Archived: Care Help Line (West Midlands) Ltd

Following our last comprehensive inspection of the service in April 2015 we found the provider was not providing the standard of service we would expect and the service was rated ‘Requires Improvement’ in all areas. During our comprehensive inspection in January 2017 we found the required improvements had been made.

We visited the offices of Care Help Line on 17 January 2017. We told the provider before the visit we were coming so they could arrange to be there and for staff to be available to talk with us about 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. The registered manager was also the provider of the service.

People felt safe with care staff that provided their care and staff understood their responsibility to protect people from abuse. There were processes to minimise risks to people’s safety, these included procedures to manage identified risks with people’s care and for managing people’s medicines safely. Care staff were properly checked during recruitment to make sure they were suitable to work with people who used the service.

People told us they were supported by care staff who they knew and who had the right skills to provide the care and support they required. Care staff understood people’s needs and abilities as they visited the same people regularly and had time to get to know people and read their care plans.

People felt involved in their care and care plans provided guidance for staff about how people liked their care delivered. Plans were regularly reviewed to make sure people continued to have the support they needed.

There were enough care staff to deliver the care and support people required. Care staff received the training and support they needed to meet people’s needs effectively. People told us care staff were kind and respected their privacy, dignity and independence.

The registered manager understood their responsibility to comply with the requirements of the Mental Capacity Act 2005 (MCA). People made their own decisions about their care and had given agreement for the care to be provided. Care staff respected people’s decisions and gained people’s consent before they provided personal care.

People knew how to complain and information about making a complaint was available for people. No complaints had been made about the service in 2016. People and care staff said they could raise any concerns or issues with the management team, knowing they would be listened to and acted on.

The management team checked people received the care they needed by monitoring the time care workers arrived at people’s homes, reviewing people’s care records and through feedback from people and staff.

The provider’s quality monitoring system included asking people for their views about the quality of the service through telephone conversations, visits to review their care and annual questionnaires. There was a programme of other checks and audits which the provider used to monitor and improve the service.

We gathered evidence against the outcomes we inspected to help answer our five key questions; Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people who used the service, the staff who supported them and from looking at records.

If you want to see the evidence supporting our summary please read our full report.

Is the service safe?

We saw people's care had been arranged according to their personal needs. People we spoke with told us they had reviews to make sure care plans were accurate and up to date.

We could not be certain people received the care as recorded in their care plan as records of completed care calls had not been returned to the office for checking.

Some people who used the service were unable to move around without assistance. There was detailed information in care plans for staff about how to move people safely. People told us care workers were competent in using equipment, including a hoist.

We found the process for managing risks associated with people's care was not robust. We could not be certain that people's assessed risks were assessed and sufficiently managed to ensure people remained safe and well.

All the people we spoke with said they felt safe with their care workers and were confident any concerns would be investigated by the service.

We asked people if they thought staff had been properly trained to provide the support they needed. We were told; 'Yes, I think so' and 'Yes, my carer tells me when she has had training.' People told us staff wore protective gloves and aprons when providing personal care.

Is the service effective?

People told us they had been involved in planning their care and the care they received met their needs. We saw care plans had been reviewed and updated so care staff could continue to provide the correct level of support.

Staff we spoke with said they were allocated regular clients and were allocated sufficient time to carry out all the tasks required. People said they had regular care workers who arrived around the time expected and stayed long enough to do everything they needed. People said staff 'logged in' by telephone when they arrived and left. One person told us, 'They (the care worker) have to phone when they get here and before they leave. The office monitors this to make sure they have arrived.'

We found staff had their practice observed to make sure they provided care and support in line with the provider's policies and procedures. Records showed care workers had not completed all the required training to work with people effectively and safely.

We found the quality monitoring systems did not ensure people received the care and support recorded in their care plans.

Is the service caring?

Care plans contained information about people's likes and preferences. This made sure people received care in a way they preferred.

We asked people if care workers treated them in the way they liked. Everyone indicated that people were treated with dignity and respect. Comments from people included, 'They treat me very well.' We asked people if care workers were polite and respected their privacy. One person said, 'Oh yes very polite, my carer is lovely.' People indicated carers were kind and understanding. Comments included, 'Yes, they will do anything for you.'

Is the service responsive?

People told us they were asked for their views and opinions during reviews and any changes were recorded and acted on. People told us that concerns were listened to and acted on.

People told us the service was flexible and responsive to change. One person told us, 'If I have a hospital appointment they are very good about coming earlier.'

Staff we spoke with said the 'on call' system could be improved. We were told, 'If you leave a message they will get back to you, but it could take some time if they are on a care call.'

Is the service well led?

The manager for the service is also the provider. We were told they were in the process of applying to become the registered manager for the agency. It is a condition of registration that Care Helpline (West Midlands) has a registered manager in place.

We found the service had some quality assurance system in place. This included reviews with people who used the service and staff spot checks.

There were no auditing procedures in place for checking people's completed daily care records or medication administration records. We could not be sure staff provided care to people as recorded in their care plans and worked in line with the provider's procedures.

People who used the service told us they were satisfied with the service they received. Comments from people included,

'I had another service before this one. I must say up till now this agency is much better.'

'I have used this agency for about ten years. If I wasn't happy with them I wouldn't use them.'