Archived: Diabetes Training and Management Services Ltd

Updated 29 November 2021

Diabetes Training and Management Services provides community diabetes services for people diagnosed with type 2 Diabetes and some with type 1 diabetes. The service is provided by a single diabetes nurse specialist to diabetic patients living in the London Borough of Lewisham. The service is delivered from GP surgeries in Lewisham.

Diabetes Training and Management Services is registered to provide the following regulated activity: Treatment of disease, disorder or injury.

The service had a registered manager at the time of the inspection and no other clinical staff employed by the service. The one diabetic nurse specialist is the registered manager.

We carried out a comprehensive inspection. This was the first inspection of Diabetes Training and Management Services Ltd, which was first registered in 2016.

As this inspection took place during the Covid-19 pandemic we adapted our approach to minimise the risk of transmission to patients, staff and our inspection team. This meant that we limited the amount of time we spent in the service to prevent cross infection. Whilst on site we wore the appropriate personal protective equipment and followed local infection control procedures. We carried out patient interviews over the telephone and a staff interview via video and analysis of evidence and documents. Our final video call interview was completed on 16 July 2021.

What people who use the service say

We spoke to three patients, who stated that the registered manager was patient when addressing their concerns around diabetes, they felt listened to and supported to make decisions about the choice of treatment available to them.

Updated 29 November 2021

We rated this service as requires improvement because:

• The registered service was delivered by one clinician who was also the registered manager. The manager did not have evidence of ongoing learning and development to ensure their practice was up to date. They did not receive clinical supervision. Some mandatory training was out of date.
• There was no record that the registered manager had checked the manufacturer’s instructions about the calibration of the blood glucose monitoring machines. This meant there was the potential risk of inaccurate blood sugar readings for patients.
• The assessments of patients were not holistic and did not consider aspects such as their mental health or other social challenges they might be facing.
• The infection control policy for the service had been updated on 28 May 2021, but it did not include COVID-19 management. However, the practice of the clinician was appropriate in terms of COVID-19 management.
• The registered manager had not kept their website up to date. This meant patients could not access links to guidance on how to manage their diabetes, information in a range of accessible formats and a complaints process.
• The service did not have systems in place to monitor the patients receiving clinical support and their outcomes to ensure the clinical input was improving the effectiveness of the treatment for people with diabetes. In addition, the service did not always follow up patients who did not attend their appointment. The registered manager did not use the results of audits carried out by commissioners to improve the service.
• The registered manager had not considered or recorded all the potential risks for the service and how these could be mitigated.
• The service did not record consent when patients were seen at appointments.
• The service did not record that they took account of people’s needs. They did not record patients’ personal, cultural, social and religious needs and how they may have related to care needs.

However:

• The registered manager planned and provided care in a way that meant patients were seen in a timely manner especially if there was any deterioration in their diabetes.
• The registered manager treated patients with compassion and kindness; respected their privacy and dignity and helped them understand their conditions. They provided emotional support to patients, families and carers so they could manage the diabetes better.
• The registered manager worked well with other care professionals including patients’ GPs. When needed they referred the patient on to other care professionals such as the dietitian.
• The registered manager understood how to protect patients from abuse and the service worked well with other agencies to do so.

Updated 29 November 2021

Diabetes Training and Management Services provides community diabetes services for people diagnosed with type 2 Diabetes and some with type 1 diabetes. The service is provided by a single diabetes nurse specialist to diabetic patients living in the London Borough of Lewisham. The service is delivered from GP surgeries in Lewisham.