We carried out a review of the data available to us about Comfort Call Gateshead on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Comfort Call Gateshead, you can give feedback on this service.
Comfort Call Gateshead is a domiciliary care agency providing personal care and support to people living in their own homes. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided. At the time of inspection 137 people were receiving personal care.
People’s experience of using this service and what we found
We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.
At the time of the inspection, the location did not care or support for anyone with a learning disability or an autistic person. However, we assessed the care provision under Right Support, Right Care, Right Culture, as it is registered as a specialist service for this population group.
People and relatives were happy with the service and the care people received. A new staff rota system had been implemented since the last inspection and most people and relatives reported they received care from consistent staff who mostly arrived on time and stayed for the correct duration. People and relatives told us they had raised concerns previously and these were acted upon and resolved. However, a small number still felt things raised weren’t always acted upon. We have made a recommendation about this.
Lessons had been learned since our last inspection and improvements had been made. The provider learned from previous accidents and incidents to reduce future risks to people.
There were enough staff to meet people’s needs and the provider was operating a continuous recruitment process to increase staffing levels further. Safe recruitment processes were followed. There were systems in place to keep people safe. Risks to people’s health, safety and well-being were managed. Staff safeguarded people from abuse. Medicines were safely administered and managed. The provider and staff protected people from the risk or spread of infection.
Staff were kind and compassionate and supported people in a respectful, dignified manner. Staff encouraged people to maintain their independence where safe and possible to do so. Relatives supported people to make decisions around their care and support.
The provider had quality assurance process in place which included regular audits and spot checks. Most people and relatives were happy with the service and felt it was well-managed. Comments included, “I would describe (staff) as kind and caring. For any major changes I am called. I know the full pool of people that come, and they support [family member] in the way that she prefers” and, “I wouldn’t have recommended in the past but now things have improved, I would.” The registered manager promoted an open and honest culture and was approachable. People and relatives were regularly consulted about the quality of the service through surveys and reviews.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was requires improvement (published 21 December 2020).
Why we inspected
We carried out a focused inspection of this service on 21 December 2020 looking at safe, caring and well-led. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve Regulation 17 (Good governance).
We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe, Caring and Well-led which contain those requirements.
For the key question not inspected, we used the rating awarded at the last comprehensive inspection to calculate the overall rating. The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Comfort Call Gateshead on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
Comfort Call Gateshead is a large domiciliary care agency providing personal and nursing care to in excess of 1000 people at the time of the inspection.
Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.
People’s experience of using this service and what we found
A significant number of people and relatives were unhappy with the current rota system. Care workers were regularly late, not always consistent and calls were often cut short. Although most people and relatives felt staff were caring, the inconsistencies they experienced had a negative impact on the care they received. Most staff gave similar feedback describing their rotas as unmanageable and constantly changing. Rotas we viewed mirrored this feedback.
People and relatives told us they had raised concerns about inconsistent care many times without improvement. During the last consultation with people using the service between September and December 2019 a significant number of people rated the service very poor or poor for time keeping, communication and dealing with complaints quickly.
The provider lacked a robust system to investigate and address incidents. Investigation reports did not evidence thorough investigations took place to ensure risks to people’s safety were managed safely. Although the provider monitored incidents, action plans lacked detail and lessons learnt were not identified and shared.
Staff knew how to raise concerns and most felt confident to do so. Safeguarding referrals were made to the local authority when required.
Although the provider had a structured approach to quality assurance, these systems had not been successful in improving people’s experience.
Staff gave mixed feedback about the culture of the organisation. A significant number of staff told us management were not approachable and felt their views were not listened to.
The provider has developed an immediate action plan to address the issues identified with the South Tyneside branch.
The provider followed safe recruitment processes to recruit new staff and managed medicines safely.
Staff had access to the personal protective equipment (PPE) they needed. The provider took timely action to ensure staff consistently followed PPE guidance.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published 8 November 2018).
Why we inspected
We undertook this targeted inspection to follow up on specific concerns which we had received about the service. The inspection was prompted in part due to concerns received about the quality of people’s care, treating people with dignity and the robustness of investigations to address concerns raised.
CQC have introduced targeted inspections to follow up on Warning Notices or to check specific concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question.
Following feedback from people using the service and staff gathered during the inspection, a decision was made for us to inspect and examine those risks.
We inspected and found there was a concern with timings and duration of care calls, poor communication and the effectiveness of investigations to address these concerns, so we widened the scope of the inspection to become a focused inspection which included the key questions of safe, effective and well-led.
The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection.
We have found evidence that the provider needs to make improvement.
You can see what action we have asked the provider to take at the end of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Comfort Call Gateshead on our website at www.cqc.org.uk.
Follow up
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to adults of all ages. Some of the people who used the service had mental health needs or were living with a dementia type illness.
On the days of our inspection there were 1490 people using the service. Not everyone using Comfort Call Gateshead receives the regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.
This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.
We last inspected the service in March 2016 and rated the service as ‘Good’. At this inspection we found the service remained ‘Good’ and met all the fundamental standards we inspected against.
Risk assessments were in place for people who used the service and staff. The registered manager understood their responsibilities with regard to safeguarding and staff had been trained in safeguarding vulnerable adults.
Appropriate arrangements were in place to support people with the administration of medicines.
Although there had been some missed and late calls, appropriate action had been taken in response and most of the feedback from people was positive.
The provider had an effective recruitment and selection procedure in place and carried out relevant vetting checks when they employed staff. Staff were suitably trained and received regular supervisions and appraisals.
People were supported to have maximum choice and control of their lives, and staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice.
People were protected from the risk of poor nutrition and staff were aware of people’s nutritional needs. People were supported with their health care needs and to attend appointments where necessary.
People who used the service and family members were complimentary about the standard of care at Comfort Call Gateshead. Staff treated people with dignity and respect and helped to maintain people’s independence by encouraging them to care for themselves where possible.
Care records showed that people’s needs were assessed before they started using the service and support plans were written in a person-centred way. Person-centred means ensuring the person is at the centre of any care or support plans and their individual wishes, needs and choices are taken into account.
People were protected from social isolation and the service had links with the local community.
The provider had an effective quality assurance process in place. Staff said they felt supported by the management team. People, family members and staff were regularly consulted about the quality of the service.
We carried out this focused inspection on 7 and 21 December 2016 to check whether the provider’s quality assurance and management systems led to improvements in the running of the service.
Comfort Call Gateshead is a domiciliary care agency which is registered with the Care Quality Commission to provide personal care for people in their own homes. The agency operates in the Sunderland, South Tyneside and Gateshead areas. The agency also provides a domiciliary care service to people who live in extra care housing schemes. There were approximately 1,500 people using the personal care service provided by this agency.
There were registered managers in place at the service. 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.
Since the last inspection the registered manager had been promoted to regional manager. Two branch managers, who were responsible for the management the care service provided in two local authority areas, had registered as managers with the Commission. A third branch manager, who was new in post, was also planning to apply for registration. This meant there was shared responsibility and greater management oversight of this very large domiciliary care agency.
We found the provider had made its quality assurance processes more robust and this was leading to improvements in the service. The managers were using the organisation's business management systems more effectively so that trends and areas for remedial action were identified and addressed.
Most of the people and relatives we spoke with felt the service was “well managed” and all felt able to contact the office.
While improvements had been made we could not improve the rating for Well-Led from requires improvement because to do so requires consistent good practice over time. We will check this during our next planned comprehensive inspection.
After the inspection the provider wrote to us to say what they would do to meet legal requirements.
On 10 and 11 February, and 4 March 2016 we carried out this comprehensive inspection to check whether the provider had addressed these breaches. We found there had been improvements in these areas.
Comfort Call Gateshead is a domiciliary care agency which is registered with the Care Quality Commission to provide personal care for people in their own homes. The agency operates in the Sunderland, South Tyneside and Gateshead areas. The agency also provides a domiciliary care service to people who live in an extra care housing scheme. At the time of this inspection there were approximately 1,500 people using the personal care service provided by this agency.
The agency 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.
During this visit we found the provider had recently begun to carry out more in-depth quality assurance audits of the service. However, these showed that some previously identified areas for improvement had not been actioned. In this way, although the provider had quality assurance processes in place, these had not always been effective. Also, some notifications required by the Care Quality Commission (CQC) had not always been sent to us in a timely way. You can see what action we asked the provider to take at the back of this report.
People told us they felt “safe” and “well treated” by the care workers who visited them. For example, one person told us, “I feel safe. I like the carers they are all good. They are kind.” Staff had training in safeguarding adults and they knew how to report any concerns.
There were enough staff employed to carry out all the visits that were required, and the agency constantly recruited new members of staff. The agency made sure that staff were fully checked before starting to work with people.
Some people had regular teams of care staff and this made them feel confident in the staff who supported them. Other people said they did not always know which care staff would visit them and were not always told if they were going to be late. Staff told us they were not allocated travelling time between calls, which meant they sometimes arrived late.
People and relatives we spoke with felt the care workers were “well trained” and provided the right support. Staff felt they received good training and were supported in their roles. One staff member told us, “The training is phenomenal.”
People who needed support with meals told us they were in control of what they had and how it was prepared. Staff liaised with other care or health services if there were changes in people’s needs.
Some people said they had had the same care staff for years. This allowed them to develop good relationships. One person said it was just like having their family come in to help because they knew them so well. All the people we spoke with said care workers were “caring” and “kind”. care and kindness of care staff. Their comments included, “The girls are polite and kind”, “they are very courteous” and “they are very nice”.
Care workers were positive about their work and spoke warmly of the people they cared for. They said they stayed longer if a person was upset or ill and in need of a bit of comfort.
The care records about people were detailed, personalised and written in a sensitive way. People kept a copy of their care plans in their own homes so they and their care workers could refer to them at any time. People felt in control of their care arrangements.
People said they were regularly asked for their views of the service they received. This was carried out during quality assurance telephone calls, quality assurance visits to their home and during ‘spot checks’ of staff practice.
Staff said there was a good culture within the service and they felt supported by their immediate line supervisor. All the staff we spoke with confirmed they could raise issues with the management and said they were “approachable”. There were two other branch managers to assist the registered manager, and there were plans for them to be registered with CQC.
Comfort Call Gateshead is a domiciliary care agency which is registered with the Care Quality Commission to provide personal care for people in their own homes. The agency operates in the Sunderland, South Tyneside, Gateshead and Chester-le-Street areas. The agency also provides a domiciliary care service to people who live in an extra care housing scheme. At the time of this inspection there were approximately 1,300 people using the personal care service provided by this agency.
The last inspection of Comfort Call Gateshead was carried out on 2 May 2014. The service met the regulations we inspected against at that time.
This inspection was carried out on 5 February, and 13 and 31 March 2015.
The agency had a registered manager who had worked for the provider for several years. 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.
We found the provider had breached Regulations 13 and 19 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. We found improvements were required to the management of medicines. People were not always supported with their medicines in a safe way. People did not always receive the right support and medicines records were not always completed.
Also, the agency did not always manage complaints in the right way. Some people felt their complaints were not listened to, some people felt their concerns continued to reoccur even after their complaint had been investigated, and the records of how some complaints were managed were not always completed. You can see what action we told the provider to take at the back of the full version of the report.
People told us they felt safe with the staff who supported them. Staff completed training in safeguarding adults before they started to work with people and had annual refresher training. This meant they knew how to deal with any concerns about people’s safety.
There were enough staff employed to carry out all the visits that were required, and the agency constantly recruited new staff. The agency made sure that staff were fully vetted before starting to work with people.
Some people had regular teams of care staff and this made them feel confident in the staff who supported them. Other people said they did not know which care staff would visit them and were not always told if they were going to be late. People and staff told us care staff were not allocated travelling time between calls, which meant they did not always get their full visit.
People felt the staff were suitably skilled to provide their care. Staff had relevant training and supervision to assist people in the right way. New members of staff received thorough induction training so they were prepared for their role.
People were involved in making decisions about their own care arrangements. Their care was planned and regularly reviewed. People who had a regular team of care workers felt staff were knowledgeable about their individual needs and preferences. People were supported with their meals if they needed support with their nutrition.
People were very positive about the caring nature of the agency staff. People and their relatives described care staff as caring, kind and helpful. People said their dignity and privacy were respected and maintained by the care workers. They told us staff supported them with closing curtains if they were getting washed.
A health care professional told us the care staff they had observed showed “compassion and kindness in their interaction with clients”.
People felt they were fully involved in making decisions about their care package. All the people we spoke with said they (and sometimes a relative) had been present when their care plan was drawn up. People kept a copy of their care plans in their own homes so they and their care workers could refer to them at any time. The care plans were personalised and written in a sensitive way.
People, relatives and health care professionals who knew the registered manager made many positive comments about her professionalism and helpfulness. Staff said they felt valued and supported by the registered manager and by the organisation.
However some people did not know any of the management staff and had no information about this. Some people felt there were not enough office staff to support the running of the agency, because they did not always receive a response when they requested return phone calls.
The provider had systems to check the quality of the service such as questionnaires, spot checks and audits. Although the system identified gaps these were not always addressed so the system was not always effective.
Is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well-led?
Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, their relatives and the staff supporting them, and from looking at records.
If you want to see the evidence supporting our summary please read the full report.
Is the service safe?
We saw checks had been completed by the manager around the persons own home environment. This meant that the provider where possible ensured the home was safe for both the people who used the service and the staff. The provider had developed systems to ensure potential risks were assessed and managed. Where staff had identified a potential risk, either during the initial assessment or after admission, a risk assessment had been completed to ensure people remained safe.
Is the service effective?
We spoke with the manager of the service about a person's journey from the point of referral to support being provided. They told us that an information pack about the service was sent to the person. If the person and/or their family or representative wished to proceed with the service, the manager and senior carer then visited in order to discuss the support required.
We saw before people started to use the service an assessment of needs was completed. This included an assessment of the support people required for activities and tasks such as waking and dressing, personal hygiene, communication needs and mobility.
Is the service caring?
We looked at five care records of people who used the service. We saw people's needs had been individually assessed, and where necessary plans of care drawn up. We saw detailed information had been supplied by other agencies, such as social services. For example, one person's care plan was on the end of life pathway and we saw appropriate information around the support other professionals were providing. This additional information was used to complement the care plans and to guide staff about how to meet people's needs. We saw formal reviews of people's care plans were held. It was evident people and their relatives or representatives had been involved. This meant the risk of people receiving unsafe or inappropriate care was reduced.
Is the service responsive?
During the inspection we spoke with the care co-ordinators who told us that people got a rota each week to inform them of the times staff would be calling and who would be providing their care. Care plans were evaluated each month to ensure they remained current. The record of the review included a summary about each person's current situation. Formal reviews of care and support took place, and the person was able to decide who they wished to invite to attend. For example, this could include a relative, social worker and an advocate. Relatives we spoke with told us, "I have come along to a review" and "I get invited to a review but they also let me know what is going on a regular basis."
Is the service well-led?
We were able to confirm that there were processes in place to monitor the quality of service provided. We saw audits were carried out monthly by the regional manager to look at complaints and to identify common themes that may arise.
Management had provided staff with up to date and comprehensive policy and procedural guidance.
Wesaw regular audits were carried out to ensure the correct completion of medication administration records and checks on staffing levels, safeguarding concerns and referrals and training.
We saw senior staff had observed staff providing care in people's homes so they could assess how they carried out their work and check they were following company policies.
People told us the agency was flexible and responsive to their requests for changes. Staff were described as being "Reliable and always on time", as well as being "Lovely". One person told us "When we agree a time they are never late" and "They always stay long enough". They all told us there had never been a time when the carer missed a visit, one said "We need two at a time and they always come at the same time".
One relative told us they had confidence in the staff and their relative felt safe and relaxed when staff were in the house, the service user agreed with this statement. No one spoken with had any concerns or had needed to make a complaint.
The records were detailed, up to date and staff knew about their content. Staff told us they could discuss concerns they had with the manager or the supervisor. They told us that they were confident that they would take any action necessary to protect people. The service had systems and records to show how they reviewed the quality of the service they provided and take action when improvements were required.
We received information through the Care Quality Commission (CQC) website that suggested there was inadequate training of staff in catheter care. We found care plans were in place and these provided detailed guidance to staff on managing the support people needed with their catheters. The daily report sheets showed the care that people had received in relation to catheter care, and these were dated and signed by the carers who provided the support.
We looked at staff training and the records showed that all staff except two had received appropriate training in catheter care. On the day of our visit to the offices of agency, we noticed some staff were receiving update training in catheter care.
Some of the comments we received from the people we spoke with included:
'I have nearly the same carers all the time which makes me happy';
'They let me know if my regular carer was not available and someone else was coming in their place';
'My carers are a great comfort to me and I have a lot of confidence in them'.
'I have concerns at about the care I get. I have been using this company for years and I have no complaints'.