The inspection took place on 5, 6, 9 and 19 October 2015. This was an announced inspection. At the last inspection in January 2014 we asked the provider to take action to make improvements in maintaining accurate records about people’s care and treatment. At this inspection we found the provider had made progress and these improvements had been made.Careline Homecare (Hartlepool) is a domiciliary care service which provides support with personal care, domestic tasks and shopping to people living in their own homes. At the time of this inspection 275 people were using the service.
The service had a registered manager. 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 found the provider had breached Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was because the registered provider did not have accurate records to support and evidence the safe administration of medicines. We found that prescribed creams and ointments were not being recorded as administered so it was unknown if this had taken place in the right way or at the right frequency.
You can see what action we told the provider to take at the back of the full version of the report.
People using the service told us they felt safe when regular staff supported them. Some people had regular teams of care staff. This made them feel confident in the staff who supported them. Other people said they did not know which care staff would visit them and were not always told if they were going to be late. People and staff told us care staff were not allocated travelling time between calls. This meant people who used the service did not always get their full visit.
Staff completed safeguarding adults training as part of their induction and had annual refresher training. Staff knew how to report concerns and were able to describe various types of abuse. Staff we spoke with said if they had any concerns they would raise them immediately. This meant they knew how to deal with any concerns about people’s safety.
There were enough staff employed to carry out most of the visits that were required, and the agency constantly recruited new staff. The agency made sure that thorough background checks were carried out before staff started to work with people who use the service.
Risks to people’s safety and health were assessed, managed and reviewed. Accidents and incidents were recorded and dealt with effectively by the provider. Where issues had occurred, actions had been taken and lessons learnt.
People and relatives felt their regular staff knew what they were doing and were competent in carrying out their role. People who did not receive regular care workers were less satisfied with the service. For example, some people felt they had new staff too often.
Staff told us they received appropriate training and opportunities to shadow established care staff before doing calls on their own. Staff received regular supervisions, spot checks and appraisals. These were used to identify future training and development needs for each staff member, so that staff were supported with their professional development.
The registered manager understood the requirements of the Mental Capacity Act 2005 (MCA), and told us no one was subject to a court of protection order. Staff received training in MCA and understood how to encourage people who used the service to make choices where they had capacity to do so. Staff knew how to seek appropriate support for people should they lack capacity in the future.
Each person who used the service had an assessment about their nutritional well-being. Where people had needs in this area they were supported with nutrition and making meals as part of their individual care package. Care plans were personalised and included details of people’s preferred way of being supported.
People were positive about the caring nature of the staff. People and their relatives described care staff as lovely, kind and like part of the family. People said their dignity and privacy were respected and maintained by care staff.
People had their needs assessed when they started using the service. This included gathering information about the person to help staff better understand the people they cared for. This information was used to develop personalised care plans so staff could support people in a way that was appropriate to their individual needs. People kept a copy of their care plans in their own homes so they and their care staff could refer to them at any time.
People knew how to complain if they were unhappy and said they would feel comfortable doing so.
People were frequently asked for their views about the service and any issues were acted upon. Feedback from the most recent consultation had been positive.
The service had a registered manager. Staff told us there was a good ethos at the agency and they felt supported by their managers.
The provider carried out annual quality audits which included areas such as safety and security of the office, staffing and the quality of the service. The audit identified some areas for improvement. An action plan listed the shortfalls and deadlines for completion, although there was no evidence that these matters had been addressed or reviewed.