This inspection took place on 9 and 11 May 2018 and was announced.

Community Careline Services (CCS) is a domiciliary care agency providing personal care to people in their own homes. It provides a service to adults and older people. When we inspected the service the service were supporting approximately 50 people across the borough of Rochdale.

The service had a registered manager who was present during the inspection. 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 2008 and associated Regulations about how the service is run.

During the last inspection of Community Careline Services in January 2016 we found there was a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was because the Medicine Administration Records (MAR) did not contain all the prescribing directions to help ensure people received their medicines as prescribed, guidance was not in place to guide staff where variable dose or ‘as required’ medicines had been prescribed, and the medicines policy was out of date. Following that inspection the provider sent us an action plan informing us that they had taken action to ensure the Regulations had been met. During this inspection we found the provider had complied with the previously breached Regulations. Systems had been put into place to ensure all pain relief medicines were documented with dosage and prescribing times; the medicine policy had been updated and all staff were made aware of the level of support and documentation required when offering pain relief. The service was no longer in breach of this regulation and we found that all other regulations were being met.

People supported by Community Careline Services told us that they felt safe with the service. They said that staff understood and respected their need for security, and ensured that the items they would need when staff left their property were easily accessible. Staff demonstrated a good understanding of the risk of abuse, and took steps to ensure people felt safe in their own homes. Risks were evaluated and assessed in line with the people they supported taking their abilities, preferences and capacity into consideration.

There were enough staff. Safe recruitment procedures ensured that people were protected from unsuitable staff, and we saw that staff were employed in small teams which ensured that people supported by Community Careline services had consistent help and support from people they knew. The staff showed us that they knew the people they supported well and were knowledgeable about their needs. There was a low rate of staff turnover, and we saw that training opportunities helped people who worked for Community Careline Services to develop their skills and improve their knowledge.

We saw that staff had access to supervision and yearly appraisal but the service would benefit from more regular spot checks to ensure that staff worked in accordance with current best practice.

Care was delivered in a person centred way by caring and patient staff; people told us that they were made to feel like they mattered. Staff understood issues around capacity and consent, and people told us that their consent was always sought. Care and support was planned around people’s needs and there was a degree of flexibility in how visits were planned to allow for people’s changing circumstances and social activity.

Care records were comprehensive and gave a good indication of people’s needs and how they liked them to be met. People were involved in reviews of their support and they influenced how their care was delivered. Dietary needs and health concerns were considered and taken into account when planning and delivering services. There was evidence of co-operation with health profe

During our inspection we spoke with two people who use the service, the relative/representative of two people and two social care professionals. We asked for their views of the service and the standard of care and support people received. People we spoke with told us; “Can’t praise them enough”, “Very, very good service” and “It’s been a very positive experience so far”.

Staff worked closely with other agencies so that people’s health and physical needs were effectively met.

Adequate numbers of staff were available to meet the needs of people. Arrangements for staff training and development were in place so that staff were adequately supported and had the knowledge and skills needed to support people safely.

Systems were in place to monitor and review the service provided so that people received a safe and efficient service which met their individual needs.

We also looked at the individual care records for people. Information provided guidance for staff about how people were to be supported so that they received safe and effective care and support.

As part of our inspection we spoke with four people who use the service and the relative of one person. Each of the people spoken with told us that they or their relative received consistent support from carers who knew what their needs were and how they wished to be supported. One person felt the staff were, “suitably trained” and another said, “they know what they were doing”.

Two people told us that the office staff kept them fully informed in there were any changes in the staff visiting them.

All of the people we spoke with had access to the office contact details and said that if they had any issues or concerns they would have no hesitation in contacting the office staff.

People told us that they were very happy with the standard of care they received. Their comments included; "I’m perfectly happy”, “Thrilled to bits, they are better than my previous carers” and “Wonderful staff, they couldn’t do anything better”.

The relative we spoke said “I have confidence in the agency” and “the main thing is I know she is safe with them [the staff]”.

As part of our review we spoke with people who use the agency, relatives and staff employed to work at agency about their experiences.

People commented on the care staff that visited them. They said; “they are very, very good”, “I enjoy them visiting”, “if there are any issues we can generally sort it with the carers” and “we’ve got every confidence in the service”.

People also confirmed they had been visited as part of the assessment process and that they received the same carer and were happy with the ‘continuity of care provided’.

We were also told that people were happy with the management of the agency. They said they had; “no hesitation in contacting the manager if they needed anything” and felt confident “things would be sorted out”.

Staff also told us they felt supported by the management team and described them as ‘supportive’ and ‘approachable’.

No issues or concerns were raised with us by the local authority quality monitoring team.

This was an announced inspection that took place on the 5 and 6 January 2016. The service was previously inspected in December 2013 and was found to be compliant with all regulations inspected.

Community Careline Services is registered to provide personal care to people in their own homes. At the time of the inspection the service was providing support for 70 people living in Rochdale and Littleborough. The agency provides a range of support services including help with personal care and domestic tasks.

The service had a registered manager in place. 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.

During this inspection we found a breach of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was because the Medicine Administration Records did not contain all the prescribing directions to help ensure people received their medicines as prescribed. Guidance was not in place to guide staff where variable dose or ‘as required’ medicines had been prescribed. The medicines policy was out of date. People who used the service told us that they received their medicines as prescribed.

Records of staff recruitment did not fully support that a robust process was in place to safeguard people as the reasons for gaps in employment history had not been recorded. The registered manager told us they asked about this at interview and that they would record this in future. Current staff files needed to be reviewed to ensure that this information is recorded where required.

People who used the service told us that they felt safe with staff from Community Careline Services. Staff had received training in safeguarding adults and knew the correct action to take to protect people from the risk of abuse. All staff said that the registered manager would listen to any concerns they raised.

People and relatives told us that staff attended the support visits on time and visits were not missed. Staff teams were organised on an area basis which enabled people to receive support from the same members of staff. Staff cover each other when one is ill or on annual leave. Agency staff were not used. This helped to ensure that staff knew the people they support well.

A written business continuity plan to show what the service would do in the event of a computer or utility failure was not in place. We have made a recommendation about written business continuity plans.

Systems were in place to assess and manage any risks people may face. A household safety hazard checklist was completed for each property staff visited.

Staff received an induction when they joined the service. They also had regular supervision and access to essential training to help ensure that they could carry out their duties effectively. Records showed that staff had received training in emergency first aid, food hygiene, dementia, nutrition and the Mental Capacity Act.

Person centred assessments and care plans were in place to guide staff about the support people required and what tasks people could complete for themselves. We saw that these were reviewed regularly with the people who used the service and the local authority.

All people spoke positively about the kindness and caring nature of the staff. Staff were flexible and would complete tasks that people asked them to do whenever possible. Staff would support people to attend medical appointments by being flexible with the support hours provided. People said that staff respected their choices.

Staff were introduced to the people who used the service before they supported them by the senior care worker.

The service had an open culture with staff visiting the office each week. Staff told us that they enjoyed working in the service and the registered manager was approachable and supportive. Staff told us that they were able to raise issues with the manager and were confident that they would be listened to. Systems were in place to gather feedback about the service. Information gathered was collated and acted upon.