Diversity Health and Social Care Limited

On this page

• 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

People were supported by regular staff who were safely recruited and who had the relevant training and qualifications to support them safely. There were sufficient staff to meet people's needs and ensure no care calls were missed. Staff understood how to protect and safeguard people. Care plans were clear and provided guidance for staff to keep people safe. Risk assessments had been carried out to identify the risks people faced. These included information about how to mitigate those risks.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People and their relatives told us they would speak with staff if they had any concerns. One person told us, “I can speak to the office when I want to, but I don’t really need to because it’s all alright." People and their relatives knew who the managers were and told us they were approachable if they needed to speak with them. One relative told us, "They carry out everything that [person] requires. They report to me anything out of the ordinary if [person] isn’t feeling well. We are both pleased by the actions taken by the carers.” Another relative said, “I am happy to contact the office if I need to. For example, the carer has said she will do a Saturday and we have had to call the office and will sometimes to a Saturday if we need it.”

Staff we spoke with told us they felt confident about reporting any concerns or poor practice to their managers. One staff member told us, “Any issues we have we can raise this to our office, and they will try and resolve this as soon as possible.” The registered manager gave an example of an incident where lessons were learnt.

There was a system in place to learn from lessons following incidents. The provider had systems to ensure lessons were learnt from any incidents. Where incidents and accidents occurred, they were recorded with appropriate actions taken to reduce the risk of re-occurrence. Incident and accident records showed issues were recorded, investigated and addressed quickly. There was evidence of actions taken to mitigate future risks. For example, in relation to a missed visit, when a staff member could not get through to the office, the staff member moved onto their next scheduled visit whilst they kept trying to contact the office. Although, the staff member eventually spoke to the office, they had not followed the correct procedure as they should have stayed at the person’s property until contact with the office was successful. This caused a delay in getting help to the person who had actually fallen and was unable to reach the door to let the carer in when they had arrived for the visit. Appropriate action was taken with the carer including them being issued with a warning. The registered manager said, “We always use scenarios like this to learn from incidents and this was discussed in the staff meeting. Staff learn what to do during the induction when they get no response to a visit and for missed or failed visits.”

We received positive views about the quality of care provided and the involvement of other healthcare agencies. Some people shared details of all the different healthcare professionals involved in their care. One relative said, “They let me know and they let the office know. The office got through to the doctor faster than I could.” Another relative said, “The regular carer picked up the beginnings of a pressure sore and the agency contacted the District Nurse who came out.”

Positive relationships had been made with other healthcare agencies involved with people's care. One staff member said, “We make referrals to local authority, district nurse and speech and language therapists (SALT), so people are being cared for.” The provider gave us examples of their process on of people being referred by the local authority.

We received feedback from partners. The local authority shared about the quality of care and safety of people using the service and has no concerns with Diversity Health and Social Care Ltd.

Processes were in place to enable a smooth transition between services and to reduce the impact on people. The quality of some people's care records and had sufficient detail to enable effective information sharing.

People were protected from the risk of abuse. People and their relatives told us they felt safe whilst being supported by staff. One relative said, "Yes, they will make sure [person] is safe. If they are not comfortable, they will report it to the office and they will get in touch with me if something is dangerous.” Another relative said, “[Person} is very safe especially with her main carer. I was sure [person] was safe and went on holiday.” People told us staff sought their consent prior to providing any care and support and respected their choices and decisions about this. One relative told us, “The regular carer talks to [person] all the time, she is very good at trying to persuade her and does her very best but if [person] says ‘no’ she will never force her.”

Staff demonstrated knowledge of the safeguarding processes in place to keep people safe. One staff member told us, "We completed local authority training recently and completed refresher training. We were taught how to protect our clients, respect them and be conscious of their safety. For example, if we spot bruises on a client how this should be dealt. Client should be priority, if we noticed carers doing something wrong, we should speak up to ensure client is safe and not cover up is something is happening." The registered manager told us they had not had any safeguarding incidents. They told us what they would do should there be a safeguarding concern and said, “Immediately we receive it we report it to CQC and the safeguarding team. We investigate. We take statements from the [person using the service] and the carer. We go through the records and the care notes. We look at the support plan to make sure the carer is working with the needs. We write a report and see if any action is needed with the carer. We always remove the carer from the package while investigating but depending on the severity we may suspend the carer.” The registered manager told us they encouraged staff to blow the whistle if they suspected abuse. They said, “There’s a whistleblowing number we have, and they can call CQC.”

The provider had safeguarding policies and procedures in place. These advised staff on what to do if they had concerns about the welfare of any of the people, they were providing care and support to. The provider also had a whistleblowing policy in place, and this gave guidance to staff on how they could raise concerns about any unsafe practice. A whistle blower is a person who exposes any kind of information or activity that is deemed illegal, unethical, or not correct within an organisation. Where safeguarding incidents had occurred, the manager had submitted the required CQC notification and safeguarding alerts without any delay and had worked in tandem with the health professionals to resolve any concerns they had.

People and their relatives were involved in the delivery of care and support being offered. This included the management of potential risks. A relative told us, "I have been included in the care of my [person], I always get reports from staff about [person]. [Person] seems fine."

Sufficient risk assessments were in place to ensure people received safe care. Staff were aware of potential risks to people and ensured they were safe when carrying out any tasks. One staff said, “Yes, all client’s risk assessments are online and, on the phone, when we log in. Yes, would say they are thorough and have enough time to look through to get the information that we need.” Another staff member said, “Risk assessments are available. There is information about a person risks, if they require wheelchair, slings or hoist, their medicine and information about themselves.” The registered manager told us how they were assured staff were following people’s risk assessments. They said, “We go through the spot check, the notes and go through it in [staff] one to one sessions. From the complaints we are able to see if they have been following the risk assessment. We always tell [staff] to tell us of any changes.”

Sufficient risk assessments were in place to ensure people received safe care. Risk assessments gave staff clear guidance on how to support people safely. For example, people who were at risk due to their physical health or their medical conditions, they had a risk assessment in place. Risk assessments were reviewed regularly to ensure they were accurate. The service had sought input from external healthcare professionals and where appropriate, advice on actions for staff to take, to mitigate risks and safely support people and reduce the risk of harm. Assessments provided clear instructions for staff to help minimise or eliminate the potential risk of harm or injury to people's health. The registered manager also had an environmental risk assessment in place which identified potential risks and how to minimise them. This helped to ensure people received care and support within a safe environment.

We did not look at Safe environments during this assessment. The score for this quality statement is based on the previous rating for Safe.

People and their relatives were complimentary of the staff who cared for them. Staff were punctual and attended their scheduled care calls on time. A relative said, “[Person] has regular carers and it’s made my life so much easier. [Person] is safe with them and the look after her very well.” Another relative said, “[Person] has mostly regular carers. One in the week and someone else on Saturday and Sunday. All I can hear is them laughing together and talking football.” Relative told us staff understood their needs and had the ability to carry out their job. One relative said, “The carer understands [person] and will even give us advice and tips on helping her for example with sleeping. They have regular training updates, and the regular carer will tell us about pressure sores for example.”

There were enough staff to meet the needs of people using the service. Staff rotas had been planned to ensure people were supported by a regular team of staff so that the care and support they received was consistent. Staff confirmed there are enough staff to support people. Staff undertook training to support them in their role. Staff told us they had a lot of training, including on mental capacity, safeguarding adults, medicines and moving and handling. Records confirmed this. One staff member said, “Yes received training and covered lots of different things. Staff at Diversity very helpful and supportive.” Another staff member said, “We have annual training and refresher training and is all up to date. We also have regular meetings with line manager and any concerns can be discussed.” We asked the registered manager and the deputy manager about training. They told us staff received training in the care certificate and this and refresher training was delivered face to face. They told us and records confirmed all staff completed training in autism, learning disability and challenging behaviour as well as the 2 day training in caring for children. The deputy manager confirmed that all staff received the above training regardless of whether they were allocated to work with anybody in these categories. The deputy manager told us staff received training in PEG feeding and a nurse had delivered hands on training in the child’s home to staff for specialist children’s moving and handling equipment.

Staff were recruited safely. The required pre-employment checks were completed to help ensure staff employed were suitable. These included conducting an interview, completing a Disclosure and Barring Service (DBS) check and obtaining references. The DBS helps to prevent unsuitable staff from working with vulnerable people. Records showed that staff had received training in a number of key areas relevant to their roles. The service had an induction programme for all new staff. The induction covered a number of areas, which included staff roles and responsibilities and key policies and procedures. Staff would shadow an experienced member of staff until they were confident to work on their own. Staff received regular one to one supervision with the registered manager. They told us that they found those meetings very helpful. This helped the registered manager to continually monitor and review staff performance and attitude towards people using the service. Systems were in place to minimise risks of late or missed calls. The service used an online call monitoring system to monitor staff timekeeping and attendance. Staff logged in and out of visits electronically and the system alerted the office if staff did not log calls. This showed they had attended and left the care visit at the allocated time.

Most people and relatives told us staff wore appropriate PPE including gloves, aprons, and masks when needed. A few people said staff arrived at their home wearing PPE.

The registered manager was able to describe and demonstrate that staff had easy access to PPE.

Staff had completed infection control training and had access to personal protective equipment (PPE), such as aprons, masks and gloves to help reduce cross infection risks. Staff were also familiar with the providers policy on infection prevention and control and the field co-ordinator carried out relevant audits related to this. Spot checks carried out by the leadership team ensured compliance and competency.

Relatives had no concerns with medicines. One relative told us, “It’s in a locked box and I won’t even keep the key, only the carers have the key, and they sort out everything and it’s all fine.” Another relative said, “They do the medication and there haven’t been any issues at all.”

Staff told us they had received medicines training and understood the importance of recording this correctly where they assisted people to take medicines. Any changes in medicines were communicated to office staff to ensure this was actioned. This was recorded in people’s care plans. One staff member said, “If clients living alone, we administer their medicines. Training includes ensuring blister pack, type of medication, read notes, check details. Care coordinator carried out spot check to make sure we do our job properly.”

The provider ensured medicine records were audited regularly and any errors were identified. The provider ensured staff received training and competency checks to ensure they were assessed as competent in medicines administration.