Archived: Comfort Call - Beechfield

Updated 25 October 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

We gave the service 48 hours’ notice of the inspection visit to ensure the registered manager and required records would be available to us in the day of the inspection. Inspection site visit activity started on 30 August 2018 and ended on 3 September 2018. It included telephone calls to people, their relatives and staff. We visited the office location on 30 August and 3 September 2018 to see the registered manager and office staff, and to review care records and policies and procedures.

The inspection team consisted of one adult social care inspector and a pharmacist inspector. An Expert by Experience spoke to people and relatives by telephone. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

We used information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make.

We reviewed information we held about the service such as notifications of serious events. We contacted the commissioners of the relevant local authorities, the local authority safeguarding team and other professionals who worked with the service, to gain their views of the care provided by Comfort Call Beechfield.

We spoke with eight people who received personal care from the service and six relatives. We looked at eight plans of care and support and eight people’s medicine records. We spoke with nine members of staff, including the registered manager, a coordinator and seven care staff. We also spoke with the provider’s area manager.

We looked at seven staff files, which included recruitment records. We also looked at records involved with the day to day managements and running of the service.

Updated 25 October 2018

This comprehensive inspection took place on 30 August and 3 September 2018 and was unannounced.

Comfort Call Beechfield provides care for people living in flats and bungalows at Beechfield Court in Middlesbrough and Orchid Close in Thirsk.

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats. It provides a service to older adults, people who have physical and mental health conditions and those who have a dementia type illness. Not everyone using Comfort Call Beechfield receives a regulated activity. CQC only inspects the service being received by people provided with personal care. At the time of our inspection 72 people using the service received personal care.

The communal areas of Beechfield Court include a café and hairdressing salon which are also open to the public. People have emergency buzzers in their homes which they can use to alert staff if they require emergency assistance outside of their regular care calls. Staff are based on-site at all times. The building is managed by Group Thirteen which is also based at the service.

There was a registered manager in place. 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.

At the last comprehensive inspection of the service in January 2017 we identified four breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 which related to Dignity and respect, Staffing, Safe care and treatment and Good governance. We issued two warning notices in relation to Safe care and treatment and Good governance and asked the registered provider to take immediate action to make improvements. A subsequent inspection took place in August 2017 which focused on the areas where we had issued warning notices. At the focused inspection we found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 related to Safe care and treatment and Good governance. Following the focused inspection, the provider sent us an action plan which detailed actions already taken and those yet to be completed. All actions had dates in place by which the registered provided expected them to be completed.

At this inspection we reviewed the action the provider had taken to address the issues we found at the last two inspections. We noted that improvements had been made however we identified two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 relating to Safe Care and treatment and Good governance.

You can see what action we told the provider to take at the back of the full version of this report.

This is the fourth time the service has been rated Requires Improvement.

We identified that medicines were not always managed safely. We found that some risks to individuals were documented but information was missing around other risks. Regular quality assurance checks took place; however, these were not robust.

People and relatives gave mixed reviews about staffing levels. Staffing levels were monitored by the registered manager.

People were safeguarded from abuse and avoidable harm. The provider followed safe recruitment procedures to minimise the risk of unsuitable staff being employed.

Infection control policies and procedures were followed to support the control of infection.

We identified some gaps in care plans relating to people’s health conditions. The care that was planned was personalised.

Staff were supported with their inductions and had regular supervision meetings and an annual appraisal. Staff received training, the provider deemed key to help them keep people safe.

Staff sought consent from people before carrying out tasks with them. People were always supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice.

People were supported to access external professionals to monitor and promote their health. People told us that staff helped them with shopping and the preparation of food when needed. The registered manager told us that procedures were in place should anyone require additional support with their nutrition and hydration.

Most of the people and relatives we spoke with said that the staff team were kind and caring. We were told by both people and their relatives that staff treated people with respect and promoted independence.

Outside of people's planned care visits, regular activities took place at the service which relatives and friends could attend. Group Thirteen, Comfort Call Beechfield and people using the service worked together to plan these activities. People told us they were happy with the activities at the service.

People and their relatives told us they knew how to complain. A complaints policy and procedure was in place. Feedback from people, relatives and staff about the service was sought.

Staff understood and followed people's care and support plans. The provider had policies in place to support people with end of life care if needed.