Diamond Heart Health Care LTD

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

Well-led – this means we looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture.

This is the first assessment for this service. This key question has been rated requires improvement. This meant the management and leadership was inconsistent. Leaders and the culture they created did not always support the delivery of high-quality, person-centred care.

In this key question the provider was in breach of the legal regulation relating to good governance.

This service scored 50 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider did not have a clear shared vision, strategy and culture which was based inclusion and engagement. The provider’s business was fundamentally a new start-up having taken several years to secure contacts with adult social care commissioners. The provider still had work to do to embed a positive work culture that created a shared direction and coherent strategy.

The provider did not always embody the culture and values of the organisation they sought to build. Whilst they had the skills, knowledge and experience, they did not dedicate enough time to the core role of registered manager. This was because they spent a significant amount of time engaged in providing direct care to people who used the service, and/or were engaged in driving duties for other members of staff.

Staff did not always feel they could speak up and that their voice would be heard. Whilst we saw notes of team meetings and a log of concerns that had been raised by some staff, there was a lack of meaningful action in addressing the concerns raised. This created a culture where some staff didn’t see the point of ‘speaking up.’ Comments from staff included, “I feel anxious about speaking up as I don’t feel concerns are taken seriously."

The provider did not always value diversity in their workforce. They did not always work towards an inclusive and fair culture by improving equality and equity for people who worked for them. For example, staff working away from their own families for prolonged periods of time and not always having regular hours of work, created an unequal workplace, with insecurity of employment, which did not take always take account of the needs of staff.

The provider did not always have clear responsibilities, roles, systems of accountability or good governance. Leadership and management of the service was the responsibility of the registered manager who was also the registered provider with CQC. This meant they are solely legally responsible for how the service is run and for the quality and safety of the care provided.

The service did not have follow a systematic approach to ensure audit, quality assurance and questioning of practice was managed consistently. Where we did see that some audit activity had been completed, it was not aways clear what actions or areas of learning flowed from such audits. The registered manager needed to dedicate more time to their role and responsibilities of registered manager.

The provider did not always understand their duty to collaborate and work in partnership, so services worked seamlessly for people. They did not always share information and learning with partners or collaborate for improvement. We spoke with the registered manager about seeking further opportunities locally to collaborate and share learning, for example, through the local adult social care registered managers’ forum. We also signposted the registered manager to Skills for Care with a view to potentially developing a values-based approach to future recruitment.

The provider did not always focus on continuous learning, innovation and improvement across the organisation and local system. Whilst the knowledge the provider was working hard in attempting to grow the business and make connections with commissioners of services, a proper foundation for learning and improvement needed to be developed.