Daryel Care Greenwich

Updated 12 September 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

Inspection team

The inspection was carried out by 3 inspectors and 2 experts by experience.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own homes.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was not a registered manager in post. A new manager had been recruited but had not completed the process to become the registered manager.

Notice of Inspection

The first day of the inspection was unannounced. The provider knew we would be returning the next day to continue the inspection.

What we did before the inspection

We reviewed information we had received about the service to plan our inspection. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make.

During the inspection

We visited the office on 26 and 27 June 2023. During the office visit we spoke with the care manager, the operation manager, quality assurance manager and 2 care coordinators. We reviewed a range of records including care and support plans for 13 people. We looked at records of recruitment and supervision for 7 members of staff. We also reviewed a variety of records relating to the management of the service, including management of medicines, quality assurance audits, training records and policies, and procedures. We reviewed the electronic care monitoring (ECM) data for 145 people who used the service which included the records for 18020 care visits.

We made calls to 34 people and/or their relatives on 29 June 2023 and 4 July 2023 and we made calls to 6 care workers to get their feedback about the service.

Updated 12 September 2023

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence, and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. We considered this guidance as there were people using the service who have a learning disability and or who are autistic.

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.