Archived: Comfort Call Hatfield

Updated 31 August 2016

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 2014 and to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This visit to the office took place on 19 and 25 July 2016. Between the 11 and 28 July 2016 people, their relatives and staff were contacted by telephone and also visited in their own homes to obtain feedback about their experience of receiving care or working for Comfort Call. The inspection was carried out by seven Inspectors and four experts by experience. An expert by experience is a person who has experience of using or caring for someone who uses this type of service. Two inspectors visited the office and the other inspectors and experts by experience spoke with people using the service and staff.

The Inspection was announced. We gave the provider 48 hours’ notice of our intended inspection to ensure appropriate senior staff would be there to support us with the inspection. Before our inspection we reviewed information we held about the service including statutory notifications relating to the service. Statutory notifications include information about important events which the provider is required to send us.

As part of the inspection we spoke with 52 people who used the service, visited 13 people in their homes in addition to the 52 people we spoke with on the telephone nine relatives, friends or advocates, 24 members of staff, the head of quality and the managing director and the manager we received feedback from health and social care professionals. We viewed 12 people’s care plans and risk assessments. We looked at staff recruitment records. We reviewed safeguarding records, complaints and compliments records. We looked at quality monitoring records including staff support documents and individual training and supervision records. We also reviewed records relating to the overall management of the service and audits. We looked at visit planning and the telephonic monitoring systems which the provider used to make sure people’s care visits happened at the times they were scheduled.

Updated 31 August 2016

The inspection took place over a two week period from 11 July - 28 July 2016 and was a follow up to the previous inspection we carried out in October 2015. At the previous inspection in October 2015 the service was given an overall rating of inadequate and there were breaches of regulations 9, 10, 11, 12, 13, 14, 16, 17, 18 and 19. We took enforcement action in November 2015 which included placing an embargo on new business and the provider was required to provide CQC with weekly reports demonstrating how they were managing the business in regard to people experiencing missed and late care calls.

We inspected the registered office for Comfort Call Hatfield the 19 and 25 July 2016 and on other dates between11 - 28 July 2016 we contacted people who used the service, their relatives by telephone, visited people in their own homes and spoke to staff to obtain feedback.

We gave the provider 48 hours’ notice that we would be visiting the office to make sure that the appropriate people would be there to assist us with our inspection.

The Hatfield branch of Comfort Call was registered on 6 April 2015 with the Care Quality Commission. At the time of our visit Comfort Call Hatfield was supporting a total of 325 people.

People who were being supported by the service had various needs including age related frailty, dementia, and physical health conditions. The service did not have a registered manager in post. However the newly appointed branch manager had recently submitted an application to CQC to become the registered manager and the application was in progress at the time of our inspection.

The previous registered manager had resigned from their post in June 2015. 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.

People who used the service told us things had improved in recent months. However some of the people we spoke with told us that they found the office staff at times unhelpful.

Staff had received training in relation to MCA. There was however on-going work in progress for further improvements including mentoring and additional training to ensure all staff behaviours were in line with their responsibilities under the Mental Capacity Act (2005) (MCA). Staff told us they always sought peoples consent before assisting them and consents were recorded in some of the care plans we saw and were reviewed periodically. However not all care plans we reviewed had people’s consent recorded.

People’s needs were assessed prior to receiving a service from Comfort Call. However some of the care plans were incomplete and did not always ensure people’s individual needs, preferences and choices were taken into account and implemented. People told us that most of the care staff were very caring and did their best.

There were risk assessments in place that gave guidance to staff on how the risks to people could be minimised. The systems in place to safeguard people from the risk of harm had been reviewed during the last three months.

Recruitment processes had been reviewed and systems put in place to help ensure that people were kept safe. We found that while there were sufficient staffing levels to meet people’s needs. People often received late visits and care staff were often changed at short notice.

Staff were well supported by the new manager who had worked hard to develop a more effective system in supporting the staff team.

People were supported and assisted to take their medicines safely and effectively. Staff had received up to date training in the safe administration of medicines and the majority had their competency assessed, and others were in progress at the time of our inspection.

People were supported to eat and drink sufficient food to meet their needs and wishes. However in some cases where visits had been delayed people had not received their meals or drinks at the required times.

The provider had a procedure in place for the investigation of complaints, and concerns. We saw that there had been improvements in the timeliness and responses to complaints and people told us this had improved recently.

The provider had some systems and processes in place to assist in the effective management and quality monitoring of the service. However these were being reviewed by the current manager to ensure that issues we found as part of our inspection would be identified and addressed in a timely way