Archived: Comfort Call (Salford)

Updated 28 November 2017

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 was 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 at the service offices on 20 and 28 September 2017. We gave the provider 48 hours’ notice as we needed to be sure that a manager would be available to participate in the inspection. Telephone interviews for staff where conducted on the, 3, 6 and12 October 2017.

The inspection was carried out by one adult social care inspector and a medicines inspector at the agency office on the first day and two adult care inspectors and medicines inspector on the second day. In addition to this, two Experts by Experience conducted telephone calls to people using the service on the first day of inspection. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

At the time of our inspection 140 people were being supported under the regulated activity by the service. Additional people were also supported by the service for cleaning and shopping visits.

Before the inspection the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements the plan to make.

Prior to the inspection we reviewed information we held about the service, including statutory notifications. A statutory notification is information about important events which the provider is required to send us by law. We also reviewed the information we held, including action plans, complaints, safeguarding information and previous inspection reports. In addition to this we contacted the local authority contract monitoring team and safeguarding team who provided us with any relevant information they held about the service.

During the inspection we spoke with 22 people who used the service and eight of their relatives. We also spoke with 18 staff members, including the registered manager and regional manager. We looked at the care records of 15 people who used the service and other associated documents such as policies and procedures, safety and quality audits and quality assurance surveys. We also looked at 10 staff personnel and training files, service agreements, 40 staff rotas, minutes of staff meeting.

Updated 28 November 2017

This inspection took place on 20 and 28 September and 3, 6 and12 October 2017 and was announced.

Comfort Call Salford is a domiciliary care agency, which provides personal care to people in their own homes who require support in order to remain independent. The office is located in Eccles near Manchester. The agency predominantly covers the areas of Swinton and Eccles.

At time of inspection there was a registered manager at the service. The registered manager had been in post since July 2016. 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.

At the last comprehensive inspection on 11 January 2017 we found the service to be in breach of four regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These were relating to staffing, monitoring and audit systems, medicines practice and the service had failed to ensure that suitable arrangements were in place for planning and reviewing people’s care and support in a way that met their individual needs and preferences. Following the inspection we held a joint meeting with the local authority and the provider to highlight the areas of concern and determine what immediate action would be taken. In addition to this we monitored the on-going compliance of the service through regular action plans submitted by the provider.

As part of this inspection we checked to see that improvements had been implemented by the service in order to meet legal requirements. We found improvements had been made in each area of concern from the previous inspection; however the service remained in breach of regulation 17 good governance.

We found on-going improvements in the recording of medicine administration. However, we saw medicine support plans were not updated and often contained incomplete or out of date information. Missing signatures were also evident on Medicine Administration Record (MAR) charts.

Improvements had been noted with the services auditing and governance systems, however these were still not robust h and had not identified the issues highlighted in the management of medicines.

Feedback we gained from people throughout the inspection was positive overall. People spoke about feeling happy and having their care needs met in a person centred, respectful manner. When questioned, staff gave relevant examples of how to care for a person in line with their individual needs and wishes, whilst ensuring the person’s dignity and privacy was respected.

Safeguarding procedures were in place and staff were able to confidently inform us about the types of abuse people could be subject to and how to raise concerns should they suspect or witness any abuse or abusive practice. All staff had received training in safeguarding and we were able to confirm this was in date.

People spoke about feeling safe in their homes and confirmed staff left them secure following a care visit. The provider ensured processes were in place to ensure a safe environment was maintained for people using the service and its staff. Environmental risk assessments were established to identify any risks associated with lone working, water temperature, sharps and the control of substances hazardous to health (COSHH).

Staff rotas and time sheets indicated that staffing levels had improved. The registered manager told us the rate of pay for care staff had recently been increased and further staff were being interviewed for jobs. People also commented that they did not feel rushed in their daily routine and did not experience any missed visits.

Recruitment procedures were thorough and robust. Staff told us their induction process contained enough information to ensure they had the knowledge to carry out their care role effectively. People spoken with confirmed staff were competent. Staff files we looked at contained all necessary information along with appropriate checks of staff’s character, to ensure the provider was following a detailed and safe recruitment selection of all staff.

Staff were provided with a suitable amount of training which enabled them to confidently and competently carry out their roles and provide people with care and support based on their individual needs.

Staff meetings and supervisions were offered and staff felt fully supported by the management structure and told us they were able to approach management whenever they had an issue.

People were provided with personalised care and support based on their individual needs and requirements, detailed care plans and risk assessments were in place in which gave clear information about people's needs, wishes, feelings and health conditions. Changes to people's needs and requirements were also captured giving staff up to date and relevant information.

Staff we spoke with were aware of the principles of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). These provide legal safeguards for people who may be unable to make their own decisions. Staff were also able to give relevant examples of how to ensure people were offered choices and supported to make decisions.