We carried out a review of the data available to us about Daniel's Special Care Ltd on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Daniel's Special Care Ltd, you can give feedback on this service.
Daniel’s Special Care Ltd is a home care agency providing personal care services for people in their own home. At the time of our inspection there were 65 people using the service.
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
The provider had embedded and sustained improvements to staffing levels and the safe management of medicines. There were processes in place to keep people safe and manage risks, including risks arising from the COVID-19 pandemic. There were sufficient staff to support people safely. There were processes to manage people's medicines, and to protect people from the risk of abuse or poor care. People told us they felt safe with the service they received.
The provider had embedded and sustained improvements to how they monitored and improved the quality of the service. The service people received was well led. The service focused on person-centred care and good outcomes for people. There were effective systems in place to manage the service, improve the quality of care people received, and support staff to deliver high quality care. The provider had implemented online systems to improve efficiency.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was requires improvement (published 11 February 2020).
Why we inspected
We received concerns in relation to staffing levels. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.
The overall rating for the service has changed from requires improvement to good based on the findings of this inspection.
We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe and well-led sections of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Daniel’s Special Care Ltd on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
Daniel's Special Care Ltd is a domiciliary care service and was providing personal care to 24 people on the day of the inspection. The service can support both younger and older adults, people living with dementia, people with a physical disability and people with a learning disability.
People’s experience of using this service and what we found
People reported they were well supported by care staff who understood the infection control processes they needed to follow during the COVID-19 pandemic. People told us staff wore all the personal protective equipment (PPE) required when they provided their care. One person commented, “We have no concerns at all. Honestly and truthfully say they do everything they are supposed to do” and another said, “They couldn’t do a better job. All most fastidious.”
The registered manager had completed a risk assessment to ensure the safe delivery of the service during the COVID-19 pandemic, which they had reviewed and updated. The registered manager had completed risk assessments for staff at higher risk from contracting COVID-19, for example, those from a Black, Asian, and minority ethnic (BAME) background in order to identify any required safety measures.
Staff had been provided with relevant online training and written guidance in relation to COVID-19, infection control, PPE use and hand hygiene. Staff told us ample PPE was provided and we saw there was plenty. Staff understood what they were required to wear.
Staff spoken with understood the symptoms of COVID-19 and their responsibilities if they developed COVID-19 symptoms. Processes were in place to monitor staff's understanding and ongoing adherence to the infection control requirements. The registered manager had ordered and distributed COVID-19 test kits to staff, which they were expected to complete weekly.
Staff followed national guidance when people were discharged from hospital into the community. They treated people as COVID-19 positive until the outcome from their test was received.
Processes were in place to reduce contact between staff, such as online meetings and office staff worked on a rota in the office to control the number of staff present. Office staff were seen to observe social distancing requirements and to wear the correct PPE.
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 requires improvement (published 11 February 2020).
Why we inspected
We undertook this targeted inspection due a specific concern we had received about infection control practices at the service. The overall rating for the service has not changed following this targeted inspection and remains requires improvement.
CQC have introduced targeted inspections to follow up on Warning Notices or to check specific concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
Daniel's Special Care Ltd is a domiciliary care service and was providing personal care to six people on the day of the inspection. The service can support both younger and older people who may have a diagnosis of dementia.
People’s experience of using this service and what we found
The service was short staffed, but people received their care, as the registered manager filled gaps in rosters whilst they recruited new staff. No new care packages had been taken on whilst they recruited more staff. The registered manager took swift action to ensure evidence of some recruitment checks for two staff were provided as required.
People received their medicines safely overall. However, some aspects of people’s medicines management required further improvement, to ensure it was consistently safe and met best practice guidance.
Processes were in place to improve the quality of the service, but some needed to be documented and further embedded.
Processes were in place to protect people from the risk of abuse. Potential risks to people had been assessed and measures were in place to manage them as effectively as possible. Processes were in place to protect people from the risk of acquiring an infection during the provision of their care. The registered manager reviewed incidents and ensured any required actions were taken for people’s safety.
People received effective care from competent staff. The provision of people's care was based on current requirements. Staff supported people to ensure they had enough to eat and drink. Staff worked in collaboration with other agencies and health care professionals to ensure people received effective care. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
People told us they were well treated by staff and said, "Carers are kind." People were supported to express their views and to be involved in making decisions about their care. Staff respected and promoted people’s privacy, dignity and independence.
People received personalised care planned with them, which reflected their preferences. People’s care plans were reviewed and updated as changes occurred. No-one was being provided with end of life care but people’s wishes had been sought.
The registered manager understood their role and had obtained relevant support and guidance. The provision of people’s care was based on clear aims and objectives. Staff worked together as a team, to ensure people received their care as planned. Processes were in place to seek people’s views on the service and these were acted upon. People were provided with information about how to make a complaint if required.
For more details, please see the full report which is on the Care Quality Commission (CQC) website at www.cqc.org.uk.
This service was registered with us on 15 February 2019 and this was the first inspection.
Why we inspected
This was a planned comprehensive inspection.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.