DayByDay Care Limited

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question good. At this assessment the rating has changed to requires improvement. This meant some aspects of the service were not always safe and there was limited assurance about safety. There was an increased risk that people could be harmed.

The service was in breach of legal regulation in relation to people’s safe care and treatment and safeguarding people from abuse.

This service scored 53 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

There was not always a strong proactive and positive culture of safety within the service. Staff told us management did not always listen to concerns about safety and did not always take timely action. Staff told us, “Sometimeswhen we reportany concerns it takes time to solve theproblem resulting in some carers switchingto other companiesbecause we don't feel safe,” and “Our management don't act accordingly, they are too ignorant to some issues and concerns, only to act when things are out of hand.”

The provider did not always robustly investigate complaints and report safety events. Investigations were not always detailed which impacted on the quality of the lessons which could be learnt. Notifications were not always submitted to CQC to inform us of allegations of abuse in line with their legal obligations.

The provider took some steps to support continuity of care. Hospital passports were in place where appropriate, to support people when accessing other services. Professionals who worked closely with the service told us communication about people’s needs was good, and staff recognised if there were any deteriorations in people’s health. However, 1 person had been complaining of low mood and lack of stimulation and, whilst the registered manager was aware of this, no referrals had been made or actions taken to support this person further.

The provider did not always concentrate on improving people’s lives or protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider did not always share concerns quickly and appropriately. We identified a safeguarding concern during the assessment which we referred to the local authority safeguarding team. Staff had been raising their concerns, but management had failed to take appropriate action. Staff told us this had happened previously. Feedback from staff included, “We have raised a concern about this. They said action has been taken but it's been months, and we haven't seen anything. I don't feel safe at work,” and “We reported the matter way back last year, no action was done.”

The provider did not always work well with people to understand and manage risks. Staff did not always have appropriate guidance to enable them to provide care to meet people’s needs that was safe, supportive and in line with best practice. There was insufficient guidance in place for staff to support people who may be communicating through behaviours which may be distressing or challenging to others. Risk assessments in this area were also insufficient to ensure staff were able to safely manage risks to both themselves and to people.

Other areas of people’s care plans contained a good level of information about the management of risk, and some professionals spoke positively about staff knowledge of people’s needs. Feedback included, “I feel the care and support staff provide is excellent. I feel the care staff have a great understanding of [person’s] needs.”

The provider carried out risk assessments concerning potential environmental risks in people’s homes where staff would be providing support. Risk assessments were documented and communicated to staff. However, the provider had not always taken appropriate measures to ensure staff safety when lone working or when supporting people who may be communicating through behaviours which may be distressing or challenging to others. The provider told us they intended to source face to face training for staff to improve their confidence in this area.

The provider did not always make sure there were enough qualified, skilled and experienced staff. They did not always make sure staff received effective support, supervision and development. Whilst care calls were covered, staff told us there were not enough staff to cover sickness and holidays, and staff were required to travel long distances to ensure calls were covered. Feedback from staff included, “At the moment there is not enough staff, we are travelling miles to cover calls from different locations that are far from each other which is tiring and stressful,” and “Staff are forced to go to work whilst not feeling well. I went to a call feeling poorly. I asked to be relieved of duty, but the manager said there was no-one to cover the shift.”

Staff did not always receive appropriate training to carry out their roles effectively. The registered manager had identified this and told us there was a plan in place to address the training shortfalls and improvements had already begun. Staff told us, “Training is not really enough. The biggest challenge is we are not given time to study. We are forced to do courses between shifts when we would be tired.”

Relatives and people who used the service were generally happy with the coverage of the care calls and the competence of the staff. One relative said, “[Person’s] care is great, and I am very happy with it. [Person] has regular carers who arrive on time.” One person said, “I am happy with the carers who arrive on time and stay the full duration. If there is ever a problem with timing, they always let me know. I have a regular team of 3 care workers who I get on with very well and have a good laugh. I have no complaints; they are well trained and experienced.”

The provider assessed and managed the risk of infection. Infection control was included in the provider’s quality assurance audit. Staff had access to readily available supplies of PPE and relatives and people told us this was used appropriately. One staff member told us, “Yes we collect PPE from the office and always have extra in our work cars.”

Medicine administration records contained key information in line with best practice guidance. The records we viewed during the assessment showed that medicines were administered as prescribed. However, there was a large number of medicine errors highlighted in audits, primarily around stock not being available for administration. We found no evidence of harm from these errors and the registered manager confirmed these issues had been identified, analysed, and new processes had been implemented with a view to reducing the number of errors occurring and strengthening the service’s stock check procedures.