Comfort Call Nottingham

Updated 21 September 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

Inspection team

The inspection was conducted by two inspectors and three Experts by Experience.

An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was not a registered manager in post. A new manager had been recently recruited and submitted an application to register.

Notice of inspection

This inspection was announced. We gave the service 48 hours' notice of the inspection. This was because we needed to be sure that the provider or management would be in the office to support the inspection. Inspection activity started on 30 June 2023 and ended on 4 July 2023. We visited the office location on 30 June 2023.

What we did before the inspection

Before our inspection, we reviewed the information we held about the service. This included reviewing the last inspection report and statutory notifications received. A statutory notification is information about important events, which the provider is required to send us by law, such as allegations of abuse and serious injuries. We sought feedback from the local authority and professionals who work with the service. The provider was not asked before this inspection to complete a Provider Information Return. This is information providers are required to send us with key information about the service, what it does well and improvements they plan to make. We took this into account in making our judgements in this report. We also contacted Healthwatch, this is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used all of this information to plan our inspection.

During the inspection

We spoke with 29 people who used the service and 3 relatives about their experience of the care provided. We spoke with the manager and regional manager, 10 care staff and one care coordinator. We reviewed a range of records. These included parts of 10 people’s care records, including medication records. We looked at three staff files in relation to recruitment. A variety of records relating to the management of the service, complaints, compliments, incidents and the systems and processes used to monitor the quality and safety of the service.

Updated 21 September 2023

About the service

Comfort Call Nottingham is a domiciliary care agency, providing personal care to people living in and around Nottingham City. 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 the inspection 240 people were receiving personal care as part of their care package.

People’s experience of using this service and what we found

Risks were not always managed effectively. Information about risks and the safety of people was not always comprehensive or up to date. People’s risk assessments were not always in place and guidance for staff on how to support people was not always clear and thorough.

Staff were not always given enough time to travel to people which resulted in some support calls being late. Staff training did not provide staff with all the skills they needed. As a result, not all staff felt confident in delivering all areas of support. For example when supporting people in distress. Not all staff felt supported, because they have not always received regular supervisions or attended staff meetings.

The leadership was not always reliable because the provider did not ensure appropriate cover for absent managers. As a result, we identified shortfalls in the governance of the service. The quality assurance processes were not always effective in ensuring risks were managed effectively. People did not always feel their complaints were managed effectively because the provider did not always follow their own complaint’s policy.

People’s mental capacity was assessed by staff who understood their responsibilities; however, the provider did not record the assessments in line with the legislation.

People’s prescribed medicines were mostly safely managed and administered by trained staff.

People were protected from abuse bullying, harassment and avoidable harm, by staff who understood their safeguarding responsibilities.

Staff had received training and ongoing information and guidance about how to reduce the potential spread of infections.

People were supported to have a healthy diet when this was identified as an area of support. People’s changing needs were monitored by staff who referred them to external health and support services when needed.

People were treated with kindness and compassion by staff who respected people’s dignity and independence.

The service was responsive to people’s needs, preferences, interests, and communication needs. People felt involved in the planning and delivery of their care. People were supported with activities of their choice when this was identified as area of support.

Staff worked in partnership with other services to support care provision, service development and joined-up care.

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 17 December 2020).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection.

Enforcement and Recommendations

We have identified breaches in relation to risk management and good governance at this inspection.

Please see the action we have told the provider to take at the end of this report.

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 continue to monitor information we receive about the service, which will help inform when we next inspect.