Diversity Social Care Ltd

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• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence. This is the first assessment of this key question for this service. This key question has been rated as good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 67 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them. People and relatives told us they regularly spoke with the registered manager to discuss their needs and care was adapted in response. Care and support was provided to meet people’s outcomes and help them to achieve goals, such as maintaining health and supporting families to have carer breaks. However, records did not always reflect a formal review had taken place. A relative told us, “We haven’t had a formal sit-down review of the care because we don’t need it, I am constantly in touch with [registered manager]” and “[Registered manager] is part of our ‘family’ so with reviews we talk and they are always willing to support all of the family.”

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. However, records did not evidence they did this in line with legislation and current evidence-based good practice and standards. Relatives assured us staff demonstrated they understood best practice. They were able to provide examples of staff following positive behaviour strategies and personalised care approaches to ensure care, treatment and support reflected best practice guidance. Comments included, “The carers are good. If [Name] is aggressive or swears at them, they go away and come back and that works usually. Sometimes [Name] doesn’t want to eat and they will come back later, they are very good” and “[Name] has very complex needs and one of us is always there for any procedures. We were taught how to do (delegated healthcare tasks) by a trained nurse, now the carers are trained and signed off by the doctor. [Registered manager] is trained too. In the beginning the carers couldn’t tube feed but (health authority) have trained 2 of the regular carers and so at least one carer on every visit knows the procedure which is what we need.” The registered manager told us they would ensure records clearly reflected this practice.

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services. The registered manager and staff demonstrated they knew people well, including their life history and experiences, what and who was important to them and their ambitions and goals. They helped people to tell their story and have their needs met consistently and safely. Staff shared relevant information and worked with families and external health and social care professionals to ensure people’s needs were understood and their wishes heard. This helped to ensure people had the right support in a timely way.

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support. Staff worked with people and health professionals to understand what people needed to stay healthy. For example, staff worked with a person’s family and delegated healthcare staff to undertake essential tasks that helped the person to avoid a crisis in their health and reduce the risk of unplanned medical intervention. Staff supported people to access routine and specialist external health and social care professionals when they needed them. A person told us, “My carer is very good, they come to hospital appointments with me.” Staff supported people to have sufficient amounts to eat and drink if this was required, though we received mixed feedback around staff competence. Whilst a person was happy with their support, a relative told us, “I prepare the food, and the carers will give it to [Name]. They don’t know how to prepare food so if I am out, I have to leave full instructions for them.”

The provider monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves. Staff worked to achieve reductions in crisis situations and the use of restrictive interventions with improved outcomes for people. A relative told us, “We have one carer and having them has changed my life (as a family carer) and reduced [Name’s] anxiety. They have spent time really getting to know [Name] and worked really hard to understand and connect with [Name]. They are amazing.” The relative described how this approach had resulted in a significant reduction in the person’s distress and overall improvement in their well being.

The provider told people about their rights around consent and respected their rights when delivering care and treatment. If people lacked capacity to make a specific decision, a mental capacity assessment and best interest decisions had not always been completed. For example, a person’s friend had signed consent to care on their behalf but this was not supported by any legal authorisation or best interest process. We raised this with the registered manager during our inspection. Staff had received training in the MCA and understood the importance of obtaining consent and supporting people to make choices and decisions. A staff member told us, “I always ask for consent prior to undertaking any tasks.”