Diamond House

Updated 11 May 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

This inspection was completed by 2 inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Diamond House is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Diamond House is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided. At the time of our inspection there was a registered manager in post.

Notice of inspection

The service was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 9 people who used the service and 1 relative about their experience of the service. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We spoke with the registered manager, deputy manager, new area manager, a unit manager, quality team leader, 2 senior care staff, 3 care staff, a domestic, the chef, an activity coordinator, and the maintenance person. We spoke with 2 visiting health or social care professionals and the visiting hairdresser. We reviewed in part, 8 people’s care records and 3 staff files and a variety of records relating to the management of the service, including audits and checks and medicine records.

Updated 11 May 2023

About the service

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.