Archived: Daryel Care Haringey

Updated 8 February 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

Inspection team

The inspection was conducted by 3 inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Daryel Care Haringey is a domiciliary care agency It provides personal care to people living in their own houses and flats.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations. At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was announced. We gave the service 48 hours’ notice of the inspection. This was because we needed to be sure that the provider or registered manager would be in the office to support the inspection.

What we did before the inspection

The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We reviewed information we had about the service. We sought feedback from the local authority who work with the service. We used all this information to plan our inspection.

During the inspection

We spoke with 5 people using the service and 6 relatives. We spoke with 8 care workers and the registered manager. We reviewed 20 people’s care records including risk assessments and 10 staff files in relation to recruitment. We also reviewed a range of management records including staff training and supervision, medicines, complaints and audits.

Updated 8 February 2023

About the service

Daryel Care Haringey is a domiciliary care agency providing personal care for 160 people. The service provides support to people living in their own home. At the time of our inspection there were 160 people using the service.

At the time of the inspection, the location did not care or support for anyone with a learning disability or an autistic person. However, we assessed the care provision under Right Support, Right Care, Right Culture, as it is registered as a specialist service for this population group.

People's experience of using this service and what we found

Recruitment of staff was not done safely. Recruitment files had gaps in all areas, for example, in some cases we did not find that references had been verified, or application forms did not contain a full job history. Medicine was not always managed safely, for example not all files contained risk assessments or “as and when needed” medicine protocols. Risk management plans lacked details for staff to follow to keep people safe from harm. Some staff did not fully understand infection control procedures.

The provider did not have an effective monitoring system in place. People, relatives and staff were not always given the opportunity to be involved in the service. The provider asked people for their views, but this was not done across the service and was inconsistent, most people we spoke with wanted to share their views if given the opportunity.

The provider carried out some auditing of the service however this was inconsistent across the service. The service worked in partnership with the local authority and health care professionals. There was an improvement plan in place at the time of our inspection.

Care plans were not personalised, people’s preferences were not recorded consistently. Daily notes had not been completed due to the changing of the electronic system, the notes that were available were from July 2022. Peoples communication needs had been assessed. People knew who to complain to if they needed to. There was a complaints procedure in place. All complaints were recorded but actions were not always clear, and it was difficult to see what improvement had been made as a result of these complaints. We have made a recommendation about complaints.

Care needs assessment were carried out prior to people using the service. Staff had completed training for their role. The provider was working within the Mental Capacity Act. Peoples nutrition and hydration needs had been assessed. All of the people we spoke with said they did not receive support with health care appointments, staff were able to explain what to do in a medical emergency. Safeguarding procedures were in place to protect people from harm.

People told us staff were caring and kind. People were treated with respect and dignity. People were encouraged to be as independent as possible

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

This service was registered with us on the 6 December 2021 and this is the first inspection.

Why we inspected

The inspection was prompted in part due to concerns received about the management of medicines, recruitment practices, governance and risk management plans. A decision was made for us to inspect and examine those risks.

Enforcement

We have identified breaches in relation to safe recruitment practices, safe care and treatment and good governance, at this inspection. Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.