The inspection of Diversity Care Solutions Limited domiciliary care agency took place on 26 and 27 September 2016 and was announced. We gave the provider 48 hours’ notice because the location provides a domiciliary care service and we needed to be sure that someone would be available for the inspection. The inspection involved a visit to the agency’s office and telephone conversations with people who used the service and healthcare professionals.

Diversity Care Solutions Limited is a nursing and domiciliary care agency based in Battle. They provide support and care for 16 children and adults living in their own home in East Sussex who require a complex range of personal and care support including nursing and overnight care.

The service had a registered manager. 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.

People told us they felt safe receiving the care and support provided by Diversity Care Solutions Limited. Staff understood and could recognise the signs of potential abuse and knew what to do if they needed to raise a safeguarding concern. Training schedules confirmed staff had received training in safeguarding adults at risk.

Robust recruitment and selection procedures were in place and appropriate checks had been made before staff began work at Diversity Care Solutions Limited. There were sufficient levels of staff to protect people’s health, safety and welfare consistently and reliably.

People said staff were caring and kind and their individual needs were met. One person told us, “The carers are professional, thoughtful, caring and kind.” Another person said, “The staff are gold standard compared to other agencies.” Staff knew people well and had a good understanding of their needs and choices.

Care plans and risk assessments reflected people’s assessed level of care needs. People were encouraged to be as independent as possible. One person told us, “I am regularly asked for my input to review my care plan.”

Staff felt supported by management, said they were well trained and understood what was expected of them. Staff were encouraged to provide feedback and report concerns to improve the service. A member of staff told us, “I feel very confident to raise concerns. The manager has an open door policy.”

There was a complaints policy and information regarding the complaints procedure was available. Complaints were listened to and investigated in a timely manner and used to improve the service.

Regular audits were in place to measure and monitor the quality of care and service provided.

People and staff surveys were positive about Diversity Care Solutions Limited. One person commented, “It’s wonderful that something is so wonderful.” A member of staff told us, “I wouldn’t change anything. It’s a great company to work for.”

A single inspector carried out this inspection. The focus of the inspection was to answer five key questions; is the service safe, effective, caring, responsive and well-led?

Below is a summary of what we found. The summary describes what the people who used the service, their relatives and the staff told us, what we observed and the records we viewed.

If you want to see the evidence that supports our summary please read the full report.

Is the service safe?

People told us they felt safe. Safeguarding procedures were in place and staff understood how to safeguard the people they supported. One person who used the service told us “I have consistent carers who are all lovely and look after me very well”.

Systems were in place to make sure that both managers and staff learnt from events such as accidents and incidents and responded to complaints and concerns.

Policies and procedures were in place to make sure that unsafe practices were identified and that people were protected.

Is the service effective?

The people we spoke with told us they were happy with the care they received and felt their needs had been met. After speaking with the staff it was clear they understood people’s care and support needs and they knew them well. One person told us “The care staff are very competent, any issues I may have are always dealt with straight away”.

Staff had received training and ongoing development to meet the needs of the people using the service.

Is the service caring?

Staff were knowledgeable and supportive to the people who used the service. Staff told us they encouraged people to maintain their independence and remain in their home.

People’s preferences, interests and complex needs had been recorded in the care plans we viewed.

People who used the service had been offered a quality assurance survey to complete. Where shortfalls or concerns were raised they had been addressed and discussed with the person.

Is the service responsive?

People’s needs had been assessed before they received care. Information had been recorded in detailed care and support plans. People told us they regularly discussed their needs with their care staff.

People knew how to make a complaint if they were unhappy. The complaints policy was explained and a copy given to the person who received care.

Is the service well-led?

The service worked with other agencies and services to make sure people received care in a joined up way.

A quality assurance system was in place and the records we viewed showed there were regular audits on the service and any shortfalls had been addressed by the manager. As a result the quality of the service was continuingly improving.

Staff told us they were clear about their roles and responsibilities. Staff we spoke with had a good understanding of their roles. One staff member told us “We have a great support network and the management are supportive and so helpful”. This helped to ensure that people received a good quality service at all times.

On the day of our inspection there were 30 people using the agency services. Nursing and caring services were offered to young people and adults. The majority of people for whom care was provided had complex medical conditions with high dependency levels. We spoke directly with two people who used the agency, however, due to communication difficulties with some people we also spoke with six people’s family members.

People we spoke with felt that staff sought consent prior to care delivery. One person told us, “The staff always check with me first.” Staff we spoke with had a good understanding of issues related to gaining relevant consent prior to providing care.

We spoke with five staff. They told us they enjoyed their work and felt supported to do their job. We looked at three staff files and found that there were effective staff recruitment systems in place.

We looked at four care plans and found that these reflected the care that was provided. People we spoke with felt involved in their care.

We found there were appropriate policies and systems in place to ensure the risks from harm through medicine was reduced.

We found there were robust quality assurance systems in place which demonstrated that systems and procedures were continuously reviewed and information used to improve services.

We spoke with two people who used the service and three staff members. Overall, people were happy with the service and the care they received. One person told us “They’re extremely professional, punctual and polite. The staff come up with ideas about my care and they’re happy to take on board any views I have.”

The people we spoke with felt involved in planning their care plan. The manager visited people in their home to carry out an assessment before care was provided.

The care plans we looked at contained risk assessments, care needs and visit reports. The plans held in people’s homes also contained information for them about safeguarding, including which agencies to call if people have concerns about their own safety.

Staff received supervision and annual appraisals. The service had ensured that staff were adequately trained to meet the individual care needs of the people they looked after.

The service had carried out audits to assure management that care was being carried out properly. Additionally, audits were used to check adherence to the Health and Social Care Act 2008, and people using the service had been asked for their views and opinions.