Archived: Diamond Home Care

Below is a summary of what we found. The summary is based on a visit to the agency's office on 11 September 2014 and discussions with nine people using the service, four relatives and a social worker by telephone after this visit. We also spoke to seven members of staff, the registered manager and Director. We looked at five records relating to people's care and other records related to the running of the service.

If you wish to see the evidence supporting our summary please read the full report.

Is the service safe?

People and relatives that we spoke with told us that they felt safe with the care workers that visited them. One person told us, 'I feel safe most of the time'.

We heard from people that they were satisfied with how care workers assisted them with medication when this was part of the support they provided. We did find that there were gaps in some people's medication records so were not assured that medication was always given as prescribed. In addition records of people's medication for use in updating other health professionals was not always accurate.

We found that care workers had training in basic core skills that they needed to meet people's support needs. However, there were instances where some care workers did not have specific knowledge of the health care needs of people they visited to ensure their safety was promoted, for example in respect of people with diabetes.

We heard from people that the way care workers were deployed did not always help them build relationships with them as they did not always receive care from care workers they knew well.

We have asked the provider to tell us what improvements they will make to ensure there is safe medication administration, that they ensure care workers are deployed appropriately and they have the knowledge and skills in respect of people's specific health care needs.

Is the service effective?

We heard from people and their representatives that they thought care workers provided care that reflected their care plans. Care workers we spoke with were aware of some people's needs and how these would be promoted, but this was not consistent We found instances where care plans were not always up to date or sufficiently detailed to provide care workers with information about health conditions or risks to their safety and welfare.

We heard concerns before our inspection that some people received care from numerous care workers which impacted on consistency and caused some people distress. Whilst most people and relatives we spoke with said they received a service from a smaller number of carers that they knew, we found others received numerous different care workers. We heard from some people that this did impact on the service they received and created some difficulties for them.

We have asked the provider to tell us what improvements that will make in relation to the way care is planned and how care workers are deployed so that people the same care workers more consistently, at the times they require them.

Is the service caring?

People we spoke with were overall positive about the service they received. One person told us a care worker, 'Kneels down to my level and will ask me how I am, she is very kind'. Another person told us care workers, 'Are very caring'.

When speaking with staff it was clear that they genuinely cared for the people they supported.

A number of people and relatives we spoke with said that their care and support was provided in accordance with their wishes. One person told us, 'They always ask me if I am okay and do I want anything else before they leave'.

Is the service responsive?

People told us they were able to complain and we heard that the agency had taken action in response to their comments meaning they felt listened too. We looked at record of complaints and saw that investigations were completed. This meant that there were systems in place to investigate complaints.

People told us that they were confident that the agency would be able to support them if their needs should change.

Is the service well-led?

Most people we spoke with were positive about the agency and some spoke of improvements that they had made. One person told us they were, 'A lot more professional and seem to have got their act together'. Another person said, 'Diamond is the best company we have used yet'.

The service had some quality assurance systems in place to identify shortfalls, for example when staff required spot checks by managers to ensure they provided a good service. We saw though that there was some slippage with some care workers not having spot checks when the manager had identified they were needed.

We found that the provider did not have a system in place for the monitoring of missed or late calls. Monitoring of these would help identify trends and ensure that risks to people from such events could be easily identified and minimised.

We have asked the provider to tell us what they are going to do to meet the requirements of the law in relation to quality assurance.