Archived: Comfort Call- Aspen Gardens

Comfort Call Stockton is a domiciliary care agency that provides care and support to people in their own homes in the community or an extra care living scheme. At the time of the inspection the service provided care and support for 173 people.

At our last inspection we rated the service good. However, we found the provider was not always notifying the Care Quality Commission of certain events they are required to by law. We took action about this outside the inspection process. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

At this inspection we found the service remained Good.

There was a manager in post who was in the process of becoming registered. A registered manager is a person who has registered with CQC 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.

The provider had arrangements in place to protect people from risks to their safety and welfare, including the risks of avoidable harm and abuse. Staffing levels were sufficient to support people safely and in line with their agreed care visits. Recruitment processes were in place to make sure the provider only employed workers who were suitable to work in a care setting. There were arrangements in place to protect people from risks associated with the management of medicines and the spread of infection.

Care and support were based on detailed assessments and care plans, which were reviewed and kept up to date. Staff received appropriate training and supervision to maintain and develop their skills and knowledge to support people according to their needs. People's rights were protected by staff who under stood the Mental Capacity Act and how this applied to their role. Where appropriate, people were supported to eat and drink enough to maintain their health and welfare. People were supported to access healthcare services, such as GPs.

Care workers had developed caring relationships with people they supported. People were supported to take part in decisions about their care and treatment, and their views were listened to. Staff respected people's independence, privacy, and dignity.

People's care and support considered people's abilities, needs and preferences, and reflected their physical, emotional and social needs. People were kept aware of the provider's complaints procedure, and complaints were managed in a professional manner.

Effective management systems were in place to monitor the quality of care provided and to promote people's safety and welfare.

Comfort Call Stockton is a domiciliary care service which provides personal care to people living in the Stockton on Tees area. The offices are situated in a local Extra Care housing complex and near to the North Tees Hospital. At the time of the inspection 130 people used the service. Some of these people lived in the Extra Care housing complex and others lived at home in the wider community.

The service was last inspected in December 2015 and January and February 2016. During that visit we identified breaches of our regulations. Care records did not record whether people had consented to their information being disclosed to their emergency contacts. It was not always clear whether people had capacity to consent to their care. Where people had been appointed to make decisions on people's behalf, the service did not retain evidence of their legal power to do so. Care plans did not always contain information of people's preferences or how they wanted to be supported. The registered provider did not maintain an accurate, complete and contemporaneous record in respect of each person using the service. The registered provider's quality assurance procedures had not identified this issue or led to remedial action. We took action by requiring the registered provider to send us action plans setting out how they would make improvements. When we returned for out latest inspection we found this action had been taken and improvements had been made.

At the previous inspection the registered provider also failed to mitigate risks relating to the health, safety and welfare of people by making required notifications without delay to the Commission on safeguarding issues. We issued a fixed penalty notice in relation to this breach of our regulations.

When we returned for our latest inspection we found that the Commission had not been notified of one safeguarding incident until three weeks after it occurred. We also saw that we had not received a notification in relation to another incident involving a medicine error. Both incidents had been investigated and the registered provider had taken remedial action but the Commission had not received required notifications without delay.

The service did not have a registered manager. There was a manager in place but they were not registered. 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. The manager had been in post since July 2017 and was supported by an area manager employed by the registered provider.

People told us they felt safe using the service. Risks to people using the service were assessed and plans put in place to reduce the chances of them occurring. Accidents and incidents were monitored to see if improvements could be made to help keep people safe. Plans were in place to support people in emergency situations that disrupted the service. Medicines were managed safely. Procedures were in place to safeguard people from the types of abuse that can occur in care settings. Staff said there were enough staff deployed to provide safe care. The registered provider’s recruitment procedures reduced the risk of unsuitable staff being employed.

People’s rights under the Mental Capacity Act 2005 were protected. People told us staff had the skills and training needed to support them effectively. Staff were supported through regular training, supervision and appraisal. Staff spoke positively about the training they received. Some people received support with food and nutrition as part of their care packages. Where this was the case people spoke positively about the support they received. People were supported to access external professionals to maintain and promote their health.

People and their relatives spoke positively about the care provided by the service, describing the service as kind and caring. People told us they were very happy with the care they received and could not think of anything they would change about the service. People told us staff treated them with dignity and respect. People also said staff helped them to maintain their independence by encouraging them to do as much as they could for themselves. The service had received written compliments about the quality of care it provided. Procedures were in place to support people to access advocacy services where appropriate.

Care plans contained detail on what was important to people and how they wished to be supported. Where a support need was identified person-centred care plans were developed. Person-centred planning is a way of helping someone to plan their life and support, focusing on what’s important to the person. People we spoke with told us staff had gotten to know their needs and preferences and that they were able to make their own decisions on how they would like to be supported. Procedures were in place to respond to and act on people’s complaints.

People and staff we spoke with said the service had improved since our last inspection and spoke positively about the manager. The manager and area manager carried out a number of quality assurance checks to monitor and improve standards at the service. Feedback was sought from people using the service through regular quality assurance visits and telephone calls.

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 Stockton is a domiciliary care service which provides personal care to people living in the Stockton on Tees area. The offices are situated in a local Extra Care housing complex and near to the North Tees Hospital. At the time of the inspection 148 people used the service. 60 people using the service lived in the Extra Care housing complex that housed the service’s office, and the remaining 88 lived at home in the wider community.

The service had a registered manager, but they had recently gone on long-term leave. In their absence, the service was being managed by the registered manager of a nearby service and an area 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.

Care records did not record whether people had consented to their information being disclosed to their emergency contacts. It was not always clear whether people had capacity to consent to their care. Where people had been appointed to make decisions on people’s behalf, the service did not retain evidence of their legal power to do so. Care plans did not always contain information people’s preferences or how they wanted to be supported. The provider did not mitigate risks relating to the health, safety and welfare of people by making required notifications to the Commission on safeguarding issues. The provider did not maintain an accurate, complete and contemporaneous record in respect of each person using the service. The provider's quality assurance procedures had not identified this issue or led to remedial action.

These were breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we took at the back of this report.

We found that the provider had failed to notify the Commission of safeguarding incidents that had occurred in 2015, as the service was required to do.

This was a breach of Regulation 18 of the Care Quality Commission (Registration) Regulations 2009. We are taking action in regards to this and will report further once our actions are complete.

People felt safe using the service. Risks to them were fully assessed and care plans were designed to minimise them. Staff understood safeguarding issues, and the service operated procedures to deal with any incidents that occurred.

The service had policies and procedures in place to ensure that medicines were handled safely. However, a record of people’s medicines was not kept in people’s care plans so we made a recommendation that the service follow the guidance issued by the National Institute of Health and Care Excellence on medicines management and record keeping.

People told us that they received a continuity of care from staff they knew. The service operated recruitment procedures that ensured that only suitable people were employed.

Staff received regular training in the areas they needed to support people effectively. Their performance was monitored and supported through a regular system of supervisions and appraisals.

People were supported to access external health services to ensure their general health and wellbeing.

People and their relatives spoke highly of staff and the care they received.

The service had a policy for dealing with complaints, but we could not see any records of investigation or that outcomes were communicated to people. We have made a recommendation about the management of complaints.

Quality assurance checks were carried out to monitor whether people were happy with the care they received, and people told us they would be happy to raise issues with management.

Staff told us that their views were sought, that management was approachable and that they felt involved in the running of the service.

We found that the manager had a core set of staff visiting each person and this allowed them to readily cover annual leave and sickness with familiar staff to the person. The manager explained how consistency in care was one of the primary principles of the service.

The people we spoke with were extremely complimentary about the staff who supported them. They felt the staff understood their needs and provided effective care.

People said, "I find the staff are always on time, are really pleasant and really do a good job", "I always get the same staff and that is fantastic", "The staff are always very friendly and polite," and "I find the staff are very good at their job and always makes me feel at ease".