Archived: Staff Line Home Care Limited

Updated 23 November 2018

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.

The inspection to the domiciliary care service office took place on 14 and 15 June and 5 July 2018 and was announced. The registered provider was given 48 hours’ notice because the location provides a domiciliary care service and we needed to be sure that someone would be in. People using the service and/or their relatives or those acting on their behalf were contacted by telephone on 5 and 6 July 2018. Staff were contacted by telephone on 13 July 2018. On 7 August 2018, feedback of our inspection findings was provided to the registered provider and manager. The inspection was undertaken by three inspectors. One inspector was on site at the domiciliary care office on all three days, one inspector was on site for two days and one inspector was on site for one day.

We reviewed the information we held about the service including safeguarding alerts and other notifications. This refers specifically to incidents, events and changes the provider and registered manager are required to notify us about by law.

We spoke with six people who used the service and 11 people’s relatives. We spoke with two members of staff whilst at the domiciliary care service, the person responsible for facilitating staff training and the registered manager. We also spoke with the registered provider when giving feedback of our inspection findings. We also contacted 10 members of staff by email with the intention of speaking to them about what it is like to work for the organisation. No staff contacted the Care Quality Commission, despite being given additional time to contact us.

We reviewed 12 people’s support plans. We looked at the service’s staff support records for six members of staff. Information relating to staff training provided at the service was viewed. We also looked at the service’s arrangements for the management of medicines, complaints and compliments information and quality monitoring and audit information.

Updated 23 November 2018

Staff Line Home Care provides personal care and support to people in their own homes.

Our previous comprehensive inspection to the service was undertaken between 4 and 17 May 2017. The overall rating of the service at that time was judged to be ‘Requires Improvement’. Five breaches of regulation were highlighted.

This inspection was completed between 14 June 2018 and 21 August 2018 and was announced. At the time of the inspection there were 108 people receiving support from the domiciliary care service.

A registered manager was in post. 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.

Quality assurance checks were not routinely being undertaken to enable the registered provider and registered manager to assess and monitor the service in line with regulatory requirements or to improve the quality of the service. The registered provider and registered manager had not taken appropriate steps to ensure they had sufficient oversight of the service to ensure that people using the service received personalised and responsive care. The lack of managerial oversight had impacted on people and the quality of care provided. The registered provider and registered manager were unable to demonstrate where improvements to the service were needed, how these had been addressed.

People’s comments about staffing remained variable. The service sought people’s views about the quality of the service provided and from this a review form was completed. These demonstrated people did not always receive a consistent service that was caring and our findings in terms of how staff supported people did not concur with people’s comments about a caring service. People did not always know if they were to have a regular member of staff attend to their care and support needs. People told us this impacted on the level of care they received as they would have to tell the member of staff what they needed to do and how they wished their care and support to be provided. People were concerned that the times of visits by staff were inconsistent especially in the evenings and at weekends. Furthermore, people and those acting on their behalf were concerned and unhappy that some members of care staff did not stay very long or for the full allocated time that they should. This also meant we could be assured people using the service always received their medication at the times they needed them and received appropriate nutrition and hydration according to their needs.

The Care Quality Commission had not been notified of safeguarding incidents, despite the service working in collaboration with the Local Authority on several safeguarding concerns since our last inspection in 2017. This was not in accordance with regulatory requirements pertaining to notifications. Where the service had been asked by the Local Authority to undertake an internal investigation and complete a subsequent written report, these were poorly completed. This showed that the management team did not fully understand their role and the relevant safeguarding processes to follow.

People’s comments about the care and support they received was variable. Our findings as discussed with people using the service, their relatives and detailed within review forms, showed people did not always receive a consistent service that was caring or respectful.

Responses to complainants did not always consider all elements of the complaint and responses to professionals and complainants were not always appropriate.

Appropriate arrangements were now in place to recruit staff safely. Risks to people were now assessed, managed and reviewed to ensure their safety.

People’s healthcare needs were managed well. Medication practices and procedures had improved since our previous inspection and although there were still some recurrent errors, these were mainly in relation to records.

Staff received opportunities for training and this ensured staff employed at the service had the right skills and competencies to meet people’s needs. Newly employed staff received a robust induction. Staff felt supported and received supervision at regular intervals and an appraisal of their overall performance. However, where concerns about a staff member’s performance had been raised, there was insufficient information available to show how this was monitored and suitable actions taken to address this with the staff member.

Staff demonstrated a good knowledge and understanding of the people they cared for and supported. People told us their personal care and support was provided in a way which maintained their privacy and dignity. We found that people’s support plans reflected information to guide staff on the care people required to meet their needs.

You can see what actions we told the provider to take at the back of the full version of the report.