Archived: Diamond House

Diamond House is registered to provide care and support for up to 74 older people. Diamond House increased its capacity from 44 to 74 people in January 2020. The additional accommodation is provided in a purpose-built extension. All the accommodation is provided over two floors, with each floor providing a number of communal rooms and bedrooms. At the time of the inspection there were 44 people using the service, a majority of people were living with dementia.

People’s experience of using this service and what we found

A family member told us, “This place is brilliant, I’m really pleased with it, the carers here are fantastic.” And a person living at Diamond House told us, “I would recommend this service wholeheartedly.”

People were safe at the service, they trusted and had confidence in staff. Potential risks were assessed and kept under review. People were supported by sufficient numbers of staff who had undergone a robust recruitment process. People had their medicines safely when they needed them. However, improvements were needed to ensure people’s rights were fully upheld and decisions made in their best interests. The premises were safe, well-maintained and clean.

People’s needs were assessed and kept under review. People were supported by staff who had the necessary skills and knowledge. Staff received ongoing support through training and supervision, to enable them to provide good quality care. Staff promoted people’s health, and people accessed health care services when needed. People’s dietary needs were met, with menus detailing the daily choices available.

People were supported to have maximum choice and control of their lives, and staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice. However, best interest meetings and their outcomes needed to be consistently implemented.

People, and in some instance’s family members were involved in the development and review of care plans. People and family members spoke highly of the care and support provided by staff, and the friendly atmosphere of the service. Family members felt welcomed by staff. People assured us their privacy and dignity was respected, and that they were encouraged to maintain their independence.

People had the opportunity to engage in activities within the service, which included pantomimes, and dramas performed by professional entertainers. Children from the local area visited the service, spending time with people and joining in activities. Concerns were actioned; however these were not recorded. People and family members told us there had no concerns or complaints about the quality of care.

People, family members and staff spoke favourably about the management of the service, stating the management team were approachable and always available to answer any queries. A system to audit the quality of the care and service provided was implemented. Management meetings were held, however the topics discussed were not recorded. An action plan was not in place to evidence how the registered manager planned to drive improvement.

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

Rating at last inspection

The last rating for this service was outstanding (published 14 August 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.

Diamond House is registered to provide care and support for up to 44 older people a majority of whom are living with dementia. It is situated within a residential area of Leicester. Accommodation is provided on the ground floor and first floor. There is a range of communal areas including lounges, dining rooms, and secluded gardens. At the time of this inspection there were 40 people using the service.

The overall rating of good, which was awarded following the CQC's previous inspection of 11 March 2015, was displayed throughout the service. The service has retained its rating of ‘outstanding’ for the key question, ‘is the service caring?’ At this inspection we found the service was now to be 'Outstanding'.

Diamond House 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 requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People told us they felt safe in the service and that staff were trained in safeguarding (protecting people who use care services from abuse) and knew what to do if they were concerned about the welfare of any of the people who used the service. Where people were at risk, staff had the information they needed to help keep them safe. During the inspection visit we observed staff had the time they needed to support people safely. If people needed assistance this was provided promptly and staff were always present in communal areas to observe people and keep them safe.

Medicine was safely managed in the service and staff provided people with assistance where it was needed to take their medicine. However we found improvements would further promote its safe and consistent use; through the provision of written guidance for staff as to the circumstance and use of medicine to be taken as and when required. The registered manager took action to address to make changes at the time of the inspection visit.

Staff were regularly supervised and had their competence to perform aspects of their role assessed. Staff had undertaken training to meet people’s needs and supported people with confidence and skill. Staff were observed putting their training in practice to ensure people’s needs were met and that people received the reassurance they needed. Staff spoke positively about their training and spoke of the support provided by the registered manager in accessing training and the help and encouragement they received to attain qualifications in care.

People were encouraged to make decisions about their day to day lives. People’s care plans provided information for staff as to what support people required, so that people’s independence was recognised and not undermined by staff. We observed staff supporting people consistent with their care plan.

People we spoke with were very complimentary about the meals provided at the service. Mealtimes were a social affair and meals were enjoyed in a calm and relaxed environment. Where people were at risk of poor nutrition, advice from health care professionals was sought and their recommendations followed.

People we spoke with and their visiting relatives told us they had good access to healthcare. Records showed people were referred to the appropriate health care professionals when necessary and that their advice was acted upon. This meant people were supported to maintain good health.

The environment was decorated and adapted to meet the needs of people living with dementia. The environment was interactive and enabled and encouraged people to take part in activities and perform tasks which provided them with reassurance and a sense of purpose. The garden was accessible and provided areas of stimulation and interest and was used by people to relax and take part in activities.

People’s needs were assessed prior to them moving into the service. The registered manager met with people to ensure their needs could be met by the service and spoke with them about the care they needed. People who used the service, visiting relatives and staff spoke to us about the care and support within the service and how this was personalised and reflective of people’s individual needs and choices.

People were supported by very kind, caring and compassionate staff who went the extra mile to provide people with excellent, high quality care. The whole staff team were extremely passionate about providing people with support based on their individual needs and wishes. There was a strong culture within the service of treating people with dignity and respect. People and the staff knew each other well and these relationships were valued. The staff, registered manager and deputy manager were always visible and listened to people and their relatives and friends, offered them choice and made them feel that they mattered.

There were open and positive relationships between people who use the service, their relatives who visited and staff. This created a friendly, calm and welcoming environment for people to live in and visit. People were supported by staff who sought to provide companionship and social interaction in a caring manner. Where people became distressed or anxious staff offered reassurance.

Staff actively encouraged people to be involved and feel included in their environment. People were offered a variety of activities and participated in an array of social events of their choice. The staff team were fully committed to ensuring that activities were offered to meet the needs and interests of each individual living at Diamond House. Activities and social events were praised by people and their families.

Records showed people were involved in how the service was run and action was taken in response to people, comments and experiences to improve the quality of care provided. Regular meetings were held for those using the service, relatives and staff. People using the service were invited to attend staff meetings and take part in staff training to further promote an inclusive environment.

We found there was a strong emphasis on continually striving to improve, recognise, promote and implement innovative systems in order to provide a high quality service. The registered manager and staff had a clear view as to the service they wished to provide which focused on promoting people’s rights and choices, and the enabling of people to have positive life experiences. People using the service, their relatives and staff were complimentary about the support provided by the service and its management.

The provider had an effective quality assurance system in place, which included consultation with people using the service and their relatives along with audits on a range of topics to ensure the service delivered high quality care. The area manager appointed by the provider regularly visited Diamond House to complete audits that focused on all aspects of the service.

Staff and the service had received external accolades in recognition of the quality of care provided.

We spent time with people and observed the interactions between people using the service and staff. People were observed to make choices as to where they spent their time. Some sitting in the garden, whilst others sat in a lounge or stayed in their bedroom. People in some instances watched the television, whilst others read a newspaper. People in the morning had the opportunity to visit the domiciliary hairdresser and in the afternoon some people took part in an art therapy session. We spent time with people at the lunchtime meal and saw people chose where to sit with many people conversing with each other during the meal. People were happy with the meals provided. People's comments included: 'The meals are lovely, I don't like everything but there's always something I like.' Through discussions with the chef and the viewing of records we found people's meals were made from fresh produce and met dietary needs and expectations.

We viewed a range of records which included people's care plans, medication records, staff recruitment records and maintenance records for the service and we found them to be in good order.

People told us they were satisfied with the care and support they received and that the staff were helpful and kind. People told us they had been involved in the development and reviewing of their care plan. People we spoke with praised the food provided by the chef's and told us that nothing was too much trouble as they catered for individual requests.

People's comments included: - 'I'm quite content here.' 'I'm quite satisfied, the staff are quite alright.' 'Oh I love it and they're all so nice.' 'I couldn't be more pleased, all a good 'shower' and you can have a laugh and joke, they'll do anything for you.' And 'I'd gone off my food before I moved into Diamond House, but all credit to the staff they've persevered and now I enjoy eating again.'

Visitors were seen visiting relatives throughout the day. We had the opportunity to speak with relatives of one person. They told us they were happy with the care and support provided to their relative and they were kept informed as to their relative's health and wellbeing. People using the service told us that if they had any concerns they would speak with the manager or a member of staff or in some instances their relatives.