The inspection took place on 29 August 2018 with the registered provider being given short notice of the visit to the office, in line with our current methodology for inspecting domiciliary care agencies. At our previous inspection in August 2017 the service was given an overall rating of ‘Requires Improvement’. Areas highlighted for improvement were around risk assessments and the quality assurance system not always being effective in identifying shortfalls. At this inspection we found improvements had been made in both areas. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for ‘Comfort Call Limited’ on our website at www.cqc.org.uk’.

Comfort Care is a domiciliary care agency which provides personal care to people living in their own houses and flats in the community in the Rotherham area. The agency currently caters for people whose main needs are those associated with older people, including people living with dementia. People with various other needs, such as sensory impairments and learning disabilities, were also being supported. At the time of our inspection approximately 200 people were receiving personal care from the service.

The service had a registered manager in post at the time of our inspection. 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 and associated Regulations about how the service is run.

Most people were happy with the quality of the care the service provided and how it was run. They said care workers met their needs and delivered their care as they wanted it delivering. People told us their privacy and dignity was respected and staff were competent in their work, kind, friendly and helpful.

There were systems in place to reduce the risk of abuse and to assess and monitor potential risks to individual people. Concerns, complaints, incidents and accidents were being effectively investigated and monitored. This aimed to reduce risks to people and make sure they received the standard of care they expected.

Recruitment processes were robust, so helped the employer make safer recruitment decisions when employing staff. Staff had undertaken a structured induction, essential training and received regular support, to help develop their knowledge and skills so they could effectively meet people’s needs.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. People had consented to their planned care and staff understood the importance of gaining people’s consent and acting in their best interest.

Where possible, people were encouraged to manage their own medication, with some people being supported by relatives. Where assistance was required support was provided by staff who had been trained to carry out this role and whose competency was checked regularly.

People’s needs had been assessed before their care package commenced and where possible they, or their relatives, had been involved in formulating care plans. Care plans provided information and guidance to staff, which assisted them to deliver the care people needed, in the way they preferred.

People were enabled to raise complaints and concerns. The people we spoke with told us they would feel comfortable raising concerns, if they had any. When concerns had been raised the correct procedure had been used to record, investigate and resolve issues.

The system for assessing if staff were following company policies had been improved since our last inspection, so shortfalls were identified in a timely manner and addressed promptly.

The way people were consulted about their satisfaction in the service provided had been improved. People had been given opportunities to share their opinions abo

The inspection took place on 10 August 2017, with the provider being given short notice of the visit to the office in line with our current methodology for inspecting domiciliary care agencies. The service was last inspected in November 2015, and was given an overall rating of “good.” No breaches of regulations were identified at that inspection.

Comfort Call Rotherham provides personal care to people living in their own homes in the Rotherham Rotherham area. At the time of the inspection over 200 people were receiving care services from this location.

At the time of the inspection, the service did not have 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 and associated Regulations about how the service is run. There was a new manager in post who was about to begin the process of applying to register with CQC.

People using the service told us that staff had a caring approach, and praised the way staff upheld their dignity and treated them with respect. There was a comprehensive training programme in place which meant that staff were equipped with the knowledge and skills to meet people’s needs.

There was an effective complaints system in place, and where complaints had been received the provider dealt with them appropriately, making alterations to the service as required.

The recruitment system was robust, meaning that only staff with the right skills and aptitude were employed by the provider. Staff performance was managed via a system of staff supervisions and appraisals.

The provider complied with the Mental Capacity Act, ensuring that people gave informed consent to their care or that appropriate procedures were followed where people lacked the mental capacity to give consent.

Where people were at risk of harm, there were risk assessments in place, however, at times these were generic and did not consider the specific risks that people were vulnerable to.

Staff told us they felt supported by managers, although many said that they did not feel their views were listened to.

There was a comprehensive audit and quality monitoring system in place, however, it did not always identify shortfalls in service delivery.

The inspection took place on 9 November 2015 with the provider being given short notice of the visit to the office in line with our current methodology for inspecting domiciliary care agencies. The service was previously inspected on 28 May 2014, when no breaches of legal requirements were identified.

Comfort Call Rotherham provides personal care to people living in their own homes in the Rotherham and Barnsley area. Its office is based on the outskirts of Rotherham. The agency currently caters for people whose main needs are those associated with older people, but also supports people with other needs, such as a learning or physical disability.

The service had a registered manager in post at the time of our inspection. 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 and associated Regulations about how the service is run.

At the time of our inspection there were 176 people using the service. We spoke with 30 people who used the service, and seven relatives, about their experiences using the agency. The majority of people we spoke with told us they were happy with the service provided, but a minority of people highlighted areas they felt could be improved, particularly regarding the timings of calls. Staff told us that overall there were enough staff employed to meet the needs of the people being supported, and we saw additional staff was being recruited. However, staff said sometimes calls were late due to last minute sickness or needing to stay with someone longer than planned, to make sure their needs were met.

People’s needs had been assessed before their care package commenced and they told us they had been involved in formulating and updating their care plans. We found the information contained in the care records we sampled was individualised and clearly identified people’s needs and preferences, as well as any risks associated with their care and the environment they lived in.

We found people received a service that was based on their personal needs and wishes. Staff told us that changes in people’s needs were quickly identified and their care plans amended to reflect these changes. Where people needed assistance taking their medication this was administered in a timely way by staff who had been trained to carry out this role.

The requirements of the Mental Capacity Act 2005 (MCA) were in place to protect people who may not have the capacity to make decisions for themselves. The Mental Capacity Act 2005 sets out what must be done to make sure that the human rights of people who may lack mental capacity to make decisions are protected, including balancing autonomy and protection in relation to consent or refusal of care or treatment.

There was a recruitment system that helped the employer make safer recruitment decisions when employing new staff. We saw new staff had received a structured induction and essential training at the beginning of their employment. This had been followed by regular refresher training to update their knowledge and skills. Staff told us they felt well supported and received an annual appraisal of their work performance.

The company had a complaints policy which was provided to each person in the information pack provided at the start of their care package. When concerns had been raised we saw the correct procedure had been used to record, investigate and resolve issues. However, a few people we spoke with felt their comments were not always acted on effectively.

The provider had a system in place to enable people to share their opinion of the service provided. However, some people who used the service, and some of the staff we spoke with, said they had raised concerns but felt were not always acted on.

We also saw an audit system had been used to check if company policies had been followed. Where improvements were needed the provider had put action plans in place to address these.

Our inspection looked at our five questions; is the service caring? Is the service responsive? Is the service safe? Is the service effective? 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, speaking with the staff supporting them and looking at records.

If you want to see the evidence supporting our summary please read the full report.

As part of our inspection we attempted to contact 25 people using the service or their relatives. We spoke with thirteen people by telephone and visited four people in their home’s to discuss the service the agency had provided. Where people were unable to speak to us we spoke with their representatives.

Is the service safe?

The people we spoke with said they were happy with the care and support provided and felt it was delivered in a safe way. One person told us, “This is our first experience (of using a care agency) so we have nothing to compare it to, but we are satisfied with the service we get.”

Care and treatment was planned and delivered in a way that ensured people’s safety and welfare. Records were in place to monitor any specific areas where people were more at risk and explained what action staff needed to take to protect them.

Systems were in place to make sure that managers and staff learnt from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations. This reduced the risks to people and helped the service to continually improve.

Checks had been carried out on staff before they started to work at the agency to make sure they were suitable to work with vulnerable people.

Is the service effective?

People’s health and care needs were assessed on a regular basis. We saw people who used the service and their relatives had been involved in writing plans of care and these were reviewed and updated regularly.

People were provided with food and drink to meet their needs. The care plans we looked at reflected any specific dietary needs people had. People who needed assistance with preparing their meals confirmed staff did this competently and that they had access to drinks and snacks between visits.

Quality audits and care reviews took place to ensure care was delivered in a way that met people’s needs.

Is the service caring?

People said they were supported by caring and friendly staff who were aware of their needs and preferences. They described how care workers encouraged them to be as independent as they were able to be, while providing support as needed. People who used the service and the relatives we spoke with were complimentary about the overall care and support provided.

People told us care and support had been provided in accordance with their wishes. One person said, “They are very obliging and kind.”

Is the service responsive?

Care records and staff comments demonstrated that when there had been changes in people’s needs, reviews of their care package had taken place. Staff also described how other health and care professionals had been involved to make sure they received the correct care and support.

The agency had a complaints procedure which was given to people using the service at the beginning of their care package. Where concerns had been raised we saw they had been recorded and action taken to address any shortfalls found.

Is the service well-led?

There were systems in place to gain people’s views and check if staff were following company policies. We saw satisfaction surveys and review meetings had been used to enable people to share their views on the service provided. This helped the provider to assess if people were receiving the care and support they needed

When we asked people if there was anything they would like to improve most people said they were happy with the care they received and could think of nothing they would change. However two people said they would like to know exactly which care workers were to visit each day. Another person commented negatively about changes made to the timings of their calls.

Satisfaction surveys and review meetings had been used to enable people to share their views on the service provided. This helped the provider to assess if people were receiving the care and support they needed.

We saw there was a system in place to assess how the service was operating and address any shortfalls. Where areas of improvement were indicated action plans were in place to address identified shortfalls.

During our inspection we contacted five people who used the service by telephone to discuss the service provided by the agency. Where people were unable to speak to us we spoke with their representatives.

People we spoke with said they were very happy with the care and support received and felt it was delivered in a safe and consistent way. They told us staff offered them choice and respected their opinions while helping them to be as independent as possible. One person said, “Everything is perfect.” A relative commented “It is much better than the last one, these are reliable, someone always comes.”

People who used the service were protected from the risk of abuse because the provider had taken reasonable steps to become knowledgeable about abuse and how concerns should be handled.

There were effective systems in place to reduce the risk and spread of infection. People we spoke with confirmed staff always wore protective clothing and washed their hands before and after providing care.

Staff had received the training and support they needed to meet people’s needs. They told us they were well supported by the management team and said they enjoyed working for the agency.

There were systems in place to gain peoples views and check if staff were following company policies. When we asked people if there was anything they would like to improve most people said they could not think of anything they wanted to change.