Daisy Chain Care Team Ltd

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.

People’s experience of using this service:

People were safe and protected from avoidable harm because staff knew how to identify and report any concerns relating to the risk of abuse. They were familiar with how to report concerns to agencies outside of the organisation. Risks to people`s health, safety and well-being were assessed and measures were put in place to remove or reduce the risks. People were supported by staff who had been safely recruited through a robust process.

People’s medicines were managed safely. Staff had received appropriate training and had their competency assessed to help ensure they were sufficiently skilled and knowledgeable in this area. Staff had received training in infection control practices and personal protective equipment such as gloves and aprons was provided for them. The management team took appropriate actions following any incidents and learning was shared with staff.

Before care delivery started the provider completed assessments to make sure people`s needs could be met by Daisy Chain Care Team. Care plans were developed from these assessments for each person’s identified needs and staff had clear guidance on how to meet those needs. Staff received training and support to enable them to carry out their roles effectively.

People told us staff prepared simple meals for them as needed and encouraged them to take fluids to maintain their health and wellbeing. Staff and the registered manager knew people well and were able to promptly identify when people`s needs changed and they sought professional advice appropriately. Staff were proactive in identifying if people were unwell and contacted appropriate healthcare professionals as needed. Mental capacity assessments were carried out where needed to establish if people making decisions affecting their lives had the capacity to do so.

People and their relatives praised the kind and caring nature of staff. People received consistent care from a small team of staff. Staff helped to relieve people’s distress and discomfort, and supported people to maintain personal relationships. People knew about their care plans and could decide what care and support they needed. People’s records were held securely in a locked cabinet within a locked office to help promote confidentiality.

People received care and support as they wished. People told us they would be confident to raise any concerns with the management team. Everyone we spoke with during this inspection was satisfied with the care and support they received.

The registered manager was committed to providing a high standard of care to the people they supported as well as the staff team and understood their responsibilities under the Duty of Candour. People, their relatives and staff members spoke highly of the registered manager and told us that they were always available and supportive. People told us that they were often asked for their views about the quality of the service.

Rating at last inspection: This was the first inspection of this service since registration with the Care Quality Commission (CQC) in November 2017.

Why we inspected: This was a scheduled inspection to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

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