Archived: Diamond Care

Updated 2 May 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the registered person continued to meet the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service and to provide a rating for the service under the Care Act 2014.

Before the inspection, we examined the information we held about the service. This included notifications of incidents that the registered person had sent us since our last inspection. These are events that happened in the service that the registered person is required to tell us about. We also invited feedback from the commissioning bodies who contributed to purchasing some of the care calls provided by the service. We did this so that they could tell us their views about how well the service was meeting people’s needs and wishes.

Shortly before our inspection visit to the service’s office, we spoke by telephone with seven people who used the service and with one of their relatives. We wanted to find out what it was like to receive care calls from the service. We also spoke by telephone with five care staff so that they could tell us about their experience of working in the service.

We visited the service’s office on 16 March 2018 and the inspection was announced. We gave the registered person a short period of notice because they are sometimes out of the office supporting staff or visiting people who use the service. We needed to be sure that they would be available to contribute to the inspection. We spoke with two care workers who were assisting the registered person to organise the completion of care calls. In addition, we met with the registered person and looked at the care records for four people who used the service. We also examined records relating to how the service was run including the times and the duration of care calls, staffing, the management of medicines, the obtaining of consent and the delivery of training. Lastly, we examined the systems and processes used to assess, monitor and evaluate the service.

The service was last inspected on 17 January 2017 when it was rated as, 'Requires Improvement'.

Updated 2 May 2018

Diamond Care is registered to provide personal care for adults of all ages in their own home. It can assist people who live with dementia, who have mental health needs and who have physical or sensory adaptive needs. At the time of our inspection the service was providing care for 14 older people.

The service had its office in Polegate and covered Eastbourne and the surrounding area.

The service was owned and operated by an individual who was both the registered provider and the registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are 'registered persons'. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. In this report when we speak about the registered provider and the registered manager we refer to them as being, 'the registered person'.

At the last comprehensive inspection on 17 January 2017 the overall rating of the service was, ‘Requires Improvement’. We found that there were five beaches of the regulations. This was because there were shortfalls in the arrangements that had been made to notify us about two occasions when there had been a concern that people had not been suitably safeguarded from the risk of abuse. There were also shortfalls in the assistance some care staff had provided to people to enable them to safely manage their medicines. Another concern referred to omissions in the way the registered person had obtained people’s consent to parts of the care they received. We also identified that some care staff had not received all of the training that the registered person said they needed. This shortfall had increase the risk of care staff not having all of the knowledge and skills they needed. In addition to these shortfalls, we noted that the registered person had not consistently assessed, monitored and evaluated the operation of the service to ensure that people reliably received safe care and treatment.

We told the registered person to take action to make improvements to address each of our concerns. After our inspection the registered person wrote to us and said that the necessary changes had been made.

At the present inspection the overall rating of the service was, ‘Good’. We found that most of the individual concerns we had previously raised had been addressed. We noted that the registered person had adopted new systems and processes that were designed to ensure that the occurrence of significant incidents were notified to us in the correct way. We also noted that care staff were supporting people to safely manage their medicines and that there were suitable arrangements to obtain people’s consent to the care they received.

Although records showed that care staff had been given additional training in relation to key parts of their work, there were still examples of individual care staff who had not received all of the training planned for them. Nevertheless, we found that in practice care staff had the knowledge and skills they needed to care for people in the right way.

Lastly, documents and records showed that the registered person had further developed the quality checks they used to assess, monitor and evaluate the operation of the service.

Our other findings were as follows. People had been safeguarded from situations in which there was the risk of them experiencing abuse. People received safe care and treatment. This included being helped to avoid preventable accidents and being supported to manage medicines safely. There were enough care staff who were organised in the right way to complete care calls as planned. Background checks had been completed before new care staff were appointed and lessons had been learned when things had gone wrong.

Suitable arrangements were in place to assess people’s needs and choices so that care was provided to achieve effective outcomes. This included providing people with the reassurance they needed if they became distressed. People were helped to eat and drink enough to maintain a balanced diet. Also, suitable arrangements had been made to help people receive coordinated care when they moved between different services.

People had been assisted to access healthcare services and care staff had helped people to ensure that their accommodation met their needs and wishes.

People were treated with kindness and compassion. Also, care staff respected people’s privacy and gave people emotional support when it was needed. Furthermore, people had been supported to express their views and be actively involved in making decisions about their care as far as possible. This included them having access to lay advocates if necessary. Confidential information was kept private.

Although people received responsive care that met their needs for assistance, information was not always presented to them in an accessible manner. However, people had been offered the support they needed to pursue their hobbies and interests and to engage in social activities. Furthermore, suitable arrangements had been made to promote equality and diversity. In addition, there were suitable arrangements for managing complaints and suitable steps had been made to support people at the end of their life to have a comfortable, dignified and pain-free death.

There was a registered manager who had taken a number of steps to enable the service to learn, innovate and ensure its sustainability so that it met regulatory requirements. Most care staff considered there to be an inclusive culture in the service and people who used the service had been consulted about its development. Furthermore, care staff had been helped to understand their responsibilities to develop good team work and to speak out if they had any concerns. In addition, the registered person was actively working in partnership with other agencies to support the development of joined-up care.