Diamond Support Services Limited

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. This is the first assessment for this registered service. This key question has been rated good. This meant people were safe and protected from avoidable harm.

This service scored 66 (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 supported people to manage their health and wellbeing to maximise their independence, choice and control.
Staff supported people to live healthier lives and where possible, reduce their future needs for care and support. Staff encouraged and supported people to make healthier choices to promote and maintain their health and wellbeing. This included support with eating and drinking, as well as personal and oral hygiene.
 

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

The service completed an initial needs assessment before people started using the service. This process included introductory meetings, visits and information about the service to ease transition. The provider involved people and their relatives to develop the care plan. A relative told us, “Yes, they came to meet us, and I explained what my [family member] needed. So far, I am happy and feel reassured leaving my [family member] in their care.”
 

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect.
The provider shared concerns quickly and appropriately. People told us they felt safe with staff and were aware of who to contact if they had any concerns regarding abuse or neglect. A person using the service told us, ‘‘We feel safe around the staff, [family member] feels safe around the staff.’’
Staff reported that they knew how to raise concerns and had received training in both adult and child safeguarding, enabling them to recognise signs of abuse or neglect.
 

The provider did not always work well with people to understand and manage risks. Staff did not always provide care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them. Where risk management plans were in place, these were not regularly reviewed or sufficiently detailed to ensure staff had all the necessary information to deliver safe care and treatment. For example, the provider had not completed appropriate risk assessments for community access to ensure that potential risks were identified and that appropriate measures were in place to keep people safe. We spoke with the registered manager, who took prompt action to ensure that all risk assessments were reviewed and updated where necessary.
However, assessments considered risks related to individuals' health, mobility and activities. These included risks related to skin breakdown, oral hygiene, diabetes, falls, and moving and handling. In addition, risk levels were assessed based on both likelihood and potential consequences. Control measures and action plans were recorded to reduce each identified risk.
 

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.
Staff had received appropriate health and safety training, including fire safety, to ensure they understood how to respond in an emergency. The provider also had robust risk assessments in place, covering environmental risks and the steps needed to reduce them.
 

The service did not always make sure there were enough qualified, skilled and experienced staff. They did not always ensure that staff received effective support, supervision, and development in a timely manner. We found that, for some staff, there was no documented evidence of regular spot checks, competency assessments, supervision, or appraisals being completed in a timely manner to assess their knowledge and skills. This meant the provider could not always be assured that staff were working safely or receiving the appropriate support to carry out their roles effectively. We raised these concerns with the provider, who informed us that improvements had now been made to the Human Resources (HR) systems, including the introduction of regular spot checks and a clearer structure for supervision and appraisal processes. They told us that a key part of these improvements had been the transition to a more digital system, which was already making processes easier to manage and monitor.
In addition, staff had not received essential training required to meet specific care needs, such as diabetes. Following our inspection, the provider informed us that staff supporting people with diabetes had been enrolled on a diabetes training course to ensure they were confident and able to provide appropriate support to individuals.
However, staff reported that they felt supported and had completed an induction programme, which prepared them to work independently. Staff received training that was appropriate and relevant to their roles, including moving and handling, and awareness of mental health conditions, dementia, and learning disabilities.
The provider had completed Disclosure and Barring Service (DBS) checks or Right to Work checks appropriately prior to staff starting their roles. A DBS check is a record of a person’s criminal convictions and cautions. These checks help employers make safe recruitment decisions.
There were enough staff employed to meet people’s needs to ensure people get the care they need when they want it. People experienced continuity of care. They told us they were supported by a regular staff team, with care delivered through an agreed routine. People using the service confirmed that staff arrived at the planned call time and stayed for the agreed visit length. One person using the service told us, “[Family member] sees one staff member regularly, and they are very experienced. They stay for the agreed time to provide support and care. They take [family member] to college, pick them up on time, and take them swimming.”

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.
Staff reported that they understood infection prevention and control (IPC) policies and wore personal protective equipment (PPE), such as disposable gloves and aprons, to help prevent and control the spread of infection. A relative told us, ‘‘Yes, the staff do use PPE, such as gloves, and they help [family member] maintain good personal hygiene. For example, they make sure they wear slippers when going to the toilet.”
 

The provider did not always make sure that medicines and treatments were safe and met people’s needs, capacities and preferences. There was insufficient oversight of medicines management in line with current legislation and guidance.
At the time of our inspection, people were self-administering their medicines or receiving support from family members. We found that staff had occasionally prompted 1 person to take their medicines. There was no Medication Administration Record (MAR) in place to evidence that this support had been provided, or that medicines had been taken safely and as prescribed. We spoke with the registered manager, who told us they would ensure all medicines support is appropriately recorded whenever an individual is prompted by staff.
However, staff had received mandatory training on medicines administration to ensure they had the knowledge and skills required to administer medicines safely. Care plans included clear information about people’s medicines, the support required, and any associated risks relating to specific medicines.