Diversity Social Care Ltd

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• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm.

At our last assessment we rated this key question good. At this assessment the rating has changed to requires improvement. This meant some aspects of the service were not always safe and there was limited assurance about safety. There was an increased risk that people could be harmed.

This service scored 62 (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 demonstrated a commitment to learning and improvement but improvements were not always sustained. They gave examples of learning from previous events. For example, following an incident where a person had sustained an injury whilst staff transferred them, the registered manager had re-trained all staff and reviewed risk assessments to mitigate the risk of further incidents. A relative told us, “The registered manager responded quickly, removing staff and re-training a newstaff team. The transition was managed well and the staff know what they are doing.” The registered manager had made improvements to staff recruitment files to evidence staff were safely recruited. However, concerns around care plans and risk assessments identified at previous inspections had not been resolved. This meant lessons had not been fully learnt to ensure improvements were embedded and sustained in all working practices. People and relatives felt the registered manager and staff were keen to put things right. A person told us, “I am very safe; I know my carer well and they know me very well.”

The provider worked well with people and healthcare partners to establish and maintain safe systems of care. However, care plans were not always up to date or accurate and therefore would not support a safe transition. People and relatives were not aware of a care plan with Diversity and relied on care plans which other agencies had completed as part of their assessment for a service or care plans they had developed independently. Comments included, “We have a care plan from Adult Care Social Services. We had a review recently with ASC but we haven’t had a review from Diversity as far as I can remember, and I don’t remember signing off a care plan with them” and “I do the care plan, and every carer is given it to read. This is something I have done.” Although people and relatives could not recall their care plan with Diversity, they told us they were constantly in touch with the registered manager and regular staff so any requests and changes were made quickly and care was consistent and safe.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately. There was a safeguarding policy in place which had been followed and staff received training. Staff were knowledgeable about the types of abuse and knew who to report any concerns to. One staff member said, “I understand my role in safeguarding people and protecting them from harm. If I had any concerns, I am confident to go to my manager or the registered manager.” A relative told us, “I am happy with the care staff are providing and I think [Name] are safe and comfortable. I am so confident in their care I can go away when I need to.” Staff supported people safely where they experienced distress and followed least restrictive approaches. A relative told us, “Our carer is amazing; [Name]is very safe with them. They have learnt to recognise the signs of anything brewing and will distract and/or give [Name] space. [Name] doesn’t have any behavioural flare ups when they are with [staff member].”

The provider worked well with people to understand and manage risks. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them. However, the records of risks were not always completed or up to date. For example, people’s care plans did not include positive behaviour support strategies to evidence risks had been assessed and interventions were consistently applied. Staff were undertaking delegated healthcare tasks including invasive procedures, for example support with bowel care. Although relatives and training records confirmed they had completed training and followed safe processes, there was no information on peoples’ risk assessments around approved protocols to follow or to indicate how staff should mitigate potential risks of infection. Staff records did not include competency checks to demonstrate they remained competent to manage these risks. Please see the Well-led section of this report for our response to these concerns.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. People’s care plans included information for staff regarding potential environmental risks, such as location of emergency utilities and any known risks, including pets and access to people’s homes.

The provider made sure there were enough qualified, skilled and experienced staff, who received regular supervision and development. People and relatives told us they received care from a regular team of staff who usually turned up on time and stayed for the duration of the call. Staff worked together well to provide safe care that met people’s individual needs. One person said, “The same carer comes every day and it works very well for me.” A relative told us, “I think the training must be excellent because the carers skills are so good and they know exactly what they are doing. They are also doing specialist training to support [Name’s] complex needs. Training records showed staff undertook regular training to keep their knowledge up to date. This included training around supporting people with a learning disability, autistic people and people with complex health needs.The provider had made improvements to the processes for recruitment of staff to ensure staff were safe and suitable to work in the service. The provider had clear records to evidence the safe recruitment of staff including the use of the Disclosure and Barring System (DBS).

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly. Staff had undertaken infection prevention and control training and were provided with personal protective equipment (PPE).

The provider had systems and processes in place so that staff followed safe administration processes for peoples’ medicines. People and relatives were generally happy with the support they received to take their medicines. A person told us, “My carer and I do the medication together. I have some in a blister pack and some separate, so we put the separate ones in an organiser and then it is all sorted. We organise everything together.” A relative felt there should be more robust recording where staff occasionally administered medicines that were primarily managed by another agency. We raised this with the registered manager who told us they would address this following our inspection. The registered manager regularly audited medicine records and daily care records to ensure people had received their medicines as prescribed.