Background to this inspection
Updated
22 February 2022
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 carried out by one inspector 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
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.
The service had a manager registered with the Care Quality Commission. This means they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure the provider would be in the office to support the inspection.
Inspection activity started on 13 December 2021 and ended on 21 January 2022. We visited the location’s office on 15 December 2021.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority, local Healthwatch, and professionals who work with the service. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England.
We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.
During the inspection
We spoke with four people who used the service and four relatives about their experience of the care provided. We spoke with six members of staff including the provider and support workers.
We reviewed a range of records. These included medication records and three people’s care records. We looked at two staff files in relation to recruitment and staff supervision. We also reviewed a variety of records relating to the management of the service, including policies and procedures.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We requested further information relating to care reviews and meeting people’s communication needs.
Updated
22 February 2022
About the service
Daisy Chain Care Team Limited is a domiciliary care service that provides personal care and support to people living in their own homes. The service was supporting 10 people at the time of our inspection.
Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.
People’s experience of using this service and what we found
People were at risk of poor care and support because the provider did not have effective auditing and governance systems in place to monitor the quality of the service. Although some audits were being completed, there was no overall analysis taking place at the service. This would make it difficult for the provider to identify areas of service improvement.
Risks management to people’s care required improvement. Known risks were not always assessed. This put people at a greater risk of harm.
Staff had variable knowledge of the Mental Capacity Act 2005 (MCA) and the impact this has on their job role. The provider confirmed they will address this.
People’s support and care plans were not being updated and policies and procedures were not dated, so it was unclear whether these were up to date or had been recently reviewed.
The provider had not ensured safe recruitment practices were being followed fully.
The provider had not completed any initial assessment paperwork for new care packages. This meant the provider could not always be assured they could meet people’s care needs prior to commencing care.
Care and support plans were detailed in relation to actual care and support required, however, information relating to people’s preferences and life history was very limited. People were involved in writing their care plans. People were positive about the care they received.
People received their medicines as prescribed and on time. Any medication errors were quickly identified by the provider and action taken.
People felt safe with staff. All staff had received safeguarding training and knew how to protect people from harm.
The service’s infection prevention control policies were being adhered to and followed throughout the pandemic. This meant both staff and people at the service were protected from cross contamination.
There were enough suitably qualified staff at the service to support people safely. New staff received an induction, which included shadowing more experienced members of staff. Staff had completed all relevant training. Staff received regular competency assessments and for new staff, spot checks would take place by senior staff.
The service worked with a wide range of organisations who are also involved in people’s care.
People spoke positively about the care and support they received from the service and told us staff were helpful, kind, caring and friendly. Staff spoke about people with kindness and compassion and were able to describe people’s care needs and preferences in detail.
People were being supported to maintain relationships and follow their interests in order to avoid social isolation. Staff spoke with us in detail about interests they support people with.
The provider was dedicated to the service and understood their responsibilities as a registered manager. People, relatives and staff spoke highly of the registered manager and dedication to the role.
People and their relatives were given the opportunity to feedback on the quality of the service.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published 12 April 2019).
Why we inspected
We undertook this inspection as part of a random selection of services rated Good and Outstanding.
Enforcement
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.
We have identified a breach in relation to good governance at this inspection. Please see the actions we have told the provider to take at the end of the 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.