Archived: Daisychain Homecare Services

Below is a summary of what we found. The summary describes what people using the service, their relatives and the staff told us, and the records we looked at. We used the evidence we collected during our inspection to answer five questions.

Is the service safe?

Risk assessments were in place for things such as moving and handling, falls, environment and the person using the service. Control measures had been put in place. This meant that people's needs were met and people were kept safe. People and their relatives confirmed they felt the service was safe. One person said, 'Yes I feel safe, the service is very good.' Another person said, 'Yes the service is safe and the staff are caring.'

Staff had an awareness of the Mental Capacity Act 2005 (MCA). We saw systems were in place to gain consent from people. If people were not able to give their consent, forms were in place to identify the persons advocate. The provider told us that the people they supported had capacity. They told us they were developing specific capacity assessment forms and would be developing their procedures to ensure all aspects of this legislation were covered. This meant that people who could not make decisions for themselves would be safeguarded as required.

Procedures were in place for the management medicine. We found that medication administration records were not completed for medicine supplied in blister packs. The registered manager explained that they only prompted people with medicine but from discussions with people who used the service and staff we concluded that some medicine was administered. We found that the provider did not audit medication administration records. However, the provider immediately put a system in place. We saw evidence that staff had received medication training.

The registered manager set the weekly staff rotas. They took people's care needs into account when making decisions about the numbers, qualifications, skills and experience required. One person said, 'A carer will support me to the hospital when I need to go.' This helped to ensure that people's needs were always met.

Staff had received appropriate professional development and were able to obtain further relevant qualifications. Staff wore uniforms and carried identification badges so people could ensure people supporting them were employed by the provider. This meant people's safety was maintained.

Is the service effective?

People experienced care and support that met their needs. People told us how they were supported. We saw that referrals had been made to professionals such as occupational therapists. One person said, 'I have a good occupational therapist they work well with the care agency.' An advocate we spoke with said, 'The service has changed the way X lives, X now has beautiful clothes.' A relative said, 'They are an excellent company, I couldn't wish for better.' This meant that people received care in the way they wanted.

Regular audits and checks took place. Issues identified were acted on. This meant the service had effective systems in place to identify improvements and continually meet people's needs.

Is the service caring?

People were supported by friendly and considerate staff. Staff we spoke with told us how they supported people. People and relatives confirmed staff were caring, respectful and polite. One person said, 'I am very pleased with the service, they are all delightful, very kind and friendly.' Another person said 'I am very happy. The staff are very cheerful.' A relative said, 'They are absolutely fantastic, I couldn't have wished for a better agency.'

People's preferences had been recorded and care and support had been provided in accordance with people's wishes. People were involved in their day to day care and were supported to maintain their independence. An advocate said, 'They have given X back his dignity, X now has a sense of pride.' A relative said, 'They are very good, X likes the staff and I have met the two ladies that run it, they are excellent.' This meant people's diversity and individuality were promoted and respected.

Is the service responsive?

People were treated with respect and dignity. This was confirmed by people we spoke with. One person said, 'I am treated with respect; they [staff] are a pleasure to have around.' Care plans had been developed and were reviewed regularly. People and relatives confirmed they were involved in changes to their care. Staff demonstrated a good understanding of people's needs. People were given choices and supported to make decisions themselves. A relative said, 'We have no concerns. It is a good service.'

People told us they would speak to the office if they were unhappy about anything. People were issued a 'service user handbook' that outlined the person's rights and how the service would support them. Details of the complaints procedure were included in the 'service user handbook'. People and relatives told us they had no complaints.

Is the service well-led?

The service worked well with other agencies and services to make sure people received their care in a joined up way. This was confirmed by people we spoke with and records we saw. People, relatives and staff were positive about the service and how it was managed. One person said, 'Most staff are well trained, some are still learning.' Another person said, 'Yes staff are well trained, I tell them what I want, I am very lucky.' A relative said, 'It seems to be a very cohesive team, they are managed well so staff will do more for the company.'

Staff were aware of their roles and responsibilities and had opportunities to raise any issues or concerns. Staff told us they enjoyed their jobs and working for the provider. Staff felt confident they would be listened to. Staff comments included, 'Yes it is very well led, you can always access the boss with issues, they always give their support.' And, 'Yes it is well led, they are brilliant, really committed and they do a lot of hands on work.'

Systems were in place to make sure that managers and staff learned from events such as accidents and incidents. A complaints process was in place but verbal complaints and comments were not recorded.

The service had a quality assurance system in place. Audits and checks were undertaken regularly. Recommendations made by other agencies were put in place. This meant the quality of the service was able to continually improve.

This review was completed using a selection of documents sent to us by the provider which showed that people's care plans now included more detailed and clear risk assessments for aspects of people's needs including falls and mental health. We also found that monthly audits were being completed to ensure that the content of people's care plans were consistent. The provider had also strengthened the arrangements they had in place to deal with foreseeable emergencies, including staff receiving training in first aid and health and safety. This showed that people were receiving care and support that ensured their safety and welfare.

All of the people we spoke with were pleased with the service provided by Daisychain. Some of their comments included, 'The service is very good, my needs are quite complex and they have adapted very well' and 'It's very good, they are willing to do anything for you.' We found that people were happy that they had been involved in the planning of their care and that their wishes had been respected.

We noted however that people's care and support was not always planned and delivered in a way that ensured their safety and welfare. This was because detailed and accurate risk assessments had not always been completed.

People who use the service were protected from the risk of abuse, because the provider had taken reasonable steps to identity the possibility of abuse and prevent abuse from happening. The provider also had effective recruitment and selection processes in place.

People who use the service, their representatives and staff were asked for their views about their care and treatment and they were acted on. The provider also had a system in place to monitor the quality of the service people received.