The inspection took place on 22 May 2018. The inspection was announced.

This service is a domiciliary care agency. It provides personal care to any adults who require care and support in their own houses and flats in the community. Not everyone using Community Careline Service receives regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided. At the time of inspection, approximately 30 people were receiving personal care in their own homes.

This was the first comprehensive inspection following a change of legal entity and new registration on 20 December 2017.

The provider employed a registered manager at the service who had been the registered manager of the service for many years with the previous provider. 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.

Risks to individual people were not always identified to ensure measures were in place to help keep people safe and prevent harm. Environmental risks inside and outside people’s homes were documented to keep people, staff and others safe from hazards.

Accidents and incidents were recorded by staff but not always followed up by the registered manager to ensure appropriate action had been taken and identify themes to learn lessons and prevent future occurrences.

Some areas of the management of people’s prescribed medicines needed improvement to ensure people received their medicines in a safe way at all times. Care plans, medicines administration records (MAR) and daily records showed conflicting information about people’s medicines. Information for staff about people’s medicines, why they were taking them and the side effects to watch out for was not available.

A safeguarding procedure with the information staff would need to follow if they had concerns about people was available. People told us they felt safe and knew who they would talk to if they did not.

The provider and registered manager followed safe recruitment practices to make sure only suitable staff were employed. Enough staff were available to be able to run an effective service and be responsive to people’s needs. The people we spoke with told us they had regular staff to support them who were on time when visiting and always stayed to support them for the whole time they were allocated. Staff had a suitable induction period when they were new where they were introduced to people before they started to support them.

Many staff had not had suitable training to make sure their skills and knowledge were up to date. Although most staff had a one to one supervision meeting, most staff had not been regularly observed while carrying out their duties to ensure they continued to provide safe care and follow good practice.

People had an initial assessment before they received a service and the assessment was used to inform their care plan. Documentation in the care plan was not always fully completed. We have made a recommendation about this.

Although people gave positive accounts of the care that staff provided, a person centred approach had not been taken in the care planning process to ensure the personal and individual information about people was documented.

People were supported to make their own decisions about their care or had a family member who helped them. The registered manager was aware of their responsibilities within the principles of the Mental Capacity Act 2005 if people required a mental capacity assessment to test their capacity.

People were supported with their nutrition and hydration needs where necessary, although many people di