Careline The Agency for Carestaff

At the time of the inspection a registered manager was 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 service remained safe. Sufficient staff were employed to manage people's needs, and enable them to engage in activities of their choice, through risk management. Staff were able to describe how to safeguard people from abuse and were aware of the protocols to follow. Staff further showed no hesitation to whistle- blow if the need arose. Where staff were involved in medicine management this were managed safely. Staff were competency checked annually and audits were completed monthly to ensure people were kept safe. If medicines errors were found during audits an investigation was completed and the necessary steps taken.

The service remained effective. Support was delivered by a highly experienced and knowledgeable staff team, who were able to respond to people's changing needs, through risk management. Staff were supervised and supported by the management team and aimed at delivering support in the most appropriate way. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. This was evidenced with staff encouraging people to go on holidays and arranging this for people.

The service remained caring. Staff were reported to be polite, respectful and ensured they maintained people's dignity whilst supporting them. They evidenced open communication with people and worked on motivating them to increase and achieve their independence.

The service remained responsive. Care plans whilst initially contained minimal information, requesting staff to seek direction from the person or the appropriate family member; were rewritten to contain detailed information on how to deliver the care. The service took necessary action to prevent and minimise the potential for social isolation. Activities were arranged and co-ordinated by the service to increase community engagement, and increase well-being. People and staff were protected from discrimination. Systems were employed by the service to monitor and investigate complaints.

The service had developed methods of governance that provided evaluation of practice. However, it was recognised that by not retaining old audits the service was unable to illustrate improvement over time. A thorough quality assurance audit was completed annually with an action plan being generated, and actioned, in addition to quarterly feedback sought for each staff member. People, relatives and stakeholders were asked for feedback on how to improve and make changes to the service. We found evidence of compliments and complaints that illustrated transparency in management.

The five questions we ask about services and what we found