Daily Comfort Healthcare Ltd

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question good. At this assessment the rating has changed to requires improvement.
This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

The provider was also in breach of good governance as records relating to people’s consent to their care were not available.

This service scored 54 (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 did not always make sure people’s care and treatment were effective because they did not always check and discuss people’s health, care, wellbeing and communication needs with them.
The provider completed initial assessments of people’s needs prior to care packages commencing. Assessments incorporated information from people and professionals; to help ensure they reflected the care required. Care plans contained limited information about people’s history, cultural, religious and spiritual needs to enable staff to understand what was important to people.
Although there were no records of reviews of care happening, some people told us senior staff did check in with them to see if they were OK. People and relatives we spoke with confirmed they had not all been involved in care reviews. One person who said, “I can’t recall a formal review but (registered manager) calls in from time to time to see if I am OK”, whilst another person told us, “I haven’t had any reviews of the care plan and don’t have access to day-to-day care information.”
Reviews of care help to ensure care plans and assessments are up to date and reflective of people’s needs.

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them.
Although the provider had worked with people to plan and deliver their care and were aware of some of the recommended tools to identify risks, they were not able to evidence their use in practice. Records did not show how the provider had followed NICE guidance when assessing pressure ulcer risks for people where a skin vulnerability had been identified (for example, when cared for in bed). The provider had not used recommended tools when monitoring and assessing the ongoing risk to people. This meant people were at risk of poor care where current evidence-based good practice was not followed.

We did not look at How staff, teams and services work together during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at Supporting people to live healthier lives during this assessment. The score for this quality statement is based on the previous rating for Effective.

The provider did not always routinely monitor people’s care and treatment to continuously improve it. They did not always ensure that outcomes were positive and consistent, or that they met both clinical expectations and the expectations of people themselves.
The provider failed to maintain accurate, complete and up-to-date records relating to the care and support people received. They were unable to provide daily care records or evidence of regular reviews of care when requested.
As a result, there was limited assurance that people's care outcomes had been formally agreed, were understood by staff, or were being consistently monitored and reviewed.
The provider could not demonstrate how they evaluated the effectiveness of care, tracked progress towards people's goals, or ensured care continued to meet people's needs and preferences.

The provider did not tell people about their rights around consent or respect these when delivering care and treatment.
Some people lacked the mental capacity to independently make decisions about their care. Their care plans noted that others made decision on their behalf. However, records did not show how people’s mental capacity had been assessed or if any best interest decisions had been made on their behalf. Evidence people’s representatives had the legal authorisation to act on their behalf was not made available to CQC when we requested this from the provider. This meant the provider could not demonstrate people’s care decisions had been taken in line with the requirements of the Mental Capacity Act 2005 and the associated Codes of Practice to protect their rights and freedom.