Diversity Care - 6A Market Street

Diversity care is a domiciliary care agency providing personal care to 16 people at the time of the inspection.

Not everyone who used the service 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

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 support this practice. People were given choice and the opportunity to participate in the planning of their care needs. There was a complaints procedure in place with which people were familiar and knew how to make a complaint.

People were made to feel safe by a staff team who were trained to recognise and respond to concerns of abuse and manage people’s risks in a safe way. Medicines were administered safely in line with people's needs.

People received consistent support from a staff team who were punctual and who knew people’s needs well.

Care plans were detailed and gave staff the information they needed to be able to support people in the most effective way. People’s preferences were assessed and recorded. People's end of life wishes and preferences were considered and documented.

The registered manager adopted an open culture where staff felt valued and proud to work for the service. The provider and registered manager worked well with other agencies and organisations to improve the quality of care people received.

The last rating for this service was Good (published 5 July 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

On our previous inspection in July 2016 we rated the service as Requires Improvement as some people did not receive their support for the agreed length of time or at the expected time. The staffing was organised in a manner which meant staff would arrive late or at a different time than planned. Where people lacked capacity to make decisions, they had not determined who could support them to make any decisions and how this was in their best interests. There were processes to monitor the quality of the service provided, although these systems had not identified these concerns. Further improvements were still needed including how new staff were recruited into the service. On this inspection we saw improvements had been made in these areas.

The service had a registered manager in place at the time of our inspection. 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.

People’s care was planned to meet their needs. Potential risks were identified and management plans were in place to guide staff on the best way to reduce the risks. Staff understood their role in protecting people from harm and poor care. There were recruitment procedures in place to ensure staff were suitable to work within the service. People received their medicines when they were needed. The staff knew when to give these and what to do if they were concerned or medicines were missed.

People received care and support from staff who were well trained and knew how people liked things done. Staff had effective supervision and their work was reviewed through regular checks on their performance and their work was appraised. Staff sought people’s consent before providing care and supported people when they needed help with their decision making.

People had developed good relationships with staff, who recognised where care needed to be reviewed to reflect changes with their support. People received kind and compassionate care and were supported to maintain their dignity, independence and privacy. Staff gained information about what was important to people so that they could provide care which met their preferences.

People were provided with information about raising concerns or complaints and were happy to speak with staff about their worries. People were given opportunities to share their views of the service. There were audits in place to monitor the quality of the service to identify where improvements could be made.

People’s care was planned to meet their needs. Potential risks were identified and management plans were in place to guide staff on the best way to reduce the risks. Staff understood their role in protecting people from harm and poor care. There were recruitment procedures in place to ensure staff were suitable to work within the service. People received their medicines when they were needed. The staff knew when to give these and what to do if they were concerned or medicines were missed.

People received care and support from staff who were well trained and knew how people liked things done. Staff had effective supervision and their work was reviewed through regular checks on their performance and their work was appraised. Staff sought people’s consent before providing care and supported people when they needed help with their decision making.

People had developed good relationships with staff, who recognised where care needed to be reviewed to reflect changes with their support. People received kind and compassionate care and were supported to maintain their dignity, independence and privacy. Staff gained information about what was important to people so that they could provide care which met their preferences.

People were provided with information about raising concerns or complaints and were happy to speak with staff about their worries. People were given opportunities to share their views of the service. There were audits in place to monitor the quality of the service to identify where improvements could be made.

The service provides care and domiciliary support for older people and people with a learning disability who live in their own home in and around Tamworth and Lichfield. At the time of the inspection 27 people were receiving a service.

There was a registered manager in the service. 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.

People generally received their support visit on time but some people did not receive their support for the agreed length of time or at the expected time. The staffing was organised in a manner which meant staff would arrive late or at a different time. The provider was flexible and had accommodated people when they wanted their time changed although this impacted on other people’s care and when they received their visits. The rotas did not include the time people wanted their visit or how traveling between the calls impacted on the allocated time.. This information was shared with commissioners of the service.

People generally had capacity to make decisions about their own care and their consent was sought before staff provided any care and support. Where the provider recognised that people may need support to make decisions they had not determined who could support the people to make any decisions and how this was in their best interests.

There were processes to monitor the quality of the service provided although these systems had not identified the concerns with when people received their support visits. Further improvements were still needed including how new staff were recruited into the service.

People received support from the same staff team and they knew who was providing their support in advance. People were treated with care and kindness and they were supported to be as independent as possible. Positive and caring relationships had been developed between staff and people who used the service. People were supported to express their views and be involved in decisions related to the planning of their care and the running of the service.

People received care and support from staff who had received training to provide the support that people wanted. The staff knew people well and how they liked to be supported. Staff received supervision and had opportunities to develop their skills to meet people’s needs.

People knew how to make a complaint if they needed to. People and staff were confident they could raise any concerns or issues with staff in the office and the registered manager, knowing they would be listened to and acted on.

We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.

We saw that people or their representatives were asked to consent to their care plans. We found that people's needs were thoroughly assessed and that care plans and the delivery of care took people's preferences into account. We found evidence that people's safety and well-being were considered at every stage of the care process.

We found that there had been medication errors by Diversity Care which had prompted safeguarding investigations by the local authority. The provider responded by reviewing the medicines administration policy with all staff and by following disciplinary procedures with some staff.

The provider and the service manager had developed quality assurance systems to check that the service people received met their needs and that care workers went about their work in an appropriate way. People who used the service were asked for their views about the service.

We saw that problems with record keeping had been identified. In response, the service had developed strategies designed to prevent a recurrence of this.

We saw that people or their representatives were asked to consent to their plans. We found that people's needs were thoroughly assessed and that care plans and the delivery of care took people's preferences into account. We found evidence that people's safety and well-being were considered at every stage of the care process.

We spoke with two care workers and read three employee files. We found evidence that care workers underwent safe recruitment processes; they had a six-week induction period and received ongoing training and supervision. The registered manager had developed quality assurance systems to check that the service people received met their needs and that care workers went about their work in an appropriate way. People who used the service were asked for their views about the service.