We carried out a review of the data available to us about Careline Homecare (Newcastle) on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Careline Homecare (Newcastle), you can give feedback on this service.
Careline Homecare (Newcastle) is a domiciliary care agency. It provides personal care to older people and people with disabilities living in their own homes.
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. There were 129 people receiving personal care at the time of the inspection.
People’s experience of using this service and what we found
People we spoke with were positive about the service they received. They said staff wore appropriate Personal Protective Equipment (PPE). Their comments included “They (the carers) wear aprons, gloves and masks which they put on before they come into my house. They take them with them when they leave the house” and “The carers definitely wear aprons, gloves and masks all of the time. They dispose of the gloves in my bin as they leave the house, but they keep the masks on until they are outside the house.”
People told us they felt safe with the care provided. Their comments included “I really am quite happy with the carers as they are very pleasant and provide me with all of my needs. They are all very friendly and do everything I ask of them” and “I don’t have any worries when they (the carers) come. They are very kind and gentle with me.”
The provider followed safe recruitment practices. There were sufficient staff to meet people's needs safely. Staff’s attendance at care calls was monitored electronically to ensure no care calls were missed. Staff logged in on arrival at a person’s home. If this wasn’t done within 15 minutes of the call time an alert was sent to the office staff who would find out where the staff member was.
Staff had completed infection and prevention control training and were able to explain the correct procedures for putting on and taking off PPE.
Quality assurance audits, including spot checks, were completed to ensure safe infection control practices were being followed.
Staff spoke positively about the support they received from the registered manager and office staff. Additional resources were available to support staff’s mental health and wellbeing.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published 16 January 2020).
Why we inspected
We received concerns in relation to infection prevention and control and staffing. As a result, we undertook a targeted inspection to review the key question of safe, looking at infection control and staffing only.
We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.
We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe section of this full report.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
Careline Homecare (Newcastle) is a domiciliary care agency. It provides personal care to older and people and people with disabilities living in their own homes.
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. There were 60 people receiving personal care at the time of the inspection.
People’s experience of using this service and what we found
People received high quality, individualised care from an exceptionally well-led service. The registered manager was passionate and proactive in following best practice, continuously improving and engaging with people, relatives and staff.
The registered manager was innovative in introducing new ways of working. They were dedicated to making sure people received the best care they could and worked closely with the local authority and other organisations to influence and improve the delivery of adult social care.
People received personalised support. People’s needs were assessed and care was planned to meet their preferences and choices. Staff were given very detailed information to support people. The service was reliable. Staff were punctual and had always attended planned visits.
People were supported by a small team of consistent staff. People told us they were very happy with their staff team. Staff demonstrated caring values. People told us staff treated them with respect, were friendly and considerate.
The service was safe. Staff understood the risks people faced and took steps to minimise them. Staff recognised the signs of abuse and reported their concerns to the registered manager. Medicines were well- managed, and staff minimised infection control risks.
There were enough staff employed to manage the service safely and effectively. Staff undertook a training programme which helped them to provide high quality care to people. Their skills and understanding were regularly checked to make sure they had the knowledge and values to deliver people with safe and compassionate care.
People had achieved positive outcomes through good support from staff. Staff supported people to access external healthcare professionals whenever they were needed.
People were supported to have maximum choice and control of their lives and were supported in the least restrictive way possible. Staff assisted people to regain or maintain their independence wherever their ability allowed.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published 22 February 2017).
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
We previously inspected this service in August 2015 when we identified the service required improvement. At that time, the provider continued to breach Regulation 12 of the Health and Social Care Regulations relating to management of medicines from an earlier inspection in February 2015. We also issued the provider with a fixed penalty notice for failing to display their previous CQC performance rating. Following the inspection, the provider sent us an action plan which detailed how they planned to address the areas of improvement and the date of when they would be compliant. This inspection took place on the 30 December 2016 and 4 January 2017 and was announced.
The service had a new registered manager 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.
The registered manager had a history of managing domiciliary care services and the staff we spoke with told us they found her supportive and approachable. The registered manager had a clear vision for the service and had been moved to this service in April 2016 by the provider from another of their services to implement the improvements required. There was a friendly office culture and we observed care workers calling into the office to speak with their supervisors.
We looked at how the service now managed medicines. We found considerable improvements had been made in this area. New robust procedures had been introduced which had significantly reduced the amount of medicine errors and improved recording and monitoring.
Care workers wore a uniform and used other personal protective equipment to reduce the risks associated with cross infection. Gloves and aprons were changed regularly between personal care and meal support to ensure any cross contamination was avoided.
People spoke highly of all the staff who supported them to live at home. They told us they felt safe and comfortable with the care workers who visited their homes and that they trusted the provider to deliver a good service. Policies and procedures were in place to safeguard people from harm and staff understood their responsibilities. Records were kept regarding concerns of a safeguarding nature and investigations had taken place in a timely manner. The registered manager had reported all incidents of a safeguarding nature to the relevant local authority’s safeguarding adults team as required.
Staff supported people to manage health and safety in their home and care records showed that risks associated with individual care needs such as moving and handling, medicine and accessing the community had been assessed and were monitored. Person-centred care plans were in place to support care workers provide a service that was personalised to each individual. There was evidence to demonstrate that regular reviews were carried out of the service people received and the information was passed onto the care workers and other agencies when necessary.
Most staff told us they felt there was enough staff employed by the service to manage it effectively and to meet people’s assessed needs. People told us the staff didn’t rush them and sometimes have time for a chat before they left. People said the service was consistent and their regular care workers were rarely late. Staff records showed the recruitment process was robust and staff were safely recruited. Training was up to date, and staff had a mix of skills and experience. Some staff had qualifications in health and social care and opportunities were available for them to further their knowledge in a variety of topics relevant to the needs of the people they supported.
The registered manager and care coordinators carried out regular supervision and appraisal of the staff which were documented. Staff meetings were also held periodically and minutes were recorded. The registered manager welcomed care workers to a weekly ‘drop in’ session for an opportunity to speak confidentially with her. This demonstrated an open culture of communication where staff had ample opportunity to speak to the office staff. Competency checks were undertaken by senior care workers and a quality officer to assess staff’s suitability for their role. Methodical checks relating to handling medicines showed care workers were competent with this task and people told us they received their medicines in a safe and timely manner.
Training in the Mental Capacity Act 2005 (MCA) had been carried out. We found staff understood their responsibilities when they assessed people’s capacity. Decisions that were made in people’s best interests’ had been appropriately taken with other professionals and relatives involved.
People were supported by staff to maintain a balanced diet. People told us care workers made good meals and always offered them a choice. Staff had undertaken equality and diversity training and people told us that they were treated as an individual and care workers took time to understand their likes and dislikes.
The staff we spoke with displayed caring and compassionate attitudes and people told us the office staff and care workers often went above and beyond what is expected of them. All of the people we spoke with said they were treated with dignity and respect and that staff were sociable and pleasant towards them and their families. The relatives we spoke with reiterated this.
Staff morale had improved. The registered manager had introduced additional recognition schemes and staff told us they had realised that the changes being made were improving the service they delivered. The staff we spoke with told us they now felt proud to work for the provider.
The registered manager held comprehensive information relating to complaints, accidents and incidents. There was a complaints policy in place and evidence showed complaints made about the service had been dealt with appropriately and in a timely manner. Management action had been taken to resolve issues and where necessary disciplinary action had been taken place. People told us they knew how to make a complaint and would not hesitate to contact the office staff should they need to.
The registered manager and the quality officer were proactively monitoring the quality of the service. Senior care workers carried out spot checks of care workers and the office staff regularly courtesy called people who used the service. An annual satisfaction survey was used to formally gather the opinion of people and their relatives.
This inspection took place on 5, 12, 14 and 19 August 2015 and was announced. We announced the inspection prior to our visit to the provider’s head office, to ensure that the office was accessible and we were able to meet the registered manager or a senior member of the service. By announcing the inspection, the manager was able to facilitate our requests to speak with staff and organise visits and telephone calls for us to see and speak with people and their relatives.
Careline Homecare (Newcastle) provides personal care and support to people in their own homes in the Newcastle area. At the time of our inspection, the service provided care and support to 450 people.
At the previous inspection in February 2015, we issued a warning notice related to medicines management. We identified breaches in a further three regulations; staffing; care and welfare and assessing and monitoring the quality of service provision. Following this inspection, the provider sent us an action plan telling us what actions they were going to take to improve.
At this inspection, we found that improvements had been made, although we still found shortfalls in medicines management.
There was a registered manager in place who had been in post since December 2014. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 and associated Regulations about how the service is run.
Some people, relatives and staff told us that more staff were required to support people, especially in the Gosforth, Kenton and Newbiggin Hall areas. The manager informed us that more staff had been recruited and more were in the “pipeline to start.” Safe recruitment procedures were followed.
Most people told us that they felt safe with the staff who visited them in their homes. One person raised concerns about her care and support and we received an anonymous concern about two people’s care and support. We referred these concerns to the local authority’s safeguarding adults team.
Staff told us that there was sufficient training available. This was confirmed by training records which we examined.
We checked how the service followed the principles of the Mental Capacity Act 2005 (MCA). The MCA governs decision-making on behalf of adults who may not be able to make particular decisions. The manager was aware of the Supreme Court judgement in relation to deprivation of liberty. She was liaising with the local authority to ascertain what implications this ruling had on people who used their service.
People’s nutritional needs were met. Healthcare professionals such as the GP or district nursing service were contacted if there were any concerns with people’s health care needs.
We found that staff were knowledgeable about people’s needs and they demonstrated a caring approach whilst supporting people.
People and relatives told us that they were involved in their care. They told us that they generally saw the same care workers or the same small team of care workers. The number of missed calls had reduced from 13 to seven since our previous inspection.
There was a complaints procedure in place and people told us that they could raise any issues or concerns with staff. Some people, relatives and staff told us that they felt the office staff needed to be more efficient in responding to telephone enquiries. Regular surveys were carried out to obtain the opinions and views of people and their representatives. We noted that 176 people were “very satisfied” with the service, 127 were “satisfied,” 49 were “neither satisfied nor dissatisfied,” six were “very dissatisfied” and nine people had just started using the service and could not comment.
Services are now required by law to display their CQC ratings at their premises and on their website. We discovered that the provider had not displayed their rating from the February 2015 inspection on their website.
We received mixed views from staff about working at Careline Homecare (Newcastle). Some staff told us that they did not feel valued or supported in their work. Other staff told us that they enjoyed their jobs and felt supported by their line manager. We considered improvements were required to ensure that there was a positive culture within the service.
There were continued issues with the Electronic Call Monitoring System. This meant that late or missed calls were not always identified in a timely manner.
During our inspection of the service, we found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These related to ‘Safe care and treatment’ in relation to medicines management and the ‘Requirement to display performance assessments.’ You can see what action we told the provider to take at the back of this report.
We issued a fixed penalty notice which related to the failure to display their CQC performance rating which the provider has accepted and paid in full.
This inspection took place on 4, 5 and 11 and 12 February 2015 and was announced.
Careline Homecare (Newcastle) provides personal care and support to people in their own homes in the Newcastle area. At the time of our inspection, the service provided care and support to 394 people.
At our last inspection in January 2014 we found that improvements were required for medicines management and records. We issued a compliance action for medicines management and told the provider they must take action to improve. Following the inspection in January 2014, the provider sent us an action plan telling us what action they were going to take to improve.
There was a new manager who had been in post since December 2014. She had previously been a registered manager for another homecare service which the provider owned. She completed her application to register with CQC on the first day of our inspection. 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 and associated Regulations about how the service is run.
People told us that they felt safe with the staff who visited them. There were safeguarding procedures in place. Staff were knowledgeable about what actions they would take if they suspected abuse had taken place.
We found that the provider was working to improve the way medicines were managed. However, further work was necessary to fully protect people from errors resulting from poor medicines records.
Staff told us that there was sufficient training available. This was confirmed by training records which we examined.
Some people, relatives and staff told us that more staff were required to support people especially in the Gosforth area. This was confirmed by our own observations. Following our inspection, the regional manager wrote to us and explained that they had recruited a further six staff in this area.
People’s nutritional needs were met. Staff supported people with their meal preparation. Healthcare professionals such as the GP or district nursing service were contacted if there were any concerns with people’s health care needs.
We found that staff were knowledgeable about people’s needs and they demonstrated a caring approach whilst supporting people.
People and relatives told us that they were involved in their care. They told us that they generally saw the same care workers or the same small team of care workers. However, there had been issues with late calls and calls where only one care worker had arrived when two were needed.
Some staff told us and our own observations confirmed that there had been an issue with missed calls. The regional manager looked into this concern and found that there had been 13 missed calls in February 2015.
There was a complaints procedure in place and people told us that they could raise any issues or concerns with staff. Some people, relatives and staff told us that they felt the office staff needed to be more efficient in responding to telephone enquiries.
Although there were systems and processes in place to monitor the quality of the service, we found that these were not always effective in highlighting the issues which we identified. In addition, the electronic call monitoring system [ECM] was not fully operational and missed calls were not being identified in a timely manner.
We received mixed views from staff about working at Careline Homecare (Newcastle). Some staff told us that they did not feel valued or supported in their work. Other staff told us that they enjoyed their jobs and felt supported by their line manager. We considered improvements were required to ensure that there was a positive culture within the service and visible leadership.
We had not been notified of the deaths of people who used the service which the provider is legally obliged to inform us of. The regional manager informed us that this would be addressed straight away.
During our inspection of the service, we found four breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. These related to care and welfare of people who use services; medicines management; staffing and assessing and monitoring the quality of service provision. In relation to medicines management this is being followed up and we will report on any action when it is complete.
These breaches corresponded with four breaches of the new Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These related to person centred care; safe care and treatment in relation to medicines; staffing and good governance. You can see what action we told the provider to take at the back of the full version of the report.
An expert by experience contacted 20 people by phone to find out their opinion of the service. Comments included, 'I would say they were very good indeed. I could not say anything different. I have always been very satisfied with Careline and the staff they have sent to me,' 'Very good. I think they are competent and well trained enough to meet my requirements, I am very happy with them,' 'They are far superior to the company I was with before I went to Careline. I am pleased with the support I get' and 'With what I have experienced I would recommend them if I could. I tell my pals that they are great.'
We found that improvements had been made to care and welfare, staffing, supporting workers and assessing and monitoring the quality of service provision.
Overall, we found that arrangements for managing medicines had improved considerably. However, we did identify that some improvement in record keeping for medication was needed.
Overall, people and their relatives seemed relatively satisfied with the service being provided. One person commented, 'They are like a family to me.' However, we found that care and treatment was not always planned and delivered in a way that was intended to ensure people's safety and welfare and appropriate arrangements were not in place to manage medicines.
Appropriate checks were undertaken before staff began work. People were mostly complimentary about the staff themselves. One person said, 'They are mainly very friendly and helpful.' Some people and relatives remarked on the lack of availability of staff at times. We found that there were not enough qualified, skilled and experienced staff to meet people's needs and staff were not always supported to deliver care and treatment safely and to an appropriate standard.
The provider did not have an effective system in place to identify, assess and manage risks to the health, safety and welfare of people who used the service and others.
We found that people's personal records were not always accurate or fit for purpose.
In relation to the care and support provided, we found the provider had suitable arrangements in place to obtain, and act upon, consent from people, and those acting on their behalf. One relative said, 'I was given information about what care was available and I have signed care plans.'
We viewed care records of four people and found that care was not always planned and delivered in a way which met people's individual needs, nor did it always ensure their welfare and safety.
Where people required assistance with their medication, we found there were arrangements in place to ensure this was provided in a safe and suitable manner.
We viewed recruitment documentation relating to five staff employed in the six months prior to our inspection. We found the provider did not always operate effective recruitment procedures.
We viewed a complaints policy and procedure in place which detailed how complaints would be dealt with. We concluded that complaints would be investigated and responded to appropriately.
They said that they were given choices as to how their care was delivered, and one person told us, 'The carers always listen to what I want'.
Another person said that he couldn't fault his care workers, and that he would give them 'ten out of ten'.
People said that their care workers were friendly but respectful, and were flexible and reliable.
People told us that they feel safe when their care workers are with them. They also told us that they thought their workers had been well trained.
They said they knew how to make a complaint, if necessary, and were confident that any concerns that they raised would be taken seriously and responded to promptly by the agency.
They said that they were given choices as to how their care was delivered, and one person told us, 'The carers always listen to what I want'.
Another person said that he couldn't fault his care workers, and that he would give them 'ten out of ten'.
People said that their care workers were friendly but respectful, and were flexible and reliable.
People told us that they feel safe when their care workers are with them. They also told us that they thought their workers had been well trained.
They said they knew how to make a complaint, if necessary, and were confident that any concerns that they raised would be taken seriously and responded to promptly by the agency.