Daily Comfort Healthcare Ltd

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

Well-led – this means we looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture.

This is the first assessment for this service. This key question has been rated requires improvement.
This meant the management and leadership was inconsistent. Leaders and the culture they created did not always support the delivery of high-quality, person-centred care.

The service was in breach of legal regulation in relation to good governance.
 

This service scored 61 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a shared vision, strategy and culture. This was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and understanding challenges and the needs of people and their communities.
The provider had a clear vision of how to sustainably grow the service without compromising safety and quality. This included moving into supported living as both the registered manager and other staff had experience of supporting people in this environment.
The registered manager promoted a positive and inclusive ethos. For example, they had taken action to improve communication between office and care staff after feedback staff had experienced some issues. This demonstrated a pro-active approach to engagement with staff to improve the culture at the service. Staff received appropriate training in equality and diversity. The registered manager had a good understanding of the protected characteristics and the need to make staff from other cultures aware of the importance of these during induction.
 

The provider had inclusive leaders at all levels who understood the context in which they delivered care, treatment and support and embodied the culture and values of their workforce and organisation. The registered manager had achieved leadership qualifications as well as train the trainer to be able to train staff face to face. Staff told us the registered manager was open and honest, and they were able to contact them when needed. Senior staff had received appropriate training and ongoing development programmes relevant to their roles.
However, we identified breaches of the legal regulations and concerns in areas such as safe care, recruitment and governance. Leaders had not independently identified and acted on these concerns prior to our assessment. This meant some development was needed in their skills and knowledge to lead effectively.
 

The provider fostered a positive culture where people felt they could speak up and their voice would be heard.
Staff told us they felt comfortable in speaking up and raising issues to senior staff. The provider had a whistleblowing policy in place and staff had received training in line with this policy. The registered manager demonstrated an open approach in their engagement with staff and acted to address their concerns when known. Staff knew who and what to report both inside and outside of the service and felt able to do so. The registered manager told us, “(We) encourage staff to report things. For us, duty of candour and transparency (is) important”.
 

The provider valued diversity in their workforce. They worked towards an inclusive and fair culture by improving equality and equity for people who worked for them.
For example, the registered manager demonstrated how they made reasonable adjustments to staff’s working patterns and training programmes, to ensure staff were treated fairly and given appropriate support in their role. This included additional support for staff recruited from abroad when they were adapting to living in a new country.
 

The provider did not always have clear responsibilities, roles, systems of accountability or good governance. They did not always act on the best information about risk, performance and outcomes, or share this securely with others when appropriate.
Improvements were needed to ensure risks in care plans were clear, accessible and sufficiently detailed. The provider also needed to ensure their auditing processes were clearly documented and effective in promoting safety and good quality care. For example, although the registered manager told us they audited medicines, PPE stock, feedback from people, care plans and daily records, we saw no evidence of this. Audits had not picked up the issues we found with recruitment and risk management plans. The provider was also unable to show us all of the information requested. This included service improvement plans and a download of call times for people and staff. The provider was not able to ensure a thorough oversight was in place.
Therefore, the service was in breach of legal regulation in relation to good governance.
 

The provider understood their duty to collaborate and work in partnership, so services worked seamlessly for people. They shared information and learning with partners and collaborated for improvement.
There was evidence of partnership working with key stakeholders, including commissioners, other providers and health professionals. For example, the provider gave regular updates to the integrated care board (ICB) when supporting people’s reablement, acting on their recommendations to adjust care where required. The registered manager also told us they followed up with GPs either by phone or visiting them if local to share updates. This helped to promote positive outcomes for people using the service.
 

The provider was motivated to work towards continuous learning and improvement across the organisation. The registered manager told us they had an action plan with areas of improvement such as ensuring morning visits were on time, although they did not provide a record of this. Although the provider was motivated to learn and improve the service for people, their overall ambition was limited by the lack of established risk and quality monitoring systems. This meant they might not always be aware of shortfalls to enable prompt improvement and learning.
However, we found a number of areas in which the provider had made service improvements. The provider had moved to a new office which had a large training room to help improve face to face training. There was also a dedicated workstation for online training which could be used by staff who did not have the facility at home. The provider had also invested in cars for staff on the sponsorship scheme to improve the number of drivers available to meet care calls. The registered manager had recognised where some improvements were needed and had taken action to address issues and concerns. This included improving communication following feedback from people, relatives, commissioners and the local authority. Team meetings for staff were now held online enabling many more staff to attend. There had been changes to the provider’s electronic systems to enable better monitoring and access for people. This was still being implemented during the inspection.