There was a manager at the service who was registered with CQC. 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.

Our inspection was discussed and arranged with the registered manager two days in advance. This was to ensure we had time to visit and contact people who used the service and speak with the registered manager and staff.

We received positive comments from people who used the service, relatives and staff about the improvements made at the service in the last 12 months.

People told us they felt “Safe” in the care of the staff who worked for Comfort Call Sheffield. Staff were aware of their responsibilities in keeping people safe and had received training in safeguarding adults.

People told us where necessary they were supported by staff to take their medicines. Staff had a good understanding of the procedures for the safe administration of medicines and had completed formal training in this.

We found there were enough staff to make sure people received the care they had requested and at the agreed times. People told us care workers were generally on time and in most cases, if staff were running late for any reason, the office staff would phone to let the person know.

The service followed the requirements of the Mental Capacity Act 2005 Code of practice and Deprivation of Liberty Safeguards. This helped to protect the rights of people who were not able to make important decisions for themselves.

Staff were given appropriate support through a programme of regular training and on-going supervision and appraisal. Staff said the training provided them with the skills and knowledge they needed to do their jobs. Care staff understood their role and what was expected of them. They were happy in their work, motivated and confident in the way the service was managed.

People we spoke with and contacted during the inspection told us the staff were kind and caring.

People thought the staff had their best interests at heart and would do what was necessary to help them lead a quality life. This included providing dignified care and helping them to take part in activities which they had an interest in.

People's care plans contained consistent up to date information about their care and support, including risk assessments and action plans. These were regularly reviewed and updated in line with the person's changing needs.

The complaints procedure was explained in the ‘service user guide’ which was provided to people when they started with the service. People who used the service and their relatives told us they knew how to raise a concern or to make a complaint. Where people had expressed concerns, appropriate action had been taken by the registered manager.

The registered provider and registered manager used a variety of methods to assess and monitor the quality of the service. These included satisfaction surveys, spot checks and care reviews. We found the majority of people were satisfied with the service they received.

An adult social care inspector carried out this inspection. At the time of this inspection Comfort Call (Sheffield) was providing care and support to approximately 388 people.

As part of our inspection we telephoned 30 people who used the service or their relatives. We were able to speak with 17 people who used the service and with seven relatives who were primary carers for their family members to obtain their views of the support provided.

We also visited the agency office and spoke with five care workers, the registered manager and the managing director. In addition we looked at a selection of records.

We considered all the evidence against the outcomes we inspected to help answer our five key questions; is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well led?

Below is a summary of what we found. If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

People who used the service and relatives told us they felt safe when the care workers were in their home and that their belongings and furniture were looked after well. One person said “I don’t have any problems with any of them coming into my house. They respect me and my home.”

People told us they did not receive any advance information about the rota for their care, so they had no idea who would be coming to their house. One person said “I wish I knew who was coming because when it’s dark in the winter I don’t like to open my door to strangers.”

We found risk assessments had been undertaken to identify any potential risk and the actions required to manage the risk. This meant that people were not put at unnecessary risk but also had access to choice and remained in control of decisions about their lives.

The service had completed enhanced Disclosure and Barring Service (DBS) checks, formerly known as Criminal Records Bureau (CRB) checks for all staff working at the agency. This helped to protect people who were receiving a service.

Is the service effective?

People who used the service and relatives said that sometimes care workers were late, but there was usually a good reason for this. There was an acknowledgement that visits could not always be on time when care workers were visiting so many people. People said sometimes the office staff would ring and explain the care workers would be late, but not always.

Most people and relatives spoken with said they preferred to have regular care workers that they could get to know and who would know what care they needed. Most people said they did not always have regular care workers and this could be a problem when the care to be delivered had to be explained to different care workers. People told us they were more likely to receive care from different care workers at evenings and weekends.

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.

We found staff were provided with an induction which lasted one week. The induction covered many areas including all mandatory training and also additional specialised training in such topics as dementia and medication administration.

People who used the service and relatives told us they thought their regular care workers were experienced and well trained. Some people and relatives did not feel that some of the younger or newer staff were so well trained. Comments included, “some of these carers are very young. They’re not experienced enough to do a good job,” “these young carers just say “what do you want me to do?” and they don’t even read your notes. I don’t think that’s good enough” and “I don’t like all these young carers. They’re not experienced and it’s not fair on them either.”

Is the service caring?

People who used the service and relatives told us that on the whole, most care workers were kind, patient, cheerful, polite and caring, especially their regular carers. Positive comments included, “they are lovely girls. I can’t say anything more,” “they really do care and I couldn’t do without them” and “we always have a good laugh together and they still manage to get their work done.”

A few people said there were some care workers who were not so kind and caring. One person said, “some of them are better than others with you. I suppose that’s what you have to expect.”

Is the service responsive?

People and relatives said they would contact the office if they had a concern or a complaint. They all knew how to contact the office. Some people said they had complained to the office staff about certain care workers and had asked the office staff not to send them again. One relative told us the same care worker was sent again to their family member after they had complained and this caused a big problem as their family member became distressed. The relative had to ring the office again. It was then resolved.

Very few people or relatives had made a formal complaint, but several people told us they had contacted the office with concerns. People said that the office team rarely got back to them. Care workers spoken with also said when they rang the office to pass on important information about people’s care this was not always dealt with promptly and appropriately.

Is the service well-led?

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 found there was no evidence to confirm people had been listened to and changes made to improve their care and support package.

When asked if there was anything about their care service they would change, the two most common responses were: More visits from their regular, experienced carers and less from unknown carers and care workers keeping to the agreed visit times.

We carried out this inspection on 6 and 7 August 2015. The provider was given 48 hours notice of the inspection.

The service was last inspected on 27 November, 1 and 3 December 2014 and was not meeting the legal requirements of the regulations for management of medicines, requirements relating to workers, safeguarding people who use the service from abuse, staffing, complaints, care and welfare of people who use the service and assessing and monitoring the quality of service provision. The provider sent us a plan of actions that they would take to meet the legal requirements in relation to each breach in regulation. The provider told us they would be meeting all regulations by31 May 2015. We followed up on these breaches during our inspection and found improvements had been made in all areas.

Comfort Call, Sheffield provides personal care to people living in their own homes in several areas of Sheffield. The office is based just outside Sheffield city centre. The agency currently provides care for people whose main needs are those associated with older people, however they also support younger people with other care needs such as those relating a physical disability. At the time of our inspection they were providing approximately 3,000 hours of care each week to 418 people living in their own homes.

It is a condition of registration with the Care Quality Commission that there is 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. There was a manager present during the first day of our inspection who told us they were in the process of registering with the Care Quality Commission.

Most people told us they were happy with the service they received. Their comments included “Very happy with everything, the carers are lovely,” “Staff at the office are good, very helpful. Always have been for the last year.”

There were sufficient staff, with appropriate experience, training and skills to meet people’s needs at the required times.

The staff recruitment process was comprehensive and ensured the safety of people was promoted.

Systems for managing medicines were safe.

Staff training was up to date. Systems for supporting staff were in place.

People told us care workers were kind, caring and respectful.

People’s views were sought through questionnaires, telephone calls and home visits.

People felt able to tell staff if there was something they were not happy with. We saw that there were now systems in place to manage complaints.

There were now systems in place to monitor and improve the quality of the service provided. Regular checks and audits were undertaken to make sure full and safe procedures were adhered to.

The provider has made significant progress since our last inspection to improve the service it provides to people living in their own home. These changes are very recent and need to be sustained.