Community Careline

However, at the last inspection we identified a number of concerns about how safe, effective and well-led the service was. At this inspection the majority concerns had not been addressed and a number of improvements were still needed.

Quality assurance systems were not robust enough to drive forward improvement. Audits of records and people's care had not always identified the concerns we found at the inspection. Where issues had been identified these had not always been addressed. The registered manager and provider continued to have regular meetings. However, these meetings had not sufficiently focused on improving quality and actions had not been taken in a timely way.

Staff did not to always have the information they needed to reduce risks to people's health and wellbeing. Risk assessments were not to always be in place. Some risk assessments continued to be missing important information. The management of people's medicines continued to need improvement to ensure they were always administered as prescribed. Improvements were needed to infection prevention and control policies and practices. Essential recruitment checks had not always been carried out.

People's needs were assessed. However, there continued to be limited information for staff in relation to people's health needs. Staff had not undertaken training in some areas such as epilepsy and diabetes but supported people with these needs. Staff were also not up to date with their refresher training.

People were supported to eat and drink safely. Where people needed support to access health care this was in place. 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. However, the policies and systems in the service did not always support this practice as the registered manager had not checked to ensure relatives had power of attorney in place.

Staff knew how to identify and report abuse. Staff were confident the registered manager would report on concerns raised. Incidents were recorded and actions were taken to reduce re-occurrence. However, there

continued to be no systems in place to monitor trends and patterns. There were enough staff to support people.

Staff were positive about the support they received and were regularly supervised and felt listened to. There had been surveys for people and their relatives and staff to seek their opinion on the service. The service continued to work in partnership with healthcare professionals.