Comficare Ltd

Updated 28 June 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

Inspection team

The inspection was undertaken by 1 inspector.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.

Inspection activity started on 24 March 2023 and ended on 17 April 2023. We visited the location’s office on 24 March 2023 and 29 March 2023.

What we did before inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England.

We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We sought feedback from the local authority and professionals who work with the service. We met with 3 people on the day and spoke to 1 person and 3 relatives on the telephone. We spoke with 7 members of staff including the registered manager and the director. We reviewed a range of records which included 7 people’s care plans and risk assessments, 3 recruitment files and records associated with governance of the service.

Updated 28 June 2023

About the service

Comficare Ltd is a domiciliary care service providing the regulated activity of personal care. It provides support to younger adults, older people (some of whom have dementia), and to some people with sensory impairment or a physical disability. At the time of our inspection there were 35 people using the service. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided.

People’s experience of using this service and what we found

People were sometimes exposed to the risk of avoidable harm. This was because some risks, for example, those associated with catheter care, were not always assessed, recorded or fully mitigated against.

Although the provider had good oversight of the service, improvements were needed to the auditing processes in place to monitor the quality and safety of the service. This meant the failings we found during the inspection had not been identified or action taken to address them.

People and their relatives told us they felt staff were knowledgeable and provided safe care, so they felt safe being supported by the service. Medicines were managed safely. There were enough staff to meet people’s needs. Staff were recruited safely and went through an induction process where their competencies would be checked before they worked on their own with people.

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; the policies and systems in the service supported this practice. People were supported to access health care when they needed it.

Staff received training to ensure they could provide safe care for people. The provider checked staff were competent to carry out their duties. People’s needs and preferences were assessed when they started using the service, and care plans were drawn up in consultation with them. Care plans were reviewed regularly, if, and when, people’s needs changed or if they requested a review.

People were frequently asked for their views about the service and the provider had created an open culture where people could say if they weren’t happy with something. People and relatives told us concerns had been responded to well and in a timely way.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 19 November 2021) and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve.

At this inspection we found the provider remained in breach of regulations. This service has been rated requires improvement for the last 2 consecutive inspections.

Why we inspected

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe, Effective and Well-led which contain those requirements.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service remains requires improvement. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Comficare Ltd on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified breaches in relation to risk assessment and governance of the service at this inspection.