This inspection took place on 29 December 2015 and was announced. The provider was given 48 hours notice because the location provides a domiciliary care service and we needed to be sure that someone would be in. A second day of inspection took place on 8 January 2016, and was announced. 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.