Daisy Care Services, a small domiciliary care agency supporting one person at the time of inspection, was rated Requires Improvement overall at its first inspection due to absent risk assessments, gaps in specialist staff training, and a lack of embedded quality audits. Caring and responsive domains were rated Good, with positive feedback from a relative about person-centred, dignified support.
Concerns (4)
moderate
Care planning
: “There were no risk assessments in place in relation to people's care. Risks to people had not been identified and mitigated. This put people and staff at risk of harm.”
moderateStaff training: “the training records did not evidence that staff had completed additional training to meet people's assessed needs such as, dementia, diabetes, skin integrity and continence.”
moderateGovernance: “The systems in place to audit the quality of the service were not embedded, robust or sufficient to alert the provider of areas for improvement within the service. No audits had taken place.”
minorLeadership: “The provider had not signed up to and completed the NHS capacity tracker to enable the NHS and CQC to monitor the organisation.”
Strengths
· Staff were recruited safely with DBS and reference checks completed.
· Effective safeguarding systems were in place to protect people from abuse.
· Care records were detailed, person-centred and promoted independence.
· Staff treated people with dignity, kindness and respect.
· Management team had a good understanding of the Mental Capacity Act and duty of candour.
Quality-Statement breakdown (18)
safe: Assessing risk, safety monitoring and managementRequires improvement
safe: Staffing and recruitmentGood
safe: Preventing and controlling infectionGood
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Using medicines safelyNot rated
effective: Staff support: induction, training, skills and experienceRequires improvement
effective: Assessing people's needs and choicesGood
effective: Ensuring consent to care and treatment in line with law and guidanceGood
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 preferencesGood
responsive: Meeting people's communication needsGood
responsive: Improving care quality in response to complaints or concernsGood
well-led: Promoting a positive culture and continuous learning and improving careRequires improvement
well-led: Duty of candourGood
well-led: Engaging and involving people, public and staffRequires improvement