Careline Berwick is a domiciliary care agency rated Good overall following a May 2022 inspection, with only Safe and Well-led key questions assessed. The service demonstrated strong safeguarding practices, safe medicines management, effective governance, and a positive person-centred culture, maintaining its Good rating from the previous 2019 inspection.
Strengths
· People and relatives spoke positively about care received; care plans were detailed with risk assessments
· Medicines managed safely with electronic records, regular audits, and safe administration of PRN medicines
· Safeguarding concerns recorded, reported and investigated appropriately; staff confident in procedures
· Effective infection prevention and control systems including spot checks on PPE use
· Staff received regular training, supervision and appraisal
Careline Berwick is rated Good overall, with improvements made since a 2015 inspection that found breaches in medicines management and record-keeping; both areas were resolved by this inspection. The service was rated Requires Improvement for Safe due to ongoing staffing pressures in rural areas, supervisory staff covering excessive care hours, and persistent issues with late visits caused by insufficient travel time between appointments.
Concerns (5)
moderateStaffing levels: “One supervisor told us that in previous weeks they had worked their normal supervisory role and undertaken an additional 32 hours care work to support care delivery.”
moderateMissed or late visits: “staff told us travel between appointments could still be an issue and they continued to sometimes 'pinch a few minutes here and there.'”
minorStaff training: “the majority of training was undertaken using workbooks...Staff said this type of training did not always cover the practical aspects in good detail.”
minorRecord keeping: “whilst old documentation was stored at the rear of files, it was not always clear that a review had taken place.”
minorMedication management: “where they had been highlighted it was not always clear from the audit what action had been taken to follow any concerns up with the care worker.”
Strengths
· People told us care staff were exceptionally caring and they looked forward to them calling, viewing them as friends.
· Medicines management had significantly improved since the previous inspection, with new medicines lead roles and clear MAR records.
· Care planning documentation had been revised and improved since the previous inspection, with detailed person-centred plans.
· Staff spoke very positively about the registered manager, describing her as approachable, supportive, and client-focused.
· Safe recruitment practices were consistently followed, including DBS checks and references.
Quality-Statement breakdown (18)
safe: Medicines managementGood
safe: Staffing levels and deploymentRequires improvement
safe: SafeguardingGood
safe: Recruitment practicesGood
safe: Infection controlGood
effective: Staff training and developmentRequires improvement
effective: Supervision and appraisalGood
effective: Mental Capacity Act / consentGood
effective: Nutrition and hydrationGood
caring: Person-centred care and dignityGood
caring: Involvement in care planningGood
caring: Communication with people using the serviceGood
responsive: Care planning and needs assessmentGood
responsive: Timeliness of visitsRequires improvement
Careline Berwick received an overall rating of Requires Improvement at its first inspection in February 2015, with two regulatory breaches found relating to unsafe medication management (Regulation 12) and inadequate care plan record-keeping (Regulation 17). The service demonstrated strengths in staff training, dignity of care and complaints handling, but must address inconsistent and insufficiently detailed care plans, medicines administration errors, and scheduling pressures causing late visits.
Concerns (8)
criticalMedication management: “instructions on one box were for the tablet to be dissolved on the tongue. However, the MAR instructions stated the tablet should be "dissolved in a little water."”
criticalMedication management: “MARs usually only identified the giving of tablets from the dossette box as a number and not the individual medicines contained within the dossette box.”
criticalCare planning: “care plans sometimes lacked detail or did not reflect the type and range of care that was being provided.”
criticalRecord keeping: “Systems were not in place to maintain an accurate, complete and contemporaneous record in respect of each service user. Regulation 17(2)(c)”
moderateCare planning: “one person's care plan we saw written the word's "Catheter care", with no explanation as to what action the care worker should take.”
moderateMissed or late visits: “no travelling time factored into their schedules... often delayed in getting to calls later on the list.”
moderateGovernance: “no registered manager in place at the service, although our records showed that a person was still registered with the Commission.”
minorConsent / capacity: “Staff told us they could not recall receiving specific dedicated training with regard to the Mental Capacity Act 2005.”
Strengths
· People consistently reported feeling safe and trusting care workers, describing them as friends.
· Robust recruitment procedures including DBS checks, references and identity verification were in place.
· Staff received regular supervision, annual appraisals and up-to-date training across a range of topics.
· Care workers treated people with dignity, respect and sensitivity, observed during shadowing visits.
· Business continuity and adverse weather policies were in place to prioritise vulnerable people.
Careline Berwick is a domiciliary care agency rated Good across all five key questions following a February 2019 inspection, providing personal care to 180 older people. The service demonstrated safe, person-centred care with consistent staffing, robust governance, and strong staff support structures, maintaining its Good rating from 2016.
Strengths
· People felt safe and staff demonstrated strong understanding of safeguarding and whistleblowing procedures
· Punctual and consistent staffing with robust pre-employment recruitment checks
· Medicines managed safely with accurate records and audits
· Staff well supported with up-to-date training, regular supervisions and appraisals
· Personalised, detailed care plans regularly reviewed to reflect current needs
Quality-Statement breakdown (22)
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Assessing risk, safety monitoring and managementGood
safe: Staffing and recruitmentGood
safe: Using medicines safelyGood
safe: Preventing and controlling infectionGood
safe: Learning lessons when things go wrongGood
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawGood
effective: Staff support: induction, training, skills and experienceGood
responsive: Care planning and assessment detailRequires improvement
responsive: Timeliness of visitsRequires improvement
responsive: Complaints handlingGood
well-led: Quality monitoring and governanceGood
well-led: Registered manager in postRequires improvement
effective: Supporting people to eat and drink enough to maintain a balanced dietGood
effective: Adapting service, design, decoration to meet people's needsGood
effective: Supporting people to live healthier lives and access healthcare services; staff working with other agenciesGood
effective: Ensuring consent to care and treatment in line with law and guidanceGood
caring: Ensuring people are well treated and supported; equality and diversityGood
caring: Supporting people to express their views and be involved in making decisions about their careGood
caring: Respecting and promoting people's privacy, dignity and independenceGood
responsive: Planning personalised care to meet people's needs, preferences, interests and give them choice and control; end of life care and supportGood
responsive: Improving care quality in response to complaints or concernsGood
well-led: Planning and promoting person-centred, high-quality care and support with openness; duty of candourGood
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsGood
well-led: Engaging and involving people using the service, the public and staff, fully considering their equality characteristicsGood
well-led: Continuous learning and improving careGood