Background to this inspection
Updated
9 January 2020
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
Inspection team
The inspection team consisted of one inspector and an expert by experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own homes.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
This inspection was announced.
We gave the service notice of the inspection. This was because we needed to be sure that the registered manager would be in the office to support the inspection.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority commissioning and safeguarding teams. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
During the inspection-
We spoke with the registered manager and the deputy manager. We reviewed a range of records. This included four people’s care records and four staff files in relation to recruitment and staff supervision. We also looked at a variety of records relating to the management of the service, including policies and procedures.
We also spoke on the telephone with six staff, four people who used the service and two relatives.
After the inspection
We requested further information from the registered manager to validate the evidence found. This was received, and the information was used as part of our inspection.
Updated
9 January 2020
About the service
Northern Community Care Line is a domiciliary care agency providing personal care to people living in their own homes. At the time of our inspection the service was providing personal care to 50 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.
People’s experience of using this service and what we found
Improvements were needed to the management of people’s medicines to ensure they were safe. Risk assessments were in place, but we noted staff were not always recognising or recording potential risks to the people they supported. Peoples usually received their calls on time. Staff had received safeguarding training and were aware of the action they needed to take in the event they had any concerns.
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. New staff were supported, and staff received supervision and checks on their performance. Staffs’ compliance with training was improving but improvements needed to be made to the training matrix to ensure it was accurate.
People and their relatives told us staff were caring and kind. Staff maintained people’s right to privacy and treated them with dignity and respect. People felt able to express their views and be involved in decisions about their care and support.
Care records were person centred and included relevant information to ensure staff could provide care and support which met their needs. Care records included information about how people communicated. People were aware of how to complain. We saw complaints were recorded and responded to.
Feedback about the service from both people, relatives and staff was positive. The registered manager had continued to make improvements to the service, but we identified systems of governance were not sufficiently robust or effective to ensure the service was fully compliant with all the regulations. Although the service did ask people and staff for feedback, improvements needed to be made to ensure the system and method provided everyone with the opportunity to engage in the process.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was requires improvement (published 17 December 2018). The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection, enough improvement had not been made and the provider was still in breach of regulations. The service remains rated requires improvement. This is the second consecutive inspection the service has been rated requires improvement.
Why we inspected
This was a planned inspection based on the previous rating.
Enforcement
We have identified breaches in relation to the management of medicines and governance. Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.