 September 2019) and there were breaches in three regulations.

The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection not enough improvement had been made and the provider was still in breach of regulations. The service remains rated requires improvement.

The service has been rated requires improvement for the last three consecutive inspections.

Why we inspected

We carried out an announced comprehensive inspection of this service on 01 August 2019 to the 12 August 2019. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment, good governance and checks to ensure that fit and proper persons were employed.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe, Effective and Well-led which contain those requirements. The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has not changed. This is based on the findings at this inspection.

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

Enforcement

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 discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to safe care and treatment, staff recruitment, staff training and the management of the service at this inspection. We took enforcement action against the provider in respect to safe care and treatment and the management of the service.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.