Archived: Comfortcare

Updated 3 January 2019

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 30 October 2018 and was announced. We also returned on 7 November 2018 to view a new monitoring system which was being implemented at the service.

The provider was given 24 hours' notice of the inspection because the service provided was domiciliary care in people's own homes and we needed to make sure the right people would be available to answer our queries.

The inspection team consisted of two inspectors.

We visited the office location to meet with the owner of the company who was also the registered manager. We also met with the care manager who also provided support to people using the service. We visited the homes of two people who used the service to meet with them and their families. At one of our visits a person was admitted to hospital immediately prior to our arrival so we were not able to speak with them, though we met briefly with their family. We contacted all staff by email and received one reply and one phone call in response.

We spoke with three health and social care professionals, including officers from the Local Authority who had supported the registered manager to drive improvements at the service.

As part of the inspection, we reviewed a range of information about the service. This included a Provider Information Return (PIR). A PIR is a form completed by the registered manager to evidence how they are providing care and any improvements they plan to make. We also looked at safeguarding alerts and statutory notifications, which related to the service. Statutory notifications include information about important events, which the provider is required to send us by law.

We looked at three care records for people who used the service. We also looked at further records relating to the management of the service, including recruitment records for three staff and systems to monitor the quality of the care people received.

Updated 3 January 2019

Comfortcare is a domiciliary care agency which provides personal care to people living in their own houses and flats in the community. These include older people, people living with dementia and people with a physical disability. At this inspection, there were ten people receiving personal care from Comfortcare.

At our last inspection of December 2017, we rated the service as inadequate overall and placed into special measures. We had concerns about all areas of the service. The provider had not ensured people received safe care in line with their needs and preferences. We found the provider to be in breach of regulation 9, 10, 12, 16, 17 and 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We asked them to complete an action plan to show what they would do and by when to improve the service to at least good.

This comprehensive inspection was completed on 30 October and 7 November 2018 and was announced.

Since our last inspection the number of people being supported had reduced from 30 to 10 and many of the people who we had been concerned about due to their complex needs were no longer supported by the service. There were also less staff due to the number of people being cared for. The registered manager and care manager had worked with the Local Authority to address our concerns and started improving the management and quality of the service. They had made significant progress and we found the service was no longer in breach of regulations. However, we found some of the new systems were not yet fully implemented or well-coordinated.

The service had a registered manager. 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. There was also a care manager who had worked closely with the registered manager to implement improvements.

The registered manager had demonstrated a commitment to improving the service by investing in a number of new systems, such as an electronic monitoring system to track staff visits and a new training room. There were new audits in place to check the quality of the service and communication had improved with people, families and staff. There was a more open culture at the service. Communication with stakeholders such as the Local Authority was usually in response to concerns.

We made a recommendation that the registered manager develop more positive and pro-active relationships with outside organisations.

There were enough safely recruited staff to meet people’s needs. The registered manager had put new measures in place to improve people’s safety, though these had not all been implemented fully and further time was needed to ensure they were effective. Staff had been retrained in administration of medicines and there were new forms to record and monitor the support provided. Staff supported people to minimise the risk of infection.

Training had improved, though there was still a need to develop staff skills and guidance where people had more complex needs. Supervision of staff had improved, however the new systems to record and review how the service managed staff practice still needed improvement. The care manager was now able to check that people’s wellbeing and nutritional needs were being met because staff recording had improved.

Staff worked more closely with external professionals to meet people’s needs. Staff ensured support took into consideration people’s ability to make decisions about their care.

There was a more caring approach throughout the service, and an expectation of staff to treat people with respect and dignity. People had an increased say in the service they received. Support was more personalised and tailored to people’s needs. The new care plans and review process were still being implemented, but once in place they would enable staff to provide a more responsive service to people and families.

The complaint process had improved but the registered manager needed to ensure the system for recording complaints was functioning effectively. There was no one in the service receiving end of life care.

We made recommendations around improvements in developing staff skills in this area.