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Diversity Health and Social Care Limited Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 2 November 2018

We carried out an announced inspection of Diversity Health and Social Care Limited on 24 and 25 September 2018. Diversity Health and Social Care Limited is registered to provide personal care to people in their own homes. The CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do, we also take into account any wider social care provided. At the time of our inspection, the service provided personal care to 241 people in their homes. At our last inspection on 16 February 2016, we rated the service ‘Good’. At this inspection, we found concerns with risk assessments, pre-employment checks, care plans, training and quality assurance systems therefore the service has been rated ‘Requires Improvement’.

The service had a 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 legal requirements in the Health and Social Care Act 2008 and the associated regulations on how the service is run.

Risks to people were not always robustly managed. We found some care plans did not contain suitable and sufficient risk assessments to effectively manage risks. This placed people at risk of not being supported in a safe way at all times.

Pre-employment checks had not been carried out in full to ensure staff were suitable to provide care and support to people safely. We found the provider did not follow their recruitment policy in some instances, which detailed that two references should be requested before employing staff.

Staff had not received mandatory and specialist training required to perform their roles effectively in accordance to people’s support needs and circumstances. Some staff had not received Mental Capacity Act 2005 (MCA) training therefore some staff we spoke to were unable to tell us what this was. Consent had been sought from people when supporting them with care and support.

People’s ability to communicate were recorded in their care plans. However, there was no information on how staff should communicate with people particularly how staff would make information accessible to people.

Effective quality assurance systems were not in place. Systems were not in place to carry out robust audits on staff training, care plans such as risk assessments and medicine management.

Accurate and complete records had not been kept to ensure people received high quality care and support.

Staff told us they had time to provide person centred care and the service had enough staff to support people. However, we noted where there was a risk staff may be late, this was not being pursued by office staff to minimise risk of late calls or missed visits. We made a recommendation in this area.

Staff, relatives and people were positive about the management team. People’s feedback was sought from surveys. However, this had not been analysed in full to identify best practise and areas of improvement ensuring a culture of continuous improvement. We made a recommendation in this area.

People received their medicines on time. Staff had been trained to manage medicines safely.

Staff were aware of how to identify abuse and knew who to report abuse to, both within the organisation and externally.

Pre-assessment forms had been completed in full to assess people’s needs and their background before they started using the service. Reviews were held regularly to identify people’s current preferences and support needs.

People were being cared for by staff who felt supported by the management team.

People had access to healthcare services if needed.

People’s privacy and dignity were respected by staff. People and relatives told us that staff were caring and they had a good relationship with them.

Complaints received had been investigated and relevant action had been taken. Staff were aware of how to manage complaints. However, the surveys were not being analysed to ascertain what the service was doing well in and what area’s required improvement. We made a recommendation in this area.

Spot checks of staff supporting people had been carried out to observe staff performance.

We identified four breaches of Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 relating to risk management, training, staff recruitment and good governance. You can see what action we have asked the provider to take at the back of the full version of this report.

Inspection areas

Safe

Requires improvement

Updated 2 November 2018

The service was not always safe.

Some risk assessments had not been completed for people with identified risks.

There were appropriate staffing arrangements to ensure staff attended care visits. However, staff call logs were not being monitored effectively to ensure missed visits were minimised.

Pre-employment checks were not always sufficient. Two references had not been requested in accordance with the providers recruitment policy.

Medicines were managed safely.

Staff were aware of safeguarding procedures and knew how to identify and report abuse.

Appropriate infection control arrangements were in place.

Effective

Requires improvement

Updated 2 November 2018

The service was not always effective.

Staff had not received essential training needed to care for people effectively.

Some staff were not aware of the MCA principles and had not received training on it. Consent had been sought from people to provide support to them.

People’s needs and choices were being assessed effectively to achieve effective outcomes.

Staff were supported to carry out their roles.

People had access to healthcare services when required.

Caring

Good

Updated 2 November 2018

The service was caring.

Staff had positive relationships with people and were caring.

People and their relatives were involved in decision making on the support people received.

People’s privacy and dignity was respected.

Responsive

Requires improvement

Updated 2 November 2018

The service was not always responsive.

Some care plans were inconsistent as they did not detail the person-centred support people would require in full.

People’s ability to communicate was recorded. However, information did not include how staff should communicate with people effectively.

Staff had a good understanding of people’s needs and preferences.

Staff knew how to manage complaints. People and relatives had access to complaint forms should they need to make a complaint.

Well-led

Requires improvement

Updated 2 November 2018

The service was not always well-led.

The quality systems in place had not identified the shortfalls we found during the inspection.

Accurate records had not been kept to ensure people received high quality care at all times.

People’s feedback about the service was obtained from surveys. However, this was not analysed in full to ensure there was culture of continuous improvements.

Staff, people and relatives were positive about the service.