We carried out an announced inspection of Diversity Health and Social Care Limited on 24 and 25 September 2018. Diversity Health and Social Care Limited is registered to provide personal care to people in their own homes. The CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do, we also take into account any wider social care provided. At the time of our inspection, the service provided personal care to 241 people in their homes. At our last inspection on 16 February 2016, we rated the service ‘Good’. At this inspection, we found concerns with risk assessments, pre-employment checks, care plans, training and quality assurance systems therefore the service has been rated ‘Requires Improvement’.

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 legal requirements in the Health and Social Care Act 2008 and the associated regulations on how the service is run.

Risks to people were not always robustly managed. We found some care plans did not contain suitable and sufficient risk assessments to effectively manage risks. This placed people at risk of not being supported in a safe way at all times.

Pre-employment checks had not been carried out in full to ensure staff were suitable to provide care and support to people safely. We found the provider did not follow their recruitment policy in some instances, which detailed that two references should be requested before employing staff.

Staff had not received mandatory and specialist training required to perform their roles effectively in accordance to people’s support needs and circumstances. Some staff had not received Mental Capacity Act 2005 (MCA) training therefore some staff we spoke to were unable to tell us what this was. Consent had been sought from people when supporting them with care and support.

People’s ability to communicate were recorded in their care plans. However, there was no information on how staff should communicate with people particularly how staff would make information accessible to people.

Effective quality assurance systems were not in place. Systems were not in place to carry out robust audits on staff training, care plans such as risk assessments and medicine management.

Accurate and complete records had not been kept to ensure people received high quality care and support.

Staff told us they had time to provide person centred care and the service had enough staff to support people. However, we noted where there was a risk staff may be late, this was not being pursued by office staff to minimise risk of late calls or missed visits. We made a recommendation in this area.

Staff, relatives and people were positive about the management team. People’s feedback was sought from surveys. However, this had not been analysed in full to identify best practise and areas of improvement ensuring a culture of continuous improvement. We made a recommendation in this area.

People received their medicines on time. Staff had been trained to manage medicines safely.

Staff were aware of how to identify abuse and knew who to report abuse to, both within the organisation and externally.

Pre-assessment forms had been completed in full to assess people’s needs and their background before they started using the service. Reviews were held regularly to identify people’s current preferences and support needs.

People were being cared for by staff who felt supported by the management team.

People had access to healthcare services if needed.

People’s privacy and dignity were respected by staff. People and relatives told us that staff were caring and they had a good relationship with them.

Complaints received had been investigated and relevant action had be

We inspected Diversity Health and Social Care Limited on 16 February 2015. This was an announced inspection. We informed the provider 48 hours in advance of our visit that we would be inspecting. This was to ensure there was somebody at the location to facilitate our inspection. This was the first inspection of the service since it was registered with the Care Quality Commission. The service provides support with personal care to adults living in their own homes. One person was using the service at the time of our inspection.

There was a registered manager at the service at the time of our inspection. 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 and associated Regulations about how the service is run.

Systems were in place to help ensure people were safe. Staff had undertaken training about safeguarding adults and had a good understanding of their responsibilities with regard to this. Risk assessments were in place which provided information about how to support people in a safe manner. Staff understood their responsibilities under the Mental Capacity Act 2005. We found there were enough staff working to support people in a safe way in line with their assessed level of need.

Staff received regular training and were knowledgeable about their roles and responsibilities. They had the skills, knowledge and experience required to support people with their care and support needs. People were cared for by sufficient numbers of suitably qualified, skilled and experienced staff. Robust recruitment and selection procedures were in place and appropriate checks had been undertaken before staff began work.

Staff knew the people they were supporting and provided a personalised service. Care plans were in place detailing how people wished to be supported and people and their relatives were involved in making decisions about their care.

The registered manager was open and supportive. Staff and relatives felt able to speak with the registered manager and provided feedback on the service. The service had various quality assurance and monitoring mechanisms in place.

We made a recommendation that on-going supervision is completed for all staff.