We carried out this inspection on 22 August 2018. This inspection was announced, which meant the provider was given 48 hours’ notice of our inspection visit. This was because the location provides a small domiciliary care service and we needed to be sure that someone would be available to meet with us.

We checked progress the registered provider had made following our inspection on 7 June 2017 when we found four breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, relating to safe care and treatment, dignity and respect, receiving and acting on complaints, and good governance.

Following the last inspection, we met with the registered provider and asked them to complete an action plan to show what they would do and by when to improve the key questions of safe, effective, caring, responsive and well-led to at least good. At this inspection we found improvements had been made and the service was no longer in breach of regulations.

This service provides care and support to people living in specialist ‘extra care’ housing. Extra care housing is purpose-built or adapted single household accommodation in a shared site or building. The accommodation is bought or rented, and is the occupant’s own home. People’s care and housing are provided under separate contractual agreements. The Care Quality Commission (CQC) does not regulate premises used for extra care housing; this inspection looked at people’s personal care and support service.

People using this service lived in flats within a purpose built building. Not everyone living at White Willows received support with personal care; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

Care and support is provided from 7am to 10pm, with an on-call service throughout the night for emergency support. At the time of this inspection there were 30 people living at White Willows who were provided with ‘personal care’ from Comfort Call.

There was a manager at the service who was registered with the Care Quality Commission (CQC). A registered manager is a person who has registered with the CQC 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.

Safe procedures were in place to make sure people received their medicines as prescribed.

Staff understood what it meant to protect people from abuse. They told us they were confident any concerns they raised would be taken seriously by the registered manager and team leader.

There were enough staff available to ensure people’s care and support needs were met. The registered provider had effective recruitment procedures in place to make sure staff had the required skills and were of suitable character and background.

Staff understood the requirements of the Mental Capacity Act 2005. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The registered provider’s policies and systems supported this practice.

People were supported to access relevant health and social care professionals to ensure they were getting the care and support they needed to best meet their needs.

Staff were provided with an effective induction and relevant training to make sure they had the right skills and knowledge for their role. Staff were supported in their jobs through regular supervisions and an annual appraisal.

Positive and supportive relationships had been developed between people, their relatives, and staff. People told us they were treated with dignity and respect.

There was a clear complaints policy and procedure in place

People received personalised care. Care records reflected peop

We carried out this inspection on 7 June 2017. This inspection was announced, which meant the provider was given 48 hours’ notice of our inspection visit. This was because the location provides a small domiciliary care service and we needed to be sure that someone would be available to meet with us.

Comfort Call provides personal care to people who live in self-contained flats within the extra care housing complex of White Willows. Care and support is provided from 7am to 10pm, with an on call service throughout the night for emergency support. At the time of this inspection there were 35 people living at White Willows who were in receipt of a service from Comfort Call.

There was a manager at the service who was registered with the Care Quality Commission (CQC). A registered manager is a person who has registered with the CQC 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.

Not all medicines were stored safely or administered correctly. We found gaps in medication administration records (MARs) which meant people may not have always have been given their medicines at the right time. MARs were not effectively audited to check that medicines were given to people as prescribed.

No everyone living at White Willows told us they felt safe living there. Some people told us the registered manager did not always respect their privacy or treat them with respect.

All staff we spoke with understood what it meant to protect people from abuse and what actions to take if they suspected someone was being abused.

The service had a safe and effective recruitment and selection procedure in place and they carried out relevant checks when they employed staff.

Staff told us and records showed they received supervisions, appraisals and team meetings to support them to carry out their jobs effectively. However, the frequency of these did not always meet the requirements of the service’s own training and development policy.

The registered manager and staff were aware of the requirements of the Mental Capacity Act 2005.

People told us they had access to a range of health care professionals to help maintain their health and wellbeing. However, we found this was not clearly or consistently documented in people’s care records, making it difficult to identify any changes in people’s care and support needs.

People’s care records were not regularly reviewed. This meant the information about how to best support people to meet their needs was incomplete, inaccurate and may have changed.

The care records we looked at included risk assessments, which identified any risks to the person’s health and wellbeing. However, there was no evidence of any of the risk assessments being updated following a review or change in the person’s needs. This meant the information regarding each risk may no longer be relevant to the person.

People were encouraged to make decisions about their meals, and were supported to go shopping if required.

We saw positive interactions throughout the day between people and all staff working for Comfort Call at White Willows. Care workers spoke passionately about the people they supported; they knew people's likes and dislikes. People's comments about the care workers were nearly all positive.

The service had an up to date complaints and compliments policy and procedure. However, some people told us they weren’t satisfied with the responses they had received. As a result some people told us they did not think it was worth complaining.

There were limited quality audits undertaken to check on the standard of the service people received. Where these did take place we saw they had been completed incorrectly or there was no clear record of any actions to be taken as a result.

The service had up to date policies and procedures whi