Daryel Care Waltham Forest, a new domiciliary care agency on its first inspection, was rated Requires Improvement overall, with breaches of Regulations 9, 12, and 17 relating to unsafe risk management, inadequate specialist staff training (autism, dementia, mental health), and ineffective governance systems. Caring was rated Good, with people reporting respectful, dignified and person-centred interactions from a staff team they trusted.
Concerns (10)
criticalCare planning: “Care plans and risk assessments were not updated from incidents that had occurred. Another person's environmental risk assessment did not identify the risk and how that impacted the person.”
criticalSafeguarding: “The risk assessment also stated the person did not have a smoke alarm in their property, which is a high risk of the person becoming harmed from a fire.”
criticalStaff training: “Staff did not receive training in supporting people with a learning disability, autism or mental health and dementia. This was a breach of Regulation 18.”
criticalGovernance: “The provider had failed to ensure governance systems were established and operating effectively to ensure oversight was robust. This was a breach of Regulation 17.”
criticalPerson-centred care: “The care and treatment of people using the service did not always match their needs. This was a breach of Regulation 9.”
moderateIncident learning: “The provider did not have effective systems in place to ensure that learning from incidents and accidents were being recorded in people care plans and risk assessment.”
moderateRecord keeping: “People's care information lacked detailed information, which meant there was a risk people would not receive the care that met their needs and preferences.”
moderateConsent / capacity: “The provider's initial assessment did not cover people's mental capacity, which meant that the provider was not always working in line with the MCA.”
moderateLeadership: “The registered manager was not always fully aware of the needs of people they supported. A person's needs assessment did not identify they had autism.”
minorComplaints handling: “The provider informed us that they had not received any complaints. However, we identified that concerns had been raised about staff not logging in and out from their care visits.”
Strengths
· Staff were trained in safeguarding and were clear on reporting procedures and escalation to external agencies.
· Robust recruitment processes including DBS checks, references, and right-to-work verification.
· Medicines administration records were completed correctly and people confirmed timely medication support.
· Staff received regular supervisions, yearly appraisals, and induction with shadowing.
· People reported being treated with kindness, dignity and respect, with privacy maintained during personal care.
Quality-Statement breakdown (21)
safe: Assessing risk, safety monitoring and managementRequires improvement
safe: Systems and processes to safeguard people from the risk of abuse; Learning lessons when things go wrongRequires improvement
safe: Staffing and recruitmentGood
safe: Using medicines safelyGood
safe: Preventing and controlling infectionGood
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawRequires improvement
effective: Staff support: induction, training, skills and experienceRequires improvement
effective: Supporting people to eat and drink enough to maintain a balanced dietGood
effective: Staff working with other agencies to provide consistent, effective, timely careGood
effective: Ensuring consent to care and treatment in line with law and guidanceRequires improvement
caring: Ensuring people are well treated and supported; respecting equality and diversityGood
caring: Supporting people to express their views and be involved in making decisions about their careGood
caring: Respecting and promoting people's privacy, dignity and independenceGood
responsive: Planning personalised care to ensure people have choice and control and to meet their needs and preferencesRequires improvement
responsive: End of life care and supportRequires improvement
responsive: Meeting people's communication needsGood
responsive: Improving care quality in response to complaints or concernsRequires improvement
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsRequires improvement
well-led: How the provider understands and acts on the duty of candour; Working in partnership; Continuous learning and improving careRequires improvement
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringGood
well-led: Engaging and involving people using the service, the public and staffRequires improvement