Daryel Care Greenwich

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

At the last inspection in June 2023 the provider was in breach of good governance due to widespread issues with safety and quality of care and lack of effective oversight. The provider has made many improvements to the safety and quality of the service. However, the processes for ensuring staff attended to people at the right time was still not robust and people continued to experience late care visits and care from inconsistent staff. Many people receiving care told us the provider needed to make further improvements to the quality and safety of care. The lack of improvement meant a continued breach of good governance.

This service scored 61 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

In general staff were positive about the shared direction and culture of the organisation. They felt improvements were being made and they had opportunities to meet for peer support and discuss ongoing issues. Positive feedback from staff included, “The culture of the organisation is fair and open in my opinion” and “They listen to our concerns and makes us feel seen and appreciated, in a way it motivates us to do our best in the field.”

At the time of the assessment the provider had not implemented an effective process for gathering feedback from people and staff in order to help drive improvements. We saw some examples of positive feedback gathered from people receiving care but very few people had responded and we could not be assured feedback was an effective way of driving improvements. We raised this with the provider and they told us they had identified this shortfall and had designed a staff feedback survey which they had not yet sent out. They had also recently introduced a staff suggestion box to enable staff to submit suggestions for improvements.

Staff commented that the support they received from the office staff and senior managers had improved since the last inspection in June 2023. We received comments such as, “My manager is fantastic with feedback! Her responses to issues are swift and on time. Yes she always finds time to get back to me if I want to speak with someone.”

The provider had made many changes to the leadership team since the last inspection. A new registered manager and deputy manager was in post. The provider's business partner had also been supporting the provider to progress their improvement plan.

Most staff told us the provider had fostered a positive culture which empowered staff to speak up and raise concerns. One member of staff said, “The service is being well-led because they are not only focusing on safeguarding the clients and offering the best service but also the workers, our concerns are being addressed and we feel noticed and less pressured.”

The registered manager ensured there were opportunities for staff to raise issues or concerns or make suggestions for improvement. Team meetings were used to provide information to staff on a range of topics and given staff the opportunity to raise concerns. The provider had also introduced a suggestion box to enable staff to contribute ideas of improvement anonymously. Whistleblowing and safeguarding procedures were discussed during team meetings to remind staff about the importance of raising concerns.

Most staff felt there was a fair and inclusive culture. The registered manager told us about cultural events they had organised at the office to celebrate the different cultures of staff and foster an environment where equality and diversity was celebrated. The registered manager told us, “Originally we were planning a coffee drop in, but this has soon turned into a potluck. We have reviewed every country that our care staff are from and are planning to incorporate as much of their home dishes as possible to share. We will sit together and have a casual catch up, and we aim to do this at least every 6 weeks so people can drop in and be together. It’ll create a tighter knit working environment as I want this to feel like a family atmosphere, rather than just a job.”

There was an equality and diversity policy in place which captured general ambitions to ensure all staff are treated fairly. The provider also offered flexible working to support staff with disabilities and/or caring responsibilities. Despite some positive initiatives there was no clear equality and diversity strategy in place to ensure initiatives were monitored for their effectiveness. We discussed this with the provider and they have agreed to make improvements in this area.

Most staff thought improvements had been made. However, some staff felt further improvements were needed. One member of staff told us, “The service is well led to an extent but there is still room for improvement” Staff told us there were processes in place such as regular spot checks which were used to monitor staff performance. Comments from staff included, “My supervisor sometimes pays unannounced visits to check what I do and ensure I follow to the dress code” and “We gather feedback from people during spot checks. In general, things have improved and people are a lot happier now.”

At the last inspection in June 2023 we found numerous issues with the safety and effectiveness of care. Despite the provider making many improvements they had not resolved all the issues and further improvements were needed. At the last inspection we found extensive issues with the electronic care monitoring (ECM) records. At this assessment, despite some improvements, there were some persistent issues with late and unlogged calls and many people were still not satisfied with staff timekeeping. The provider’s monitoring processes had identified some issues with staff compliance and persistent lateness, however, there was not a robust system for auditing ECM records and they had not identified all the issues with lateness and unlogged calls that we found. The provider had acknowledged the current ECM system was not effective and they told us they would be installing a new system which will enable them to monitor staff attendance more accurately to ensure people get their care visits at the right time. They have also made changes to their staffing to ensure people receive visits from regular staff.

There was mixed feedback from people and their relatives about how the provider was working in partnership. Many people and/or relatives felt staff did not communicate well and this had an adverse effect on partnership working. Negative comments included, I feel the communication is patchy and inconsistent” and “I'm not aware that they have any kind of out of hours telephone number and many times I've phoned the telephone number during office hours and no one has answered. Some people felt partnership working was effective. One person told us, “They do communicate with me for example if my friend is running low on food or pads and they have my telephone number.”

The provider understood their responsibility to work in partnership with a range of external health and social care professionals. The registered manager told us staff made referrals to the local authority social care team, occupational therapists and district nurses as required.

The provider had been working through their improvement plan with the local authority who told us improvements had been made to the quality and safety of care. Other professionals told us the provider communicated effectively with relevant parties and provided necessary information in good time when required.

There were effective processes in place to ensure staff worked in partnership with external partners and other health and social care professionals to improve the quality of the service provided.

The provider used feedback gathered during staff meetings and staff supervisions to build a picture of themes and concerns about people’s care. Ongoing issues were shared with the local authority adult social care team. The registered manager told us lessons learnt were also captured on the improvement plan and discussed during staff meetings. Despite many improvements some staff felt further improvements were required. Comments included, “They still need improve the rotas” and “There have been significant improvements but the 2 way communication still needs to be worked on. At times there are no response to emails.”

The provider had made improvements to their systems and processes. There was clear evidence that people’s assessments and care plans were being reviewed and the registered manager had good oversight over the quality of records. Despite this we found further improvements were needed to the way improvements were embedded. The improvement plan did not accurately reflect the ongoing issues with ECM system so we could not be assured it was entirely effective. Negative feedback from people about the care they received and the responsiveness of the provider also showed further improvements were needed.