This comprehensive inspection took place on 17 July 2018 and was announced. This was the first inspection since the provider registered with the Care Quality Commission (CQC) in December 2016. This service is a domiciliary care agency. It provides personal care to people living in their own homes in the community. It provides a service to older adults and younger disabled adults. At the time of the inspection they were supporting two people in the London Borough of Tower Hamlets. Not everyone using Daallo Care Services Ltd 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.
Both people had been receiving personal care since May 2018. This meant that although we were able to carry out an inspection we did not find enough information and evidence about parts of the key questions we ask about services, or the experiences of people using the service, to provide a rating for each of the five questions and an overall rating for the service. We were therefore not able to rate the service against the characteristics for inadequate, requires improvement, good and outstanding ratings at this inspection.
There was 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 (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.
There were inconsistencies between the two care records we reviewed. Records did not contain sufficient and detailed information about the care and support people received.
Risk assessments covered a range of factors that people were at risk of, including environmental assessments to ensure people’s homes were safe. However not all risks were fully addressed with sufficient information available for staff to follow to keep people safe.
People who were supported with their medicines did not always have the full up-to-date information recorded in their care records.
Staff were aware of their safeguarding responsibilities and were confident the registered manager would take the appropriate action if they had any concerns. Safe recruitment procedures were followed to ensure people were supported by suitable staff.
Staff had received training around the Mental Capacity Act 2005 (MCA) and there was evidence people had consented to their care, with records in place where people lacked capacity. However, one care record did not fully reflect how consent had been sought in line with best practice.
Care workers were positive about the supervision they had received but the agreed regular cycle of supervision had not been carried out at the time of the inspection. An induction and mandatory training programme was in place when new staff started to support them in their role.
Care records highlighted if people were supported with their nutritional needs and if they had any dietary preferences. However, one person’s nutritional risk had not been highlighted and more information was required to provide a more accurate summary of the support that was given.
People and their relatives had been actively involved in decisions about their agreed care and support. We received positive comments about the kind and caring nature of care workers and how respectful they were when carrying out their tasks.
Care workers did not always accurately complete records of the care and support people received.
The provider listened to people’s preferences with regard to how they wanted staff to support them with their cultural or religious needs.
People were provided with information on how to make a complaint and were able to share their views and opinions about the service they received.
The service promoted an open and honest culture. We received positive feedback about the management team and staff felt well supported. Staff were confident they could raise any concerns or issues, knowing they would be listened to and acted upon.
There were arrangements in place to assess and monitor the quality and effectiveness of the service and use these findings to make ongoing improvements. As the service had not been providing care and support for a substantial period of time, some of these policies had not yet been enacted.
The management team were proactive and responsive to the feedback they received about the shortfalls we had identified. We asked the registered manager to send us an action plan about the improvements they planned to make.
We will be in contact with the provider as the service develops and will aim to return within six months to carry out the next inspection and provide a rating for the service.