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Archived: Careline Homecare (Middlesbrough) Good

The provider of this service changed - see old profile

This service is now registered at a different address - see new profile

Inspection Summary


Overall summary & rating

Good

Updated 29 January 2016

We inspected Careline Homecare (Middlesbrough) on 26 November and 10 December 2015. This was an announced inspection. We informed the registered provider at short notice (48 hours before) that we would be visiting to inspect. We did this because we wanted the registered manager to be present at the service on the day of the inspection to provide us with the information that we needed.

The service is registered to provide personal care to people living in their own homes. The service can provide care and support to older people, people with mental health conditions, people with a learning disability, physical disability or those people who are at end of life. Careline Homecare (Middlesbrough) also provide a rapid response service. The aim of the rapid response is to provide care and support to those people in their own homes whose informal care and support package has broken down unexpectedly and who may have had to go into a hospital or care home because they were unable to manage at home. This service is also provided to people who are discharged from hospital. Healthcare professionals contact the service when a person is identified as needing rapid response. Staff at the service respond by visiting the person at home within two hours of the initial call. This service is provided to people for up to 10 days and then the person is reassessed and their ongoing needs determined.

The home 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.

Systems were in place for the management of medicines so that people received their medicines safely. Care Records we reviewed contained lists of people’s medicines, how they should be administered and what time they should be taken. However we did see some gaps on medicine administration records. Some improvement was also needed for the record keeping of those people prescribed anticoagulants and a second staff member needed to check and countersign medicine records to confirm they were correct.

Assessments were undertaken to identify people’s care and support needs. Care records reviewed contained information about the person's likes, dislikes and personal choices. However some records needed further detail to ensure care and support was delivered in a way that they wanted it to be.

There were enough staff employed to provide support and ensure that people’s needs were met. However people did tell us they would like to receive a rota in advance informing them the name of care staff who would be visiting.

There were systems and processes in place to protect people from the risk of harm. Staff were aware of the different types of abuse and what would constitute poor practice.

Prior to the commencement of the service staff from Careline completed environmental risk assessments of the person’s home. Safety checks looked at the gas and electricity points, equipment to be used and general environment checking for clutter and falls risks. This meant that the registered provider took steps to ensure the safety of people and staff.

There were risk assessments in place for people who used the service. The risk assessments and care plans had been reviewed and updated on a regular basis. Risk assessments covered areas such as mobility, medicines and falls. This meant that staff had the written guidance they needed to help people to remain safe.

Staff told us that the registered manager was supportive. Most staff had received regular and recent supervision. Supervision is a process, usually a meeting, by which an organisation provide guidance and support to staff. Records indicated 86% of staff had received an annual appraisal within the last 12 months. The registered manager told us the remaining appraisals would be completed over the next few weeks.

The majority of staff were up to date with training Staff told us they had received training which had provided them with the knowledge and skills to provide care and support. Any outstanding training had been arranged for early January 2016 to ensure that all staff were up to date with all training. Effective recruitment and selection procedures were in place and we saw that appropriate checks had been undertaken before staff began work. The checks included obtaining references from previous employers to show staff employed were safe to work with vulnerable people.

The registered manager and staff we spoke with had an understanding of the principles and responsibilities in accordance with the Mental Capacity Act (MCA) 2005. The registered manager told us that staff had been trained in the Mental Capacity Act (MCA) 2005. MCA is legislation to protect and empower people who may not be able to make their own decisions, particularly about their health care, welfare or finances.

People and relatives told us that staff treated people with dignity and respect. Staff were attentive, showed compassion, were patient and gave encouragement to people.

People were provided with their choice of food and drinks which helped to ensure that their nutritional needs were met.

Staff at the service worked with other healthcare professionals to support the people. Staff worked and communicated with social workers, occupational therapists, hospital staff as part of the assessment and ongoing reviews.

The registered provider had a system in place for responding to people’s concerns and complaints. People told us they knew how to complain and felt confident that staff would respond and take action to support them.

There were systems in place to monitor and improve the quality of the service provided. Staff told us that the service had an open, inclusive and positive culture.

Inspection areas

Safe

Requires improvement

Updated 29 January 2016

The service was not always safe.

Systems were in place for the management and administration of medicines. However some improvement was needed in respect of the recording of medicines.

Staff were knowledgeable in recognising signs of potential abuse and said that they would report any concerns regarding the safety of people to the registered manager.

There were sufficient staff employed to meet people’s needs. However some people did not receive a rota telling them the names of staff who would be visiting them. Safe recruitment procedures were in place. Appropriate checks were undertaken before staff started work.

Effective

Good

Updated 29 January 2016

The service was effective

Staff had a programme of training and were trained to care and support people who used the service both safely and to a good standard. Most staff had received supervision and an annual appraisal.

The registered manager and most staff had an understanding of the Mental Capacity Act 2005 and had received training.

People were supported to maintain good health and had access to healthcare professionals and services.  Staff encouraged and supported people to have meals of their choice.  

Caring

Good

Updated 29 January 2016

This service was caring.

People told us that they were well cared for. People were treated in a kind and compassionate way.

People were treated with respect and their independence, privacy and dignity were promoted. People were included in making decisions about their care. The staff were knowledgeable about the support people required and about how they wanted their care to be provided.

Responsive

Good

Updated 29 January 2016

The service was responsive.

People’s needs were assessed and care plans were in place. Some plans needed more information to ensure that care and support was provided in a way which was acceptable to the person.

People we spoke with were aware of how to make a complaint or raise a concern. They were confident their concerns would be dealt with effectively and in a timely way.

Well-led

Good

Updated 29 January 2016

The service was well led.

Staff were supported by their registered manager and felt able to have open and transparent discussions with them through one-to-one meetings and staff meetings.

There were systems in place to monitor and improve the quality of the service provided. The service had an open, inclusive and positive culture.