We carried out a review of the data available to us about Diwali Nivas on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Diwali Nivas, you can give feedback on this service.
Diwali Nivas is a 'care home' for a maximum of 21 people. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Twenty-one people lived at the home at the time of our inspection visit.
Diwali Nivas is a care home for older Asian people who may have a mental health condition or live with dementia. People who live at the home are vegetarian.
The home is an extended residential property close to the centre of Leicester. It is within walking distance of places of worship and local shops which serve the Asian community.
At our last inspection we rated the service as ‘good’. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns.
The service continued to be safe. There were enough staff on duty to meet people’s needs; and staff recruitment checks reduced the risk of the service employing unsuitable staff. Staff understood how to safeguard people from harm and knew the risks related to people’s health and wellbeing. People received their medicines as prescribed. The home was clean and tidy and staff understood infection control practice. Premises were well-maintained.
The service continued to be effective. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The principles of the Mental Capacity Act (MCA) were followed. The policies and systems in the service support this practice. Staff received training to support them work effectively with people who lived at the home. People had access to different health and social care professionals when required, and good relationships had been formed between the service and those professionals. People received food which was culturally appropriate, which they enjoyed, and choices with each meal.
The service continued to be caring. People received care from staff who were kind, treated them with dignity and respected their privacy. Staff had developed positive relationships with the people they supported, they understood people’s needs, preferences, and what was important to them. The service supported people to maintain relationships with their family and friends.
The service continued to be responsive. People’s needs were assessed and staff ensured their needs were met. The service was responsive to people's religious and cultural needs, and provided daily activities to support emotional wellbeing. The small number of complaints had been responded to well. The service ensured people’s end of life care needs were met.
The service continued to be well-led. The registered manager and care manager provided good support to the staff group, and to people who lived at the home. Checks were made to ensure the service met its obligations to provide safe accommodation to people and to deliver care and support which met people’s individual needs.
Further information is in the detailed findings below.
Diwali Nivas is registered to provide care and support for Asian elders who may experience a mental health condition or be living with dementia. Diwali Nivas is registered to provide care for up to 21 people. At the time of our inspection there were 21 people living at the home, however one person was in hospital.
A registered manager was in post. The registered manager was also the provider, and they were supported by a registered manager at the home. 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.
At the last two inspections of the service in June 2014 and April 2015 we asked the provider to take action. We asked the provider to make improvements in the arrangements for cleanliness and infection control. We received an action plan from the provider which outlined the action they were going to take which advised us of their plan to be compliant by November 2015. We found that the provider had taken the appropriate action. Medicines were ordered and stored safely, and staff were trained to administer the medicines people required. Staff sought medical advice and support from health care professionals.
Personal evacuation plans (PEEP’s) were available and stored securely along with other documents and were placed near the fire board and main exit from the home. Copies of the PEEP’s were also kept in each person’s file and reviewed regularly along with other personal file documents.
People felt their privacy and dignity was respected and staff were kind and caring when delivering care and their choice of lifestyle. Relatives we spoke with were complimentary about the staff and the care offered to their relations. People’s care and support needs had been assessed and people were involved in the development of their care plans, and when able were involved in the review of their care plan. When appropriate people were happy for their relatives to be involved in care planning and review. We observed staff offered people everyday choices and respected their decisions. Staff had access to people’s care plans and received regular updates about people’s care needs. Care plans included changes to people’s care and treatment, and people attended routine health checks.
People were provided with a choice of meals that met their cultural and dietary preferences. The catering and care staff were provided with up to date information about people’s allergies and dietary needs. People’s opinions were sought to meet their individual meal choices. There were sufficient person centred activities provided on a regular basis and people’s cultural and religious needs were met. Staff had a good understanding of people’s care needs, and people were able to maintain contact with family and friends as visitors were welcome without undue restrictions.
Staff were subject to a thorough recruitment procedure that ensured staff were qualified and suitable to work at the home. They received induction and on-going training for their specific job role, and were able to explain how they kept people safe from abuse. Staff were aware of whistleblowing and what external assistance there was to follow up and report suspected abuse. Staff were employed in sufficient numbers to meet people’s personal care needs and we saw staff worked together to meet people's needs.
Staff told us they had access to information about people’s care and support needs and what was important to them. Staff knew they could make comments or raise concerns with the management team about the way the service was run and knew these would be acted on.
The provider had a clear management structure within the home, which meant that the staff were aware who to contact out of hours. The provider undertook quality monitoring in the home supported by the registered manager. The provider had developed opportunities for people to express their views about the service which included the views and opinions from people using the service, their relatives and health and social care professionals. We received positive feedback from a visiting health professional and contracting staff from the local authority with regard to the care and services offered to people. Staff were aware of the reporting procedure for faults and repairs and had access to the maintenance to manage any emergency repairs. A series of checks had been introduced that were overseen by the registered manager and then checked by the provider.
This inspection took place on 28 April 2015 and was unannounced.
Diwali Nivas is a care home that provides residential care for up to 16 Asian elders who may in addition experience dementia or a mental health condition. The home specialises in caring for older people including those with physical disabilities, people living with dementia or those who require end of life care. At the time of our inspection there were 15 people in residence.
A registered manager was in post. 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. The registered provider was also the registered manager at this service.
People were happy and told us that they felt safe. Staff were able to explain how they kept people safe from abuse, and knew what external assistance there was to follow up and report suspected abuse. Staff were knowledgeable about their responsibilities and trained to look after people and protect them from harm and abuse.
There was an on-going refurbishment in the home which restricted the space the dining room and lounges. We spoke with people and their relatives, who understood the current situation was for a limited time.
Staff did not always communicate people’s dietary needs properly, which allowed people to be at risk of choking. People’s care and support needs had been assessed and were involved in the development of their plan of care. People told us they were satisfied with the care provided.
Staff were recruited in accordance with the provider’s recruitment procedures that ensured staff were qualified and suitable to work at the home. We observed there to be sufficient staff available to meet people’s needs and worked in a co-ordinated manner.
Most medicines were stored safely, however some creams were stored in bedroom areas. These were not locked away, so open to anyone entering the room. We found a number of these were not dated on being opened, so we could not tell how long they had been in use, and assess if they remained active. There were also a number of these that had the label obscured, so again we could not ascertain if they were prescribed for a particular person, or how often they should be applied. People received their tablet, capsule and liquid medication as prescribed. Staff were trained in medicines management and their competency assessed to ensure people’s medicines were managed properly. Staff failed to see the significance of medicines stored in bedrooms that may not have been appropriate for the person residing there.
We found a number of infection control issues in the ground floor shower rooms, bedrooms and kitchen area. The staff had cleaning schedules in place. These described which areas were to be cleaned on any given day, as bedrooms were ‘deep’ cleaned on a rotational basis. There was also a policy and procedure for infection control, and staff had access to these documents. We found that staff did not have a working knowledge of either document, which meant that areas were not cleaned or disinfected in line with the policy.
Staff received an appropriate induction and on-going training for their job role, and all could speak a range of English and Asian languages. Staff had access to people’s care records and were knowledgeable about people’s needs that were important to them.
The management team and staff knew how to protect people under the Mental Capacity Act, 2005 and the Deprivation of Liberty Safeguard (DoLS). We observed that staff gained consent before care and support was provided. Staff followed the principles of the MCA Code of Practice which promoted people’s rights and choices about their care and treatment.
People were provided with a choice of meals that met people’s cultural and dietary needs. There were drinks and snacks available throughout the day and night. We saw staff supported people in their bedrooms who needed help to eat and drink in a sensitive manner. The catering staff were provided with up to date information about people’s dietary needs but not people’s special requirements. We found there was a lack of communication between the cook and care staff for people who had their food blended. Peoples’ food was blended to aid the persons swallowing where they had been assessed as having swallowing difficulties by a health professional.
People felt staff were kind and caring, and their privacy and dignity was respected in the delivery of care and their choice of lifestyle. Relatives we spoke with were also complimentary about the staff and the care offered to their relatives.
We observed staff speak to, and assist people in a kind, caring and compassionate way, and people told us that care workers were polite, respectful and protected their privacy. We saw that people’s dignity and privacy was respected which promoted their wellbeing.
Staff had a good understanding of people’s care and cultural needs. People told us that they had developed good relationships with staff and were enabled to speak with them using their first language.
People are involved in the review of their care plan, and those that are not are happy for their relatives to be involved. We observed staff offered people everyday choices and respected their decisions. Staff spoke clearly to people, and explained what they were doing and where appropriate in the persons first language.
Some people chose to be involved with activities such as painting, puzzles, arts & crafts and finger nail painting. We saw a member of staff who was providing hand massages for people. We also spoke with a beautician who told us they attend the home once a month if anyone requests reflexology. That meant the staff consider people’s wellbeing.
People told us that they were able to pursue their hobbies and interests that was important to them. These included the opportunity to maintain contact with family and friends as visitors were welcome without undue restrictions. People were also able to have their cultural and religious needs recognised, for some this meant being dressed in culturally appropriate clothes and for others having their religious needs met. This protected people from social isolation.
Staff told us they had access to information about people’s care and support needs and what was important to people. Care staff were supported and trained to ensure their knowledge, skills and practice in the delivery of care was kept up to date. Staff knew they could make comments or raise concerns with the management team about the way the service was run and knew it would be acted on.
The provider had developed opportunities for people to express their views about the service. These included the views and suggestions from people using the service, their relatives and health and social care professionals.
Staff sought appropriate medical advice and support from health care professionals. Care plans included the changes to peoples care and treatment, and people attended routine health checks.
People were confident to raise any issues, concerns or to make complaints. People said they felt staff listened to them and responded promptly.
People who used the service and their visiting relatives spoke positively about the open culture and communication with the staff. We noted that the provider interacted politely with people and they responded well to him. When we spoke to the provider, it was clear he knew people and their relatives, by the way in which they conversed.
The provider had a clear management structure within the home, which meant that the staff were aware who to contact out of hours. However on the day we visited the staff rota had not been updated to reflect the changes to the staff on duty. That meant that the record had not been maintained properly in line with current legislation and guidance, and was not a true reflection of staffing on the day.
The provider understood their responsibilities and displayed a commitment to providing quality care through employing staff that were culturally appropriate. Care staff understood their roles and responsibilities and knew how to access support. Staff had access to people’s care plans and received regular updates about people’s care needs.
There were effective systems in place for monitoring of the building and equipment which meant people lived in an environment which was regularly maintained. However the internal audits and monitoring of the environment, and monitoring and consistency of people’s special dietary needs did not provide people with safety. Staff were aware of the reporting procedure for faults and repairs and had access to external contractors for maintenance and to manage any emergency repairs.
If you want to see the evidence supporting our summary please read the full report.
Is the service safe?
Care plans were written in an individual way that ensured people received personalised care and support. Medicines were stored and administered securely.
The home had proper policies and procedures in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards although no recent applications had needed to be submitted. Relevant staff were aware when an application should be submitted.
People were safeguarded from financial abuse by detailed and secure processes when staff dealt with people's money.
Staff told us they were provided with personal protective equipment (PPE). We also saw plentiful supplies of PPE placed around the home. Though we found staff did not automatically change their gloves and aprons when completing one task and prior to commencing another.
We also found that cleaning materials and disposable hand towels were inappropriately stored in an external store. There was also inappropriate storage of soiled dressing within the medication store.
Is the service effective?
People's health and care needs were assessed, and they and their representatives were involved in the agreement of their plans of care.
Is the service caring?
All the people using the service that were spoken with said they were well cared for and the staff helped them with their daily care needs. Several people made similar comments in both Punjabi and Gujarati and said, 'The carers are like my daughter, always polite, never raise their voice or answer back inappropriately.'
Is the service responsive?
People had access to bedroom door keys to ensure their property was secure at all times.
Is the service well-led?
Quality assurance systems were in place to make sure that managers and staff learnt from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations.
We observed that staff were able to speak with people in their first language, which included Gujarati, Punjabi and Hindi. People's diversity and values were respected with regards to conversation, clothing, religious practices and diet. People watched Asian movies and serials on the television. We observed people taking part in a musical session, whilst some completed jigsaw puzzles.
We found the environment to be adequately maintained and people chose two sit in one of the two lounges. We found there were sufficient staff on duty to meet the needs of people and that staff had a good understanding as the care and support people required. People were supported by staff with regards to their personal care and people's requests were met in a timely manner.
People's diversity and values were respected. People watched Asian movies, serials and international news on the television. We observed people taking part in a game of bingo. People were complimentary about the choice of Asian vegetarian meals.
Visitors said they were kept informed about any changes to their relatives' health and the registered manager always spoke with them when they visited. People confirmed they saw the doctor or nurse when needed. We found people's needs had been assessed and were regularly reviewed. Care plans had been developed which detailed the care and support which was to be provided by staff.
Records relevant to the management of the service were accurate and fit for purpose and appropriate checks were undertaken before staff began work. Records showed staff had access to a range of training which enabled them to promote the health and welfare of people who used the service.
We saw people living at Diwali Nivas speaking with staff and being supported by them in providing personal care and support.
The expert by experience spoke with people in Gujarati, Punjabi and Hindi. We observed that staff were speaking with people in their first language and that they had a good understanding of people's faiths and religious and cultural needs.
People were supported to practice their faith and religious needs by accessing external places of Worship and by the carrying out of religious readings within Diwali Nivas. The service provides an Asian vegetarian diet to people which is served in a manner which reflects their cultural needs.
People told us that they were happy with the care and support they received and that they enjoyed the food and activities provided. We observed that people received visits from relatives throughout the day and that visitors spoke with others who lived at Diwali Nivas as well as staff, the atmospheres appeared relaxed and welcoming.
People told the expert by experience that they felt safe. Staff need to receive more training which helps them to promote choices and understand the rights of people who are unable to make decisions for themselves.
Care plans reflected the needs of people and had been signed by the person's relatives. We noted that relatives had regular telephone contact throughout our visit with staff enquiring after their relative's health. Care plans showed that people have access to health care professionals who support staff in promoting people's health.
The service needs to improve the opportunities for people to comment and influence the care and service they receive and improve its quality assurance system by providing greater support to its staff and looking at the effectiveness of staff training.