Diversity Social Care Ltd

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

Well-led – this means we looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture. At our last inspection we rated this key question requires improvement. At this inspection, the rating has remained requires improvement. This meant the management and leadership was inconsistent. Leaders and the culture they created did not always support the delivery of high-quality, person-centred care.

The service was in breach of legal regulation in relation to the management oversight of the service and the failure to ensure records were up to date and relevant to the support people were receiving.

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 had a shared vision, strategy and culture that was based on providing personalised care with people and their families. The care and support put each individual person at the centre of their support when decisions about their lives were being made. The registered manager and staff described a commitment to improving people’s lives and outcomes and this was confirmed by people and relatives we spoke with. A staff member told us, “The values of the service are always putting people’s needs first and ensuring I am providing satisfactory care. Being reliable, responsive, empathetic and treating people with dignity and respect. These are the values I work to. “

The provider had inclusive leaders at all levels who understood the context in which they delivered care; they led with integrity, openness and honesty. Further improvements were needed around care planning skills and understanding. However, people and relatives told us the service was well managed. Comments included, “[Registered manager] runs a tight ship. They are open to criticism and wants to know what works” and “I talk to the [registered] manager and to the carers directly. Before we used to have a carers group but now I text individuals. The manager respects all our decisions and works with us.”

The provider fostered a positive culture where people felt they could speak up and their voice would be heard. People and relatives told us they felt staff and the management team listened to their concerns or requests and action was taken promptly. A person told us, “I know the [registered] manager and I can call them with anything; if I need anything they will help me.” A relative said they felt able to speak to their carer or the registered manager if they needed to. Staff told us there was a culture where they were given opportunities to speak up, both formally and informally.

The provider valued diversity in their workforce. They worked towards an inclusive and fair culture by improving equality and equity for people who worked for them. Staff told us they felt treated fairly and felt they would be able to speak with the management team if they had concerns in relation to this. One staff member told us, “I feel valued and supported as a member of staff. I have a good relationship with my teams and colleagues.”

The provider did not always have clear responsibilities, roles, systems of accountability or good governance. They did not always act on the best information about risk, performance and outcomes, or share this securely with others when appropriate. Quality assurance processes were not sufficiently robust to monitor the support people received and the systems in place. No audits of care plans, risk assessments and Mental Capacity Act processes had been completed. This meant the provider did not have a system that was fully effective in monitoring the support people received or the impact this had on their quality of life. Where audits were completed this had led to improvements and minimised risks. For example, daily care notes were regularly audited, and this had led to an improvement in the information and standard of recordings to support consistent care.

Care records did not reflect the support people required. The registered manager was able to describe how people were supported and any changes to their care, but care records had not been updated and were not sufficiently detailed. They told us they were in the process of developing their own digital system and care plans would be reviewed and developed as part of this. However, there was no date of implementation for this, and existing care plans did not include essential information and guidance relating to people’s care. This meant they had failed to ensure accurate records and guidance for staff were maintained.

The provider understood their duty to collaborate and work in partnership, so services worked seamlessly for people. They shared information and learning with families and partners and collaborated for improvement. Staff worked with external agencies and the local community to ensure people could access the services they needed and had equal access to facilities and opportunities in the local community. This included links with education and community facilities.

The provider did not always focus on continuous learning, innovation and improvement across the organisation and local system. The provider did not always encourage creative ways of delivering equality of experience, outcome and quality of life for people. The provider had not developed an action plan to identify, plan and monitor the improvements needed across the service. Whilst improvements could be seen in the support people received and in areas we had previously identified, including staff recruitment, there was no proactive approach to identifying and acting on areas that required improvement. Whilst we observed improvements had been made in some areas and we received positive feedback about people’s care, the lack of planning and monitoring meant should the systems not work effectively risks would not continually be identified.