Archived: 1 Diamond Home Care Ltd

Updated 13 July 2015

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check 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.

The inspection team consisted of an adult social care inspector and this inspection took place on 13, 14 and 18 May 2015 and was announced. The provider was given 48 hours’ notice because we needed to be sure that someone would be available when we visited people in their own home. We also needed to ensure the registered manager was available at the office for us to speak to her.

Prior to the inspection visit we gathered information from a number of sources. We looked at the information received about the service from notifications sent to the Care Quality Commission by the registered manager. We also obtained the views of service commissioners from the local council who also monitor the service provided by the agency. Because they told us about concerns that had been logged against this service we decided to bring forward this inspection and the local authority contracts and commissioning officer joined us on this inspection. We also spoke with a social worker and a diabetic nurse regarding the care provided to two people who used the service.

At the office we spoke with the registered manager. We also spoke with a person who had been appointed as acting manager who had been asked to assist with the inspection. We were also introduced and spoke briefly to a person who had been appointed to undertake spot checks on staff and deliver training to staff. We also visited and spoke with two people who used the service and spoke with 7 people who used the service and their relatives by telephone. We telephoned and spoke with four care workers who worked with people who used the service in the community.

We looked at documentation relating to four people who used the service, staff and the management of the service. This took place in the office. We also looked at two people’s written records, including their plans of their care. This took place in people’s own homes and we asked permission from the people before we looked at these records.

Updated 13 July 2015

The inspection took place on 13, 14 and 18 May 2015 with the provider being given short notice of the visit to the office in line with our current methodology for inspecting domiciliary care agencies. The service was previously inspected on 16 January 2014, when no breaches of legal requirements were identified.

1 Diamond Jones Service Limited is a domiciliary care service which is situated in Carcroft on the outskirts of Doncaster. The service is registered to provide personal care to people in their own homes. At the time of our inspection the service was supporting people with a variety of care needs including older people and people living with dementia. Care and support was co-ordinated from the services office which is based in Carcroft.

There is a registered manager which manages the day to day operations of the service. 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.

At the time of our inspection there were approximately 21 people using the service. We asked people about their experiences using the agency; three people told us they were satisfied with the care, however, four people raised concerns with us about calls being missed or late calls.

At this inspection, we found that a number of breaches of legal requirements. This put people using the service at significant risk of receiving inappropriate or unsafe care.

People provided us with mixed views on the services they received. Whilst some people praised their regular care workers, some people told us of feeling rushed during care visits and care workers not listening to them. We found that some people received care visits that were shorter than half their allocated time, and that some people did not receive a consistent set of care workers who got to know their individual care needs and preferences. This meant people were not always treated in a caring way that met their individual needs.

We found that people were not being supported to manage their medicines safely. Most medicines records we saw had not been filled in to demonstrate that people had been supported to take their medicines as prescribed.

People’s needs had been assessed before their care package commenced and they told us they had been involved in formulating and updating their care plans. We found the information contained in the care records were inadequate with some key information missing. For example support to enable people to take their medication safely, and support with personal care.

We found that people’s complaints were not identified as complaints and addressed. Some complaints records showed they had not been addressed in a timely manner. This meant people were not listened to, and action was not taken to prevent any unsafe or inappropriate care that was being reported.

Safeguarding processes did not always keep people safe from abuse. The registered manager had not informed us of allegations of abuse relating to services provided by the agency. However, we received an alert form from the local councils safeguarding team which stated there had been a breach of confidential information involving several people who used the service. Following this inspection we raised a safeguarding alert on behalf of a person we visited.

We found that care workers were inconsistently trained, supervised and supported. Recruitment procedures were not sufficiently robust to ensure the right staff were employed to keep people safe. Staff were not supported to deliver care to people safely and to an appropriate standard.

Quality assurance checks on care plans were ineffective as they were recorded by the registered manager in a diary. This meant there were no records to demonstrate if care plans were up to date and were reviewed. People’s views of the service were not always formally recorded and we found no action was taken when issues were raised. Records were not always provided to us in full when we requested them, which undermined our confidence in the transparency and management of the service.

Due to the many concerns that we found, we did not have confidence that the registered manager had oversight of quality and risk at the agency, and concluded that the service is not well-led.

We found overall that people using the service were at significant risk of receiving inappropriate or unsafe care. We found six breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

The overall rating for this service is ‘Inadequate’ and the service is therefore in 'Special measures'. The service will be kept under review and, if we have not taken immediate action to propose to cancel the provider’s registration of the service, will be inspected again within six months. The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe.