Diamond Gate Care Services Limited

On this page

• 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 for this service. The rating for this key question is requires improvement. This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

We identified breaches of 2 legal regulations relating to consent and safe care and treatment.

This service scored 58 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People’s needs were assessed before they joined the service to ensure their needs could be met. Assessments were carried out to determine if the service was right for people, could support them and meet their needs. Assessments were used to inform people’s care plans.

We saw 1 person had a ‘hospital passport’ in their care file, this had important information for other health professionals to refer to should the person be admitted to hospital. It contained easy read information about the person, their health needs and their preferences.

Records showed that staff had received training in areas such as safeguarding, infection control, medicines, learning disability, autism, first aid, food hygiene, epilepsy and moving and handling. However, we saw minutes from a meeting in April 2025 that recorded ‘all staff will be enrolled on the ‘Prevention Management Violence Aggression (PMVA) training to enable staff better manage service user with challenging behaviour’. However, records have shown that out of 3 staff members, only 1 had undertaken this training. The provider told us that all staff will undertake this training imminently.

The provider involved people and their relatives in planning and delivering their care and treatment, the level of support they needed, including what was important and mattered to them. For example, what was important to them and their desired goals and aspirations This promoted people’s independence and facilitated working with them to achieve their goals.

Staff teams worked well together. Regular care staff meetings were held. This meant staff had the opportunity to discuss the running of the service and people's individual support needs. Staff received formal supervision to monitor and review staff performance. Staff knew details of people’s GP’s and mental health teams should they be needed.

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. People were supported to access healthcare professionals when needed. Staff told us that they would call other services such as a GP, mental health team or paramedics if they felt people needed support from these services.

Staff supported people with their medicines and meals, encouraging them to have a healthy and varied diet.

The provider did not routinely monitor people’s care and treatment to continuously improve it. They did not always ensure that outcomes were positive and consistent, or that they met health care expectations. This was because people’s care needs were not consistently monitored, for example, Positive Behaviour Support (PBS) plans were not in place,

ABC observational charts were not always effectively used to understand monitor and identify repeat behaviours, themes, trends or factors that could trigger or reinforce acute behavioural incidents. This meant the provider could not be assured that people were monitored and supported safely in line with their care requirements.

The provider was not working within the principles of the Mental Capacity Act 2005 (MCA). The manager and staff did not have a clear understanding of the MCA and when it should be applied. The MCA provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The Act requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible.

People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the MCA. When people receive care and treatment in their own homes an application must be made to the Court of Protection for them to authorise people to be deprived of their liberty.

Assessments of people's capacity to make specific decisions, for example in relation to their finances and medicines, had not always been completed. Records showed that ‘consent to care’ forms had been signed by people, although they did not have the mental capacity to make complex decisions. For example, 1 person had signed a ‘Medicines’ consent form, but the provider could not be assured that they fully understood the information in the form.

The principles of MCA had not been followed to establish if there was a need to consider applications to the Court of Protection to authorise any deprivation of liberty for people's own safety.

The provider told us they had not assessed anyone’s capacity prior to delivering care to people as they had left it to social workers involved in people’s care to carry out the MCA and consider applications to the Court of Protection.

Staff we spoke to were not clear if the person they supported had the capacity to make complex decisions. One staff member said, “Yes, [person] has capacity, but no capacity assessment carried out. But [person] has difficulty managing money.” Another staff member said, “[Person] has capacity to make small decisions not complex ones.” A third staff member said, “For now [person] does not have capacity, but does need an assessment.”

We saw records of a ‘Best Interest’ meeting which was attended by relatives, healthcare professionals and others involved in the person's care. Staff understood their responsibility to seek consent from people before offering them support.