CQC report explained · a residential care home
What the CQC found at Diamond House
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- Risk management and medicines had improved, and the home was no longer in breach of Regulation 12. However, staffing was not consistently safe or effective, and inspectors found cleanliness and hygiene shortfalls.
- Effective?
- Requires improvement
- People received support with food, drinks and health needs, and staff training had improved. However, mental capacity assessments and best interest decisions were not consistently recorded correctly, and some training gaps remained.
- Caring?
- Good
- People were treated with kindness, dignity and respect. Staff listened to people's choices, promoted independence and knew their needs and routines.
- Responsive?
- Good
- Care plans reflected people's preferences, communication needs, cultural needs and end of life wishes. People were offered activities based on their interests, including individual activities for those who stayed in their rooms.
- Well-led?
- Requires improvement
- There had been improvements in meetings, feedback, care plans and staff competency checks. However, quality systems did not identify cleanliness problems, behavioural incidents or overdue improvement actions, so Regulation 17 remained breached.
What inspectors found, May 2023
Rated Requires Improvement; inspectors found kind and personalised care, but staffing, cleanliness, consent records and quality checks were not always reliable.
This was an unannounced follow-up inspection on 11 and 12 April 2023. Inspectors spoke with people, a relative, staff and health professionals. They observed care and reviewed care plans, medicines records, staff files and management records.
The home had improved since the previous inspection. People received respectful care, activities and support suited to their needs. Medicines, risk management and infection control had improved, but cleanliness and hygiene problems remained in some areas. Staffing in one building was not consistently enough to meet people's needs, and immediate action was taken.
The home was rated Good for Caring and Responsive. It was rated Requires Improvement for Safe, Effective and Well-led, giving an overall rating of Requires Improvement. The home remained in breach of Regulation 17 because its systems for checking and improving quality and safety were not strong enough.
Kind and respectful care
People and relatives spoke positively about staff. Inspectors saw staff listen to people, use their preferred names and support their choices and independence.
“People received care that was respectful, compassionate, and dignified.” from the report
Personalised support
Care plans included people's routines, preferences, life history, communication needs and cultural or spiritual needs. A new document recorded people's wishes for end of life care.
“Care plans were detailed and supported staff to provide care and treatment in a way people wanted.” from the report
Activities and social contact
People could take part in group and one-to-one activities based on their interests. Staff also supported some people to go out to local shops and cafes.
“We have monthly resident meetings where we discuss what activities people like to do.” from the report
Food and healthcare
People were offered meal and drink choices, with support and adapted equipment where needed. Staff monitored health needs and worked with outside health professionals.
“People were positive about the choice and quality of meals and drinks.” from the report
Staffing levels
seriousStaffing in one building was not consistently enough for people's assessed needs. The provider increased staffing immediately, but families should check whether this change has continued.
“Staff deployment was not consistently safe and effective.” from the report
Cleanliness and hygiene
needs fixingInspectors found cleanliness and hygiene shortfalls in some parts of the home. Cleaning schedules and checks were not detailed or reliable enough, and immediate action was taken during the inspection.
“some shortfalls were identified in relation to cleanliness and hygiene in some parts of the service and we were not assured.” from the report
Mental capacity records
needs fixingMental capacity assessments did not always explain how decisions were reached or who was involved. The home knew this needed improvement, but the work was still ongoing.
“MCA assessments were not consistently decision specific.” from the report
Weak quality checks
seriousThe home's monitoring systems did not identify cleanliness concerns, a person's repeated behavioural incidents or overdue improvement actions. This led to a continued breach of Regulation 17.
“The provider had failed to ensure systems and processes monitored and improved the quality and safety of the service.” from the report
- 01What staffing changes were made in the building that needed an additional daily care staff floater, and are they still in place?
- 02What cleaning schedules and checks are now used during the day and at weekends?
- 03How are mental capacity assessments and best interest decisions now recorded and checked?
- 04How are behavioural incidents reviewed so that repeated incidents are identified and acted on?
- 05Which of the seven overdue improvement actions have now been completed, and what are the new target dates for the rest?
This was an unannounced follow-up inspection checking action from the previous inspection, including infection prevention and control under Safe; the report gives ratings for all five key questions. This explanation was written from the published report of 11 May 2023 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, July 2022
Rated Requires Improvement; inspectors found unsafe care, poor person-centred support and weak leadership across all five areas.
Inspectors visited unannounced on 9 and 10 May 2022. They spoke with people living at the home, relatives, staff and health professionals. They also reviewed care records, medicine records, staff files and management records.
They found risks were not always managed safely. These included unsafe diabetes support, medicine errors, incomplete fire evacuation plans, unlocked cleaning areas and weak infection control. Care plans were often not personal or up to date, and people's choices, dignity and freedom were not always respected.
The home supported people to eat and drink enough, involved health professionals when needed and allowed visitors. Managers responded to some concerns and began making changes, but the systems used to check care were not effective. The overall rating fell from Good at the previous inspection to Requires Improvement.
Food and drink support
People at risk of weight loss received extra calories and monitoring. Staff gave prompts and encouragement when people needed help to eat.
“People were supported to eat and drink enough.” from the report
Health professional involvement
The home made prompt referrals when people became unwell. External professionals said staff listened to advice and acted quickly.
“Really good with residents if I pick up something, I have found they are very quick to respond.” from the report
Privacy during care
Staff generally knocked before entering bedrooms and closed doors before providing personal care.
“We saw staff knocked on bedroom doors before entering and closed bedroom doors before providing care.” from the report
Changes after feedback
The provider took some immediate action during the inspection and supplied further evidence of changes afterwards.
“Where we raised concerns during the inspection process, the provider was responsive at making changes.” from the report
Unsafe care and medicines
seriousAn untrained care worker administered insulin. Medicine storage, recording and instructions for creams and as-required medicines were not always safe.
“Insulin had been administered by an untrained member of care staff.” from the report
Fire and infection risks
seriousFire evacuation plans and checks were not up to date. Some equipment was dirty and staff did not always use face masks correctly.
“All this puts people at risk in the event of a fire.” from the report
Lack of person-centred care
seriousCare plans did not reliably reflect people's routines, religion, personal care wishes or end of life preferences. Personal care was sometimes organised around tasks rather than individual choice.
“People did not always receive care which was person centred.” from the report
Dignity and respect
seriousInspectors saw staff shouting across communal areas and observed a person being hoisted without reassurance. Staff sometimes used room numbers instead of people's names.
“Staff referred to people as their room numbers both to each other and to the inspectors, rather than using people’s individual names.” from the report
Restrictions and consent
seriousDoLS referrals were not always followed up, and some staff did not understand who had authorisation. Staff said people who were not subject to a DoLS would not be allowed to leave the locked service.
“This is an infringement of the persons freedom to leave the service.” from the report
Weak management checks
seriousAudits and management checks failed to identify inaccurate records, poor care plans and medicine fridges outside the desired temperature range.
“Regular audits did take place in many areas; however, they were often ineffective.” from the report
- 01How have you stopped untrained staff from administering insulin, and how is diabetes care now checked?
- 02What changes have been made to medicine storage, stock counts, fridge temperatures and instructions for creams and as-required medicines?
- 03How are care plans now checked to make sure they reflect each person's routines, religion, personal care wishes and end of life preferences?
- 04How do you make sure staff use people's names, protect their dignity and do not wake people or provide personal care earlier than they wish?
- 05What evidence can you show that the warning notice and the required improvements have been completed?
This was an unannounced inspection covering all five key questions and infection prevention and control; all five ratings changed from Good at the previous inspection to Requires Improvement. This explanation was written from the published report of 30 July 2022 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Diamond House
5 rated inspections over 8 years: the service has slipped, from Good to Requires improvement.
- May 2023Requires improvementcurrent ratingstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- July 2022Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- March 2020Gooddown from OutstandingSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- August 2017Outstandingup from GoodSafe: GoodEffective: GoodCaring: OutstandingResponsive: OutstandingWell-led: Good
- May 2015GoodSafe: GoodEffective: GoodCaring: OutstandingResponsive: GoodWell-led: Good
- May 2020
Registered with the Care Quality Commission on 12 May 2020.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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At least 100 live-in carers within about an hour of Leicester
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £980 to £1,270 a week. 83 can care for a couple. 12 years' experience on average.
“If you bump into her in the night on her way to the bathroom she will still inquire how you are and if everything is alright.”
“Tino was the most wonderfully rounded, empathetic and intuitive person. He not only developed a great relationship with Neville but also had a great working relationship with our existing carer.”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.