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Archived: Comfortcare Requires improvement

The provider of this service changed - see old profile

Inspection Summary


Overall summary & rating

Requires improvement

Updated 3 January 2019

Comfortcare is a domiciliary care agency which provides personal care to people living in their own houses and flats in the community. These include older people, people living with dementia and people with a physical disability. At this inspection, there were ten people receiving personal care from Comfortcare.

At our last inspection of December 2017, we rated the service as inadequate overall and placed into special measures. We had concerns about all areas of the service. The provider had not ensured people received safe care in line with their needs and preferences. We found the provider to be in breach of regulation 9, 10, 12, 16, 17 and 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We asked them to complete an action plan to show what they would do and by when to improve the service to at least good.

This comprehensive inspection was completed on 30 October and 7 November 2018 and was announced.

Since our last inspection the number of people being supported had reduced from 30 to 10 and many of the people who we had been concerned about due to their complex needs were no longer supported by the service. There were also less staff due to the number of people being cared for. The registered manager and care manager had worked with the Local Authority to address our concerns and started improving the management and quality of the service. They had made significant progress and we found the service was no longer in breach of regulations. However, we found some of the new systems were not yet fully implemented or well-coordinated.

The service had a registered manager. 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. There was also a care manager who had worked closely with the registered manager to implement improvements.

The registered manager had demonstrated a commitment to improving the service by investing in a number of new systems, such as an electronic monitoring system to track staff visits and a new training room. There were new audits in place to check the quality of the service and communication had improved with people, families and staff. There was a more open culture at the service. Communication with stakeholders such as the Local Authority was usually in response to concerns.

We made a recommendation that the registered manager develop more positive and pro-active relationships with outside organisations.

There were enough safely recruited staff to meet people’s needs. The registered manager had put new measures in place to improve people’s safety, though these had not all been implemented fully and further time was needed to ensure they were effective. Staff had been retrained in administration of medicines and there were new forms to record and monitor the support provided. Staff supported people to minimise the risk of infection.

Training had improved, though there was still a need to develop staff skills and guidance where people had more complex needs. Supervision of staff had improved, however the new systems to record and review how the service managed staff practice still needed improvement. The care manager was now able to check that people’s wellbeing and nutritional needs were being met because staff recording had improved.

Staff worked more closely with external professionals to meet people’s needs. Staff ensured support took into consideration people’s ability to make decisions about their care.

There was a more caring approach throughout the service, and an expectation of staff to treat people with respect and dignity. People had an increased say in the service they received. Support was more personalised and tailored to people’s needs. The new care plans and revie

Inspection areas

Safe

Requires improvement

Updated 3 January 2019

The service was not consistently safe.

Staff rotas were better organised and there were new systems to monitor staff visit times.

Accidents and incidents were recorded and investigated, however this process was not yet fully effective.

There had been improvements in the way the service worked to safeguard the people they supported.

Systems around medicine administration were improving.

Effective

Requires improvement

Updated 3 January 2019

The service was not consistently effective.

There had been increased investment in training. Staff did not receive adequate specialised guidance and training to meet more complex needs.

Support and monitoring of good health, nutrition and wellbeing had improved.

Staff considered people’s capacity to make decisions when providing care.

Caring

Good

Updated 3 January 2019

The service was caring.

The registered manager and care manager had worked with staff to ensure support was provided in a caring manner.

People were treated with respect and dignity.

There was an improved understanding of the need to keep people’s information safe.

Responsive

Requires improvement

Updated 3 January 2019

The service was not always responsive

Care plans were being improved to better reflect people’s needs and preferences. There was a new system in place to review the care people received.

People received flexible care, tailored to their needs.

The registered manager responded more openly to complaints. The new systems to record the outcome of complaints and any actions taken, had not yet been fully implemented.

Well-led

Requires improvement

Updated 3 January 2019

The service was not consistently well-led.

A number of new systems were still being implemented, which had the potential to result in sustainable improvements.

Relationships with external professionals and organisations were improving, however developing these further would benefit the service.

The culture was more open and communication between senior staff and people, families and care staff had improved.

There were new measures in place to check on the quality of the service which senior staff needed to coordinate better to ensure they worked effectively.