26 June 2023
During a routine inspection
About the service
Daryel Care Greenwich is a domiciliary care service which provides personal care to people living in their own homes. CQC only inspects where people receive support with 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 145 people receiving personal care.
People’s experience of using this service and what we found
Right Support: People were not protected from the risk of harm as risks were not always identified and/or mitigated. The risks associated with people’s health care needs had not been thoroughly assessed and assessment documents contained conflicting information. This meant staff did not have accurate information about potential risks. People’s medicines were not always administered safely. Staff were not recruited in line with provider’s policy.
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. However, formal systems were not in place to assess people's mental capacity. We raised this with the provider and they have reviewed their processes around ensuring capacity assessments are carried out.
Right Care: People were not satisfied that their complaints had been listened to and dealt with sufficiently as people experienced ongoing issues with visits. People told us they received care that met their needs and preferences, but care plans did not contain adequate detail about these which meant people were at risk of not getting care in line with their wishes. Most people told us they were treated with kindness and respect. People’s communication needs were assessed.
Right Culture: The service was not always well managed. The provider was not following its own quality assurance policy and there was a lack of formal audits and quality assurance checks. The checks that had been carried out had failed to identify the issues with the safety and quality of the service. The provider was not ensuring the personal information of people receiving care and staff was being stored securely. There were widespread issues with the scheduling, recording, and monitoring of care visits which meant people experienced late and missed visits. There were processes in place to gather feedback but these were not effective as many people were not happy with the service they received and did not feel the provider was resolving issues or concerns sufficiently. Many people told us they were unhappy with how the organisation was managed but praised the individual approach by the staff delivering care. One person told us, “I would recommend the carers as individuals but not the agency.”
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 16 December 2022 and this is the first inspection.
Why we inspected
The inspection was prompted in part due to concerns we received about recruitment processes, risk management and the overall management of the service. A decision was made for us to inspect and examine those risks. As this is the first inspection of the newly registered service we looked at all key questions during this inspection in order to provide a rating.
Enforcement and Recommendations
We have identified a breaches in relation to managing risks and medicines, staff training and good governance.
Please see the action we have told the provider to take at the end of this 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.
Special Measures
The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.
If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.
For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.