Background to this inspection
Updated
15 September 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
This inspection was carried out by 1 inspector.
Service and service type
Daryel Care Waltham Forest is a domiciliary care agency which 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
The provider was given 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the service to support the inspection.
What we did before the inspection
We reviewed information we received about the service. 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 used all of this information to plan our inspection.
During the inspection
We visited the office on the 25 July 2023 and spoke with the registered manager. We reviewed a range of records. This included 8 people’s care plans and risk assessments, 2 people’s medicine administration records (MAR charts), 6 recruitment records and 2 quality audits. We also checked the providers had key policies and procedures in place to help guide staff. We spoke with 8 people who used the service and 2 family members about their experience of the care provided. This was done on the 2 August 2023, 7 August 2023 and the 14 August 2023. We also received feedback about the service from 8 members of staff including the registered manager and care staff.
Updated
15 September 2023
We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence, and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. We considered this guidance as there were people using the service who have a learning disability and or who are autistic.
About the service
Daryel Care Waltham Forest is a domiciliary care agency providing personal care and support to people living in their own homes in the London Borough of Waltham Forest. 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. At the time of the inspection there were 36 people receiving a service that is regulated by CQC.
People's experience of using this service and what we found
Right Support: We found that people were not protected from the risk of harm as risks were not always identified and, care plans and records contained inconsistent information. The risks related to people’s environmental needs were not thoroughly assessed. People were supported to have maximum choice and control of their lives and staff supported in the least restrictive way possible and in their best interests.
Right Care: People told us they received care that met their support needs and preferences. And that they were treated with kindness and respect. People's communication needs were assessed. However, we noted care plans did not always contain enough information that matched people’s needs assessments and risks.
We looked at the provider’s call monitoring system and identified that the this was not always effective in this area. And that their initial assessment process for people's mental capacity were not in place.
Right Culture: The service was not always well managed. The provider did not always identify areas of improvement in their audits that was carried out and issues with safety concerns were not picked up.
Most people told us that they were receiving care and support on time. There were systems in place to receive feedback, however we were informed that not everyone was asked to give feedback.
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 8 December 2022, and this is their first inspection.
Why we inspected
The inspection was prompted in part due to concerns we received about risk management and the overall management of the service. A decision was made for us to inspect and examine those risks.
Enforcement and Recommendations
We have identified breaches in relation to managing risks, staff training and good governance. We also made recommendations in relation to the providers call monitoring system and the provider’s mental capacity assessments.
Full information about CQC's regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.
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.