11 April 2023
During a routine inspection
Diamond House is a residential care home providing the regulated activity accommodation and personal care. The care home accommodates 74 people across two separate buildings, each of which has separate adapted facilities. The service provides support to people with a physical disability and/or people living with dementia. At the time of our inspection, there were 64 people using the service.
People’s experience of using this service and what we found
The systems and processes that assessed and monitored quality and risks had been improved upon but were not sufficiently robust in some areas.
Improvements to the cleanliness and hygiene in some parts of the service was required. Immediate actions were taken to make these improvements.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. However, improvements were required in how MCA assessments and best interest decisions were documented.
Staff deployment in 1 building was not consistently adequate, to meet people’s needs and safety. Immediate action was taken to improve staffing.
Staff training had improved, but gaps were still evident in some areas. Staff were recruited safely and received opportunities to review their work, training, and development needs.
Care documents used to provide staff with detailed guidance of how to meet people’s known risks and individual care needs, were being reviewed and updated. Where completed, guidance was detailed and reflected people’s needs and preferred routines.
Risks associated with fire safety had improved and were being monitored. Staff were aware of their responsibilities to protect people from abuse and avoidable harm.
People were positive about the choice and quality of food and drinks. People’s individual dietary needs were known, understood, and monitored.
People’s health needs were monitored, and staff worked with external health care professionals, in supporting people to achieve positive outcomes.
People received care that was respectful, compassionate, and dignified. Choice and independence were promoted. People were positive about the caring approach of staff, whom they believed knew and understood their needs well.
People received opportunities to participate in group and individual activities based on their interests and hobbies. A new document to reflect people’s end of life care wishes had been introduced. People’s diverse and cultural needs and preferences were recorded and understood by staff. People’s individual communication needs had been assessed.
People, visitors, and staff received opportunities to share their experience to help develop the service. Staff were positive about working at the service and improvements had been made to the frequency of staff meetings and communication. Staff competency checks had been introduced and were an effective way to measure staff skills and learning needs.
The registered manager and provider understood their registration regulatory responsibilities. The last rating for the service was clearly displayed.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was requires improvement (published 30 July 2022) and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found some improvements had been made; however, the provider remained in breach of 1 regulation and the rating remains requires improvement.
Why we inspected
This inspection was carried out to follow up on action we told the provider to take at the last inspection.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Diamond House on our website at www.cqc.org.uk.
Enforcement
A continued breach of Regulation 17 Good Governance was identified.
Follow up
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.