Daisychain Homecare Services

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

Well-led – this means we looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture. At our last assessment we rated this key question good. At this assessment the rating has changed to requires improvement. This meant the management and leadership was inconsistent. Leaders and the culture they created did not always support the delivery of high-quality, person-centred care.

The service was in breach of legal regulation in relation to governance at the service.

This service scored 50 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider did not have a clear shared vision, strategy and culture which was based on transparency, equity, equality and human rights, diversity and inclusion, and engagement. They did not always understand the challenges and the needs of people and their communities. The provider expressed a commitment to person centred care and providing individualised support, however, the information we reviewed did not consistently reflect these values in practice. Care planning processes were not robust and did not ensure these principles were embedded into practice. We found that staff did not always demonstrate a clear understanding of their responsibilities in recognising and responding to safeguarding concerns. The lack of understanding and oversight compromised the provider’s ability to provide safe and consistent care.

The provider did not have inclusive leaders at all levels who understood the context in which they delivered care, treatment and support, or who embodied the culture and values of their workforce and organisation. Systems and processes in place had not been sustained to ensure risks to people’s safety were managed. We found accidents and incidents were not always thoroughly investigated and used to inform learning and drive service improvement. These issues impacted the provider’s ability to consistently deliver care that was safe and person-centred, this placed people at risk of avoidable harm.

Staff told us they felt able to speak to the provider should they have any concerns, and they felt the provider would act on any issues they had. We found staff received regular supervisions where they could discuss any concerns they had. The provider had systems in place to ensure staff had sufficient support outside of office hours in the event they had any concerns about people. We reviewed the records of these calls and found appropriate advice and action had been taken to ensure people’s immediate safety.

We did not look at Workforce equality, diversity and inclusion during this assessment. The score for this quality statement is based on the previous rating for Well-led.

The provider did not have clear responsibilities, roles, systems of accountability and good governance. They did not act on the best information about risk, performance and outcomes, or share this securely with others when appropriate. The providers governance systems did not provide a thorough oversight of the service. Systems to monitor quality and safety did not identify areas of concern. For example, audits carried out by the registered manager lacked analysis of accidents and incidents and were not used to drive improvements in the service. One person had experienced a significant increase in falls, this had not been recognised as a potential safety issue. We also found other potential safeguarding concerns that had not been identified or reported to the local authority or CQC, as required. Care review audits did not identify people’s care plans lacked sufficient guidance for staff, on managing people’s known risks including moving and handling, skin integrity, and catheter care. This placed people at risk of avoidable harm.

We did not look at Partnerships and communities during this assessment. The score for this quality statement is based on the previous rating for Well-led.

The provider did not always focus on continuous learning, innovation and improvement across the organisation and local system. The providers systems in place did not support the effective assessment, monitoring, and mitigation of risk to people’s safety. This did not support a culture of openness and learning within the service. The provider had identified concerns in governance and care planning and had developed an action plan to address these areas, at the time of our inspection this plan was in its early stages. As a result, the necessary systems and processes to support a culture of learning and improvement had not yet been fully embedded.