• Services in your home
  • Homecare service

Archived: Comfort Call Hatfield

Overall: Requires improvement read more about inspection ratings

Second Floor, Suite 7 Bishops Court,, 17A The Broadway,, Hatfield, Hertfordshire, AL9 5HZ (01707) 261066

Provided and run by:
Comfort Call Limited

All Inspections

11 July 2016

During a routine inspection

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

27, 28, 30 October & 2, 6,9 & 11 &12 November 2015

During a routine inspection

We carried out this inspection by visiting the registered office for Comfort Call Hatfield on 27 October 2015; Between this date and 12 November 2015, we spoke with care staff, visited and telephoned people who used the service and their relatives or friends to get feedback about the service. We gave the provider 24 hours’ notice that we would be visiting the office to make sure that the appropriate people were there during the visit.

We decided to bring forward the inspection following the receipt of concerning information. This related to allegations of missed and late visits and people being left without care and support for many hours. Allegations included people’s personal care needs not being met; people not receiving their medicines at the prescribed times, and in some cases people being unable to access food and drink because of the lack of support.

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 664 people. This included five flexi care schemes; These are sheltered housing complexes where people live in individual flats or accommodations. These were Chiltern Green, Swanfield Court and Woodside house (Welwyn Hatfield) and Emmanuel Lodge and Wormley Court in Broxbourne.

The service provides care and support to adults and a small number of children in their own homes. People supported by the service were living with a variety of needs including age related health conditions, physical fragility and people living with dementia.

The service did not have a registered manager in post. 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.

Although people told us they found the staff who delivered their care to be respectful and kind, many people found the behaviour and competency of the office staff, to be both unreliable and unhelpful.

Some staff were not fully aware of their role in relation to Mental Capacity Act (2005) (MCA) and not all staff had received training in this area

People’s needs had not always been assessed prior to receiving a service from Comfort Call, care plans were incomplete and did not always ensure people’s individual needs, preferences and choices were taken into account and implemented.

There were risk assessments in place that gave guidance to staff on how risks to people could be minimised. The systems in place to safeguard people from the risk of avoidable harm were inadequate as some were historic and had been completed by a previous care provider. Recent risk assessments were not done for many of the people and likewise reviews of the risks to people were not happening in a planned or timely way.

The provider failed to protect and support people safely due to ineffective and incomplete recruitment practices and insufficient staffing levels to ensure people’s health and welfare was met. Staff did not always receive regular support and supervision from their managers. Staff were working long hours and many described feeling exhausted.

The provider failed to support and supervise people safely and effectively to take their medicines. Not all staff had received up to date training or supervision of their practice in relation to administering medicines or had their competency assessed.

People were not always provided with sufficient food and drinks due to a series of missed visits which placed them at risk of malnutrition and dehydration.

The provider had a procedure for handling complaints, comments and concerns but failed to ensure that complaints were handled effectively and in a timely manner.

The provider had ineffective management and quality monitoring systems in place that failed to identify serious errors and omissions in the monitoring of missed calls, which placed people at risk of serious harm.

At this inspection we found the service to be in breach of regulations 9, 10, 11, 12, 13,14, 16, 17, 18 and 19 of the Health and Social care Act 2008 (Regulated activities) Regulations 2014.

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘Special measures’.

Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the provider’s registration of the service, will be inspected again within six months.

The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe.

If not enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. This service will continue to be kept under review and, if needed, could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement so there is still a rating of inadequate for any key question or overall, we will take action to prevent the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration.

For adult social care services the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures