Diamond House

Updated 26 April 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 12 and 13 December 2017 and was unannounced.

The inspection was carried out by two inspectors on 12 December and by one on the following day. Prior to the inspection, we reviewed all information available to us. This included a Provider Information Return (PIR). A PIR is a form completed by the registered manager to evidence how they are providing care and documents any improvements they plan to make. We also reviewed notifications. Notifications are information about specific events that the provider is required to send us by law.

We spoke with six people who used the service and three relatives. We also carried out a SOFI observation. This is a structured observation that helps us understand the experiences of people who are not able to communicate with us easily. We spoke with seven members of the care staff including one senior staff member, the head of housekeeping, the cook, an agency staff member, the registered manager and the regional manager. We also spoke with a visiting healthcare professional. We reviewed care records for eight people, nine people’s medication records, four staff files and other records relating to the quality and safety of the service

Updated 26 April 2018

The inspection took place on12 and 13 December 2017.

Diamond House provides accommodation; support and care for up to 42 older people, some of are living with dementia. People in care homes receive accommodation and personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Although the service is registered to provide nursing care, this is not provided as the service is not staffed to provide nursing care. At the time of our inspection 35 people were using the service and one was in hospital.

There was a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People who used the service and relatives were happy with the care provided and many praised the skills and kindness of the staff.

People received safe care but at times staffing was stretched which meant people living with dementia were left without staff supervision. The shortage of activities staff meant that some people were not meaningfully occupied during the day which had an impact on their quality of life. The manager had strategies in place to try and address the staffing concerns.

Medicines were mostly well managed and people received their prescribed medicines on time. Some stocktaking errors meant we could not be fully assured that all medicines were being given as prescribed. The provider had already identified this as an issue and was taking action to address the issue.

The manager assessed and managed risks well. People were supported to be as independent as possible and any associated risks were incorporated into their care plan.

Staff understood their responsibilities with regard to keeping people safe from the risk of abuse. Staff were confident and knew how to raise concerns. Individual safeguarding incidents were well managed and the provider was open and transparent when carrying out safeguarding investigations.

Infection control procedures were in place and staff demonstrated a good knowledge of how to reduce the risk and spread of infection.

Staff were well trained and supported in their roles. Sone staff had received specific training related to eating and drinking and this was managed very well.

People had good and prompt access to healthcare and staff worked well with other healthcare professionals to meet people’s healthcare needs.

The service worked in line with the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). The MCA ensures that people’s capacity to consent to care and treatment is assessed. If people do not have the capacity to consent for themselves the appropriate professionals, relatives or legal representatives should be involved to ensure that decisions are taken in people’s best interests according to a structured process. DoLS ensure that people are not unlawfully deprived of their liberty and where restrictions are required to protect people and keep them safe, this is done in line with legislation.

Staff were kind and caring and demonstrated that they had built up good relationships with the people they were supporting and caring for. People were supported to be as involved in decisions about their care as they wished to be.

People who used the service had the opportunity to follow a variety of hobbies and interests, although it was hoped that this would improve further when new activity staff were recruited.

New care plans were person centred and reflected people’s individual need and preferences. People confirmed that their wishes with regard to their care, were respected.

Care for people at the end of their life was good. There was a commitment to ensuring people had a dignified and pain free death and were not left alone, unless this was their wish.

The service was well-led by the newly appointed registered manager. There was a clear vision for the service and a structured approach to driving improvement. Staff, including the manager, were well supported and there were effective quality assurance systems in place. We had confidence in the manager to continue delivering the good practice we found and to address the concerns, which they themselves had already identified.