Community Care Line Services

Community Care Line Services is a domiciliary care agency providing personal care to people in their own homes. At the time of the inspection the service was supporting 240 people. 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.

At the time of the inspection, the location did not care for or support anyone whose primary support need was their learning disability or autism. However, we assessed the care provision under Right Support, Right Care, Right Culture, as it is registered as a specialist service for this population group.

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

Right Support

People received their medicines safely. Medicine errors were reported, and lessons were learned to mitigate risk.

The service made reasonable adjustments for people so they could be fully in discussions about how they received support.

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.

Right Care

The provider promoted equality and diversity in their support for people.

Staff understood how to protect people from poor care and abuse. The service worked well with other agencies to do so. Staff had training on how to recognise and report abuse and they knew how to apply it.

The service had enough appropriately skilled staff to meet people’s needs and keep them safe.

People’s care, treatment and support plans reflected their range of needs, and this promoted their wellbeing and enjoyment of life. Staff and people cooperated to assess risks people might face.

Right Culture

The service provided opportunities for people and those important to them to feed back into the service. Staff were involved in the running of the service, people and staff felt valued.

The provider promoted a positive and inclusive culture which was understood by staff. Staff were kind and caring. People were supported to achieve good outcomes.

People and those important to them were involved in planning their care.

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

Rating at last inspection

The last rating for this service was good (published 28 July 2018).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

On our last inspection in August 2016 the service was rated as requires improvement as improvements were needed with how people were supported to make decisions where they needed help; how risks were assessed and how the quality of the service was reviewed. On this inspection we found improvements had been made.

The service had a registered manager in place at the time of our inspection. 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.

Improvements had been made to ensure that people felt safe and were happy with the care and support they received from staff. Risks to people’s health and wellbeing were now assessed and this was reviewed to ensure people were assisted in a safe manner. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. People were able to make decisions about how they wanted to receive support and when they needed help, decisions were made in their best interests.

The staff understood how to protect people from harm and knew how to raise alerts if they were concerned about people’s welfare. People received assistance to take medicines and records were kept to ensure that this was done safely. There were safe recruitment procedures in place to ensure new staff were suitable to work with people. Staff were provided with opportunities to develop their skills and knowledge to support people effectively.

Staff felt supported by the registered manager. People could comment on the quality of service provision and were informed about improvements the provider planned to make. The staff worked in partnership with other professionals to maintain the care and support people needed.

Community Care Line Services is a domiciliary care agency providing personal care for adults living in their own homes. At the time of our inspection, 242 people were using the service. Community Care Line Services provides personal care for people with a range of needs, including dementia, learning disabilities and physical disabilities.

The service had a registered manager at the time of our inspection visit. 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. The registered manager was not available during our inspection visits.

People were not consistently protected from the risk of avoidable harm. Risks associated with care were not always identified and assessed. People were kept safe from the risk of potential abuse. Staff felt confident to recognise and report concerns.

People were happy with staff who provided their personal care. They were cared for by sufficient numbers of staff who were suitably skilled, experienced and knowledgeable about people’s needs. However, people had mixed views about staff arriving at the times they expected them.

The provider took steps to ensure checks were undertaken to ensure that potential staff were suitable to work with people needing care. However, they could not always demonstrate that staff had received a consistent induction. Staff received supervision and had checks on their knowledge and skills. They also received training in a range of skills the provider felt necessary to meet the needs of people at the service.

The systems for managing medicines were safe, and staff worked in cooperation with health and social care professionals to ensure that people received appropriate healthcare and treatment in a timely manner.

Appropriate arrangements were in place to assess whether people were able to consent to their care. The provider met the legal requirements of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DOLS).

People felt cared for by staff who treated them with dignity and respect. People were supported to be involved in their care planning and delivery. The support people received was tailored to meet their individual needs, wishes and aspirations. People, their relatives, and staff felt able to raise concerns or suggestions in relation to the quality of care. The provider had a complaints procedure to ensure that issues with quality of care were addressed.

Systems were in place to monitor the quality of the service provided and ensure people received safe and effective care. These included seeking and responding to feedback from people in relation to the standard of care. However, the systems did not always identify areas where improvements needed to be made. Checks were undertaken on all aspects of care provision and actions were taken to improve people’s experience of care.

The support was provided by staff who knew the needs of people well and what to do to assist them. People said they had no concerns about the service and knew how to raise concerns should they need to. One person told us, 'We have information about who to speak to if we are not happy, but I've never had to use this.'

The staff received training that was appropriate for their individual needs and provided them with the information they needed to care for the people living in their own home.

The care records did not always contain accurate personal information about the care people needed.

Quality monitoring systems were in place which confirmed the quality of the care was reviewed and monitored.

We found that the provider had taken appropriate action following our last inspection regarding the arrangements for the management of medicines. This meant that people using the service were protected against the risks associated with medicines.

We found that the provider had taken appropriate action following our last inspection to ensure that risk assessments were regularly reviewed. This meant that changes in people's needs were identified and met.

We found that there were discrepancies and gaps in medication records. This meant that people were at risk because the provider did not have suitable arrangements in place for the management of medication.