Archived: Comfort Call Bristol

When the service was last inspected on 31 March 2016 we found two breaches of the Health and Social Care Act 2008. Breaches of legal requirements were found where medicines were not always managed safely and up to date, accurate records were not maintained. These breaches were followed up as part of our inspection, however we found the required improvements had not been made.

You can read the report from our last comprehensive inspection, by selecting the 'All reports' link for Comfort Call, on our website at www.cqc.org.uk

At the time of this inspection, the service was providing care and support to 133 people in their own homes.

There was not a registered manager in post. A manager was in post who was going through the registration process. 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 told us there were not enough staff to meet their needs. Staff often arrived late to provide care and support to people, or missed visits altogether. Staff rotas showed staff were sometimes expected to be in two places at once, and were not always given sufficient travel time between people. People told us they had to rely on family members for their care. Managers had not identified the shortfalls with the rotas and had prioritised other things.

Not all risks to people had been assessed. Risk assessments did not always inform the plans of care. Staff did not have guidance in care plans what to look for if people with health conditions, such as diabetes, were to become unwell. Staff told us they had not received training to support people with complex needs.

People did not always have their medicines in a timely way. The manager had identified some people could not be guaranteed to receive their medicines at specific times, so had informed the local authority, who were in the process of transferring their care to other providers.

Where people had consistency in staffing, staff knew the people they supported and provided a personalised service. Some people did not benefit from consistent staffing and had different staff for many of their visits. People and their relatives had mixed views about the skills and caring nature of staff. We observed some positive interactions between staff and people they supported, however we also observed some staff were rushed.

There were suitable recruitment procedures and required employment checks were undertaken before staff began to work with the service. Staff received training in manual handling, safeguarding and infection control. Staff had not received specific training for conditions such as pressure ulcers or epilepsy and told us the training they were given wasn’t enough.

Care plans were in place detailing how people wished to be supported and families were involved in making decisions about their care. Although people had been involved in writing their care plans, most people told us they were not involved in regular reviews of their care. People were supported to eat and drink.

People told us their complaints had not always been responded to. The manager explained complaints had not been logged prior to them joining the service. People’s feedback was regularly obtained via telephone calls and quality assurance visits.

The staff understood their role in relation current legislation around helping people to make decisions where they lacked capacity. People told us staff respected their choices.

The manager and provider undertook audits to review the quality of the service provided and made some of the necessary improvements to the service.

We found five breaches of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 during our inspection. Full information about CQC’s regulatory response to any concerns found during inspections is added to reports after any representations and appeals have been concluded.

Comfort Call Bristol was first registered with the Commission in August 2015. It is a domiciliary care service that provides personal care to people living in their own homes in the Bristol area. At the time of our inspection, the service was providing personal care for 87 people.

There was a registered manager in post. 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.

Risks to people were assessed and plans were in place to reduce these and to keep people, and staff, safe. However, we found the actions taken were not always documented.

We found people’s medicines were not always managed in a safe way.

People were asked for consent before care was provided and staff acted in accordance with the Mental Capacity Act 2005. People had signed to confirm they had given consent.

People felt safe and staff knew how to respond to actual or suspected abuse. The provider had a safeguarding policy and guidance was readily accessible for staff to follow.

People and their relatives praised the care they received from staff. Staff were described as “Very nice carers.”

Staff were provided with regular training and supervision processes were in place. Staff told us they felt well supported. Checks were carried out on staff to ensure they were suitable to work with people.

People’s care records showed their involvement in the care planning and care review processes. However, care records were not always complete and up to date

The registered manager was spoken of highly by the staff. Staff felt very supported in their roles and sufficient systems were in place to communicate effectively with the staff.

Systems were in place to monitor the quality of care provided and auditing systems to monitor records and care documentation used by staff.

We found two breaches of the Health and Social Care Act 2008 (Regulated Activity) Regulations 2014 during our inspection. You can see what action we told the provider to take at the back of the full version of the report.