The inspection tool place on the 12 and 14 September and was announced. We gave the service 48 hours' notice of the inspection visit because we needed to be sure that a manager would be available.

This service is a domiciliary care agency, providing personal care to people living in their own houses and flats in the community. It provides a service to older adults and younger adults who may have additional needs including physical and learning disabilities and sensory impairments.

Not everyone using Comfort Call receives regulated activity; 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. At the time of the inspection the service was supporting 167 people with personal care.

The service had 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.

The people we spoke with were happy with the service they received. They told us “they’ve been very good” and “I’ve always been very pleased, I have no complaints.”

There was a safe system of recruitment in place which helped protect people who used the service from unsuitable staff. Staff received training, supervision and appraisals. This meant that staff were supported to undertake their job roles effectively.

Medicines were managed safely and people received their medicines as prescribed.

Staff were aware of how to protect people from harm. Risks to people who used the service and staff were assessed. Guidance was given to staff on how to minimise those risks.

Suitable arrangements were in place to help ensure people's health and nutritional needs were met. Staff were aware of infection control procedures and had access to appropriate equipment.

Care records were person-centred and included people’s interests and preferences. Care and support provided were reviewed regularly with people, and those important to them, were also involved in these reviews.

People were consulted about the care provided and staff always sought their consent before providing support. The requirements of the Mental Capacity Act (MCA) 2005 were being met.

People told us staff were nice and caring. Staff knew people well and were positive about the role of supporting people. Staff we spoke with understood the importance of maintaining and promoting people's independence and choice.

Accidents, incidents, safeguarding concerns and complaints were investigated fully and action taken to reduce the risk of reoccurrence. This learning was shared throughout the provider’s other locations.

Systems were in place to allow the registered manager to have a good overview of the quality of care being delivered.

The last inspection of Comfort Call Tameside was carried out on 13, 14 and 19 August 2015. The overall rating for the service following that inspection was ‘Requires improvement’.

Following the inspection the provider sent us an action plan detailing how the identified breaches would be addressed. This inspection was to check if satisfactory improvements had been made and to review the ratings.

This inspection took place on 28 February and 1, 3 March 2017. The inspection was announced to ensure that the registered manager or other responsible person would be available to assist with the inspection visit.

Comfort Call Tameside provides care and support to people who require the services of a domiciliary care agency. The offices of the agency are situated in the Tameside area of Manchester.

A registered manager was in post. 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.

People told us they felt safe in the support and care of the staff who worked for Comfort Call Tameside. Staff completed training in safeguarding adults as part of their induction training which was then refreshed on an annual basis.

We found that staff were recruited using a robust recruitment process and all pre-employment checks were satisfactorily completed before a person started working for the agency.

The service followed the requirements of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. Records and staff spoken with confirmed they had received training in these topics.

People were supported by staff that had received regular training and on-going supervision and appraisal. Staff told us that the training and management support provided them with the knowledge and skills to carry out their jobs.

People who used the service told us that staff were cheerful, very caring and patient.

Staff we spoke with confirmed that people’s care plans provided enough relevant and appropriate information to enable them to know and understand people’s needs and how they were to support the person so that their needs would be met.

When people first received a service from Comfort Call Tameside they were provided with a ‘service user guide’ in which the complaints procedure was explained. People who used the service told us they were aware of the formal complaints procedure and would feel confident in raising a concern or complaint.

The provider had used annual survey questionnaires to gain people’s views about the quality of service being provided.

The registered manager provided evidence of regular audits they completed to check the quality of service provision. These audits included training, medicine management, staffing and health and safety matters. Other audits included regular reviews of care plans and risk assessments and spot checks whilst staff carried out their caring duties.

People using the service told us that they were very happy with the care and support they received from staff working for Comfort Call. They told us that they felt involved in planning how they wanted to be supported and that their views were listened to.

Most people told us that they could raise concerns with the staff and the manager and felt confident that their concerns were taken seriously. One person told us , " I have never had to complain, but if I did, all the staff are so nice, I know they would try and make things right for me".

We found that there were good systems in place to monitor and respond to complaints.

Staff told us that they had appropriate training to enable them to carry out their job in a safe and effective way and records confirmed good access to training and development opportunities.

Comments made from people using the service included:

"I have no concerns about the staff, they are absolutely brilliant. Sometimes the office don't keep us fully informed if they make changes in the rota, but the staff are fantastic".

"The care and support is great. I would like to see less change at the top".

"The staff are great at their job. Definitely qualified and experienced. Some of the younger one's may need a bit more help".

"I mentioned a problem to the office, and it was sorted and so far it is working well".

People using the service told us that the staff from Comfort Call Tameside were meeting their support and care needs effectively. They also said that they were involved and consulted about how they were cared for and supported and that care staff treated them with respect and maintained their dignity.

Comments made included;

"My views have been asked from the beginning and have been respected at all times, I have no concerns.”

"The support they give me meets my requirements exactly and means that I can stay in my own home."

"The staff in the office at the agency regularly ask me if I am happy with the care I get. If I have any concerns they sort it out quickly. I feel my views are important to them."

“The support I get from my care staff is really very good, I couldn’t do without them.”

“They staff are very reliable and thorough and they are all very nice as well."

“They (the staff) are great and help me with the things I cannot do for myself anymore.”

The last inspection of Comfort Call Tameside was carried out on 27 February 2014. The service met the regulations we inspected against at that time.

This inspection took place on 13, 14 and 19 August 2015. The inspection was announced to ensure that the registered manager or other responsible person would be available to assist with the inspection visit.

Comfort Call Tameside provides care and support to people who require the services of a domiciliary care agency. The offices of the agency are situated in the Tameside area of Manchester.

A registered manager was in post. 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.

We found the provider had breached Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We found improvements were required to the way in which management of medicines was carried out. Medicine records were not always completed. You can see what action we told the provider to take at the back of the full version of the report.

Although a system was in place to audit how the service was operating, the audit to review the way in which medicines were managed within the service was not as effective as it should have been, and improvements were needed.

People we spoke with told us they felt safe with the staff that visited and supported them. Staff completed training in safeguarding adults as part of their induction training which was then refreshed on an annual basis.

Both people using the service and relatives we spoke with said that staff had the knowledge and skills to do a good job.

People were very positive about the caring and compassionate nature of the staff that supported them. They told us that their privacy and dignity was maintained when being supported with personal care tasks. People who we spoke with also told us that they were always asked for their consent before care staff carried out any particular care or support tasks.

Staff were provided with and had access to, information to help them deliver care and support to meet the identified and assessed needs of the people using the service.

There was a recruitment and selection process in place that helped the employer to make safe recruitment decisions when employing new staff. The staff we spoke with confirmed they had received an induction and relevant training when they started their employment with the agency. Records indicated that training was then regularly updated for each member of the staff team.

We looked at the complaints records kept by the agency. Each complaint that had been made had been logged individually and we saw that a total of 13 complaints had been recorded since the fifth of January 2015. A complaint investigation report had been completed which detailed the summary of the complaint, investigation methodology, findings and corrective and preventative actions.

The provider had used annual survey questionnaires to gain people’s views about the quality of service being provided.

We saw there were policies and procedures available to support, inform and guide staff and people using the service.