About the service DayByDay Care Limited is a domiciliary care service, which is registered with the Care Quality Commission (CQC) to provide regulated activities of personal care to older people, people with learning disabilities or autistic spectrum disorder, people living with dementia, and people with physical disability, in their own homes. At the time of our inspection there were five people using the service.
Everyone who used the service at the time of the inspection received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided.
People’s experience of using this service and what we found
The provider had failed to ensure staff always received appropriate induction, training, professional development, supervision and appraisal as necessary to enable and support them to carry out the duties they were employed to perform. The new manager was aware of the omissions and discussed how they planned to quickly implement the required improvements.
Management completed a range of audits and checks to maintain standards of service. However, management oversight failed to always ensure these checks remained effective to ensure actions identified as requiring improvement were always implemented in a timely way following the provider policy.
People told us they felt safe with the staff who supported them. Staff were clear on types of abuse to look out for and how to raise their concerns when required. Processes ensured any incidents were routinely investigated with outcomes and actions implemented to help keep people safe.
Risks associated with people's care were assessed to help staff provide safe care and staff also had access to information to keep them safe when entering people’s homes. Where people required support to take their medicines, this was done safely as prescribed with appropriate record keeping checked for accuracy.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
Staff had good access to personal protective equipment to manage the risks associated with the spread of infection including CVOID-19 and adhered to government guidance to protect people.
Although the service was not providing care to anyone with a learning disability, 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.
The service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.
Right support: Model of care and setting maximised people's choice, control and independence;
People told us they knew when to expect visits and that visits respected their preferred times. People spoke positively about the service they received and the way the service was managed. The new manager was passionate about providing people with a personalised service to help them remain living as independent as possible in their own homes. People told us that staff supported them when their care needs changed to ensure they were able to retain their independence.
Right care: Care was person-centred and promoted people's dignity, privacy and human rights;
People told us staff were respectful, caring and understanding around people's
emotional and physical needs. People were involved in planning their care and support. Care was delivered following a robust assessment of needs to ensure people’s wishes preferences and any personal characteristics were recorded and supported.
Right culture: The ethos, values, attitudes and behaviours of leaders and care staff ensured people using services led confident, inclusive and empowered lives; The culture of the service was open and empowered individuals to express their views and be in control of their lives with the support of staff. People told us they felt confident to approach the management team and that their suggestions would be listened to.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
This service was registered with CQC on 02 November 2020 and this is the first inspection.
Why we inspected
This inspection was prompted by a review of the information we held about this service.
Enforcement and Recommendations
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.
We have identified a breach in relation to Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 (Part 3) Regulation 18: Staffing at this inspection.
We have made a recommendation for the provider to review their policies to ensure audit systems, and process checks remained effective in driving the areas requiring improvement which we found during the inspection.
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.