This inspection visit took place on 28 January 2019.

Diwali Nivas is a 'care home' for a maximum of 21 people. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Twenty-one people lived at the home at the time of our inspection visit.

Diwali Nivas is a care home for older Asian people who may have a mental health condition or live with dementia. People who live at the home are vegetarian.

The home is an extended residential property close to the centre of Leicester. It is within walking distance of places of worship and local shops which serve the Asian community.

At our last inspection we rated the service as ‘good’. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns.

The service continued to be safe. There were enough staff on duty to meet people’s needs; and staff recruitment checks reduced the risk of the service employing unsuitable staff. Staff understood how to safeguard people from harm and knew the risks related to people’s health and wellbeing. People received their medicines as prescribed. The home was clean and tidy and staff understood infection control practice. Premises were well-maintained.

The service continued to be effective. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The principles of the Mental Capacity Act (MCA) were followed. The policies and systems in the service support this practice. Staff received training to support them work effectively with people who lived at the home. People had access to different health and social care professionals when required, and good relationships had been formed between the service and those professionals. People received food which was culturally appropriate, which they enjoyed, and choices with each meal.

The service continued to be caring. People received care from staff who were kind, treated them with dignity and respected their privacy. Staff had developed positive relationships with the people they supported, they understood people’s needs, preferences, and what was important to them. The service supported people to maintain relationships with their family and friends.

The service continued to be responsive. People’s needs were assessed and staff ensured their needs were met. The service was responsive to people's religious and cultural needs, and provided daily activities to support emotional wellbeing. The small number of complaints had been responded to well. The service ensured people’s end of life care needs were met.

The service continued to be well-led. The registered manager and care manager provided good support to the staff group, and to people who lived at the home. Checks were made to ensure the service met its obligations to provide safe accommodation to people and to deliver care and support which met people’s individual needs.

Further information is in the detailed findings below.

The inspection took place on 3 August 2016.

Diwali Nivas is registered to provide care and support for Asian elders who may experience a mental health condition or be living with dementia. Diwali Nivas is registered to provide care for up to 21 people. At the time of our inspection there were 21 people living at the home, however one person was in hospital.

A registered manager was in post. The registered manager was also the provider, and they were supported by a registered manager at the home. 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 last two inspections of the service in June 2014 and April 2015 we asked the provider to take action. We asked the provider to make improvements in the arrangements for cleanliness and infection control. We received an action plan from the provider which outlined the action they were going to take which advised us of their plan to be compliant by November 2015. We found that the provider had taken the appropriate action. Medicines were ordered and stored safely, and staff were trained to administer the medicines people required. Staff sought medical advice and support from health care professionals.

Personal evacuation plans (PEEP’s) were available and stored securely along with other documents and were placed near the fire board and main exit from the home. Copies of the PEEP’s were also kept in each person’s file and reviewed regularly along with other personal file documents.

People felt their privacy and dignity was respected and staff were kind and caring when delivering care and their choice of lifestyle. Relatives we spoke with were complimentary about the staff and the care offered to their relations. People’s care and support needs had been assessed and people were involved in the development of their care plans, and when able were involved in the review of their care plan. When appropriate people were happy for their relatives to be involved in care planning and review. We observed staff offered people everyday choices and respected their decisions. Staff had access to people’s care plans and received regular updates about people’s care needs. Care plans included changes to people’s care and treatment, and people attended routine health checks.

People were provided with a choice of meals that met their cultural and dietary preferences. The catering and care staff were provided with up to date information about people’s allergies and dietary needs. People’s opinions were sought to meet their individual meal choices. There were sufficient person centred activities provided on a regular basis and people’s cultural and religious needs were met. Staff had a good understanding of people’s care needs, and people were able to maintain contact with family and friends as visitors were welcome without undue restrictions.

Staff were subject to a thorough recruitment procedure that ensured staff were qualified and suitable to work at the home. They received induction and on-going training for their specific job role, and were able to explain how they kept people safe from abuse. Staff were aware of whistleblowing and what external assistance there was to follow up and report suspected abuse. Staff were employed in sufficient numbers to meet people’s personal care needs and we saw staff worked together to meet people's needs.

Staff told us they had access to information about people’s care and support needs and what was important to them. Staff knew they could make comments or raise concerns with the management team about the way the service was run and knew these would be acted on.

The provider had a clear management structure within the home, which meant that the staff were aware who to c

We brought forward this inspection because we had received concerns about the care and welfare of people who used the service. We spoke with twelve of the people living in the home and four staff. There were two Inspectors who undertook this visit, one with Asian language skills to enable us to ascertain people’s opinions about the home. Some of the people we saw had memory problems or difficulty with communicating their needs.

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

Is the service safe?

Care plans were written in an individual way that ensured people received personalised care and support. Medicines were stored and administered securely.

The home had proper policies and procedures in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards although no recent applications had needed to be submitted. Relevant staff were aware when an application should be submitted.

People were safeguarded from financial abuse by detailed and secure processes when staff dealt with people’s money.

Staff told us they were provided with personal protective equipment (PPE). We also saw plentiful supplies of PPE placed around the home. Though we found staff did not automatically change their gloves and aprons when completing one task and prior to commencing another.

We also found that cleaning materials and disposable hand towels were inappropriately stored in an external store. There was also inappropriate storage of soiled dressing within the medication store.

Is the service effective?

People’s health and care needs were assessed, and they and their representatives were involved in the agreement of their plans of care.

Is the service caring?

All the people using the service that were spoken with said they were well cared for and the staff helped them with their daily care needs. Several people made similar comments in both Punjabi and Gujarati and said, “The carers are like my daughter, always polite, never raise their voice or answer back inappropriately.”

Is the service responsive?

People had access to bedroom door keys to ensure their property was secure at all times.

Is the service well-led?

Quality assurance systems were in place to make sure that managers and staff learnt from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations.

One person asked that we visited them in their room after lunch as they wished to speak with us. We asked the person for their views about the care they received. They told us: “All the people here are really nice and they look after you very well and nicely. They look after everything.” They told us how they enjoyed watching the Asian television channels in the lounge and in their bedroom. They also told us they liked the food at the home and that they had regular contact with some of their relatives who visited frequently and took them out.

We observed that staff were able to speak with people in their first language, which included Gujarati, Punjabi and Hindi. People’s diversity and values were respected with regards to conversation, clothing, religious practices and diet. People watched Asian movies and serials on the television. We observed people taking part in a musical session, whilst some completed jigsaw puzzles.

We found the environment to be adequately maintained and people chose two sit in one of the two lounges. We found there were sufficient staff on duty to meet the needs of people and that staff had a good understanding as the care and support people required. People were supported by staff with regards to their personal care and people’s requests were met in a timely manner.

We spoke with seven people who lived at Diwali Nivas in Gujarati or Punjabi. People told us staff treated them with respect and addressed them using the culturally appropriate form of addressing elders.

People’s diversity and values were respected. People watched Asian movies, serials and international news on the television. We observed people taking part in a game of bingo. People were complimentary about the choice of Asian vegetarian meals.

Visitors said they were kept informed about any changes to their relatives’ health and the registered manager always spoke with them when they visited. People confirmed they saw the doctor or nurse when needed. We found people’s needs had been assessed and were regularly reviewed. Care plans had been developed which detailed the care and support which was to be provided by staff.

Records relevant to the management of the service were accurate and fit for purpose and appropriate checks were undertaken before staff began work. Records showed staff had access to a range of training which enabled them to promote the health and welfare of people who used the service.

We spoke with someone who had recently moved into the home. They told us the staff were very friendly and that they liked living at Diwali Nivas.

We saw people living at Diwali Nivas speaking with staff and being supported by them in providing personal care and support.

An expert by experience accompanied us on our visit to the service. An expert by experience has personal experience of using or caring for someone who uses a health, mental health and/or social care service.

The expert by experience spoke with people in Gujarati, Punjabi and Hindi. We observed that staff were speaking with people in their first language and that they had a good understanding of people’s faiths and religious and cultural needs.

People were supported to practice their faith and religious needs by accessing external places of Worship and by the carrying out of religious readings within Diwali Nivas. The service provides an Asian vegetarian diet to people which is served in a manner which reflects their cultural needs.

People told us that they were happy with the care and support they received and that they enjoyed the food and activities provided. We observed that people received visits from relatives throughout the day and that visitors spoke with others who lived at Diwali Nivas as well as staff, the atmospheres appeared relaxed and welcoming.

People told the expert by experience that they felt safe. Staff need to receive more training which helps them to promote choices and understand the rights of people who are unable to make decisions for themselves.

Care plans reflected the needs of people and had been signed by the person’s relatives. We noted that relatives had regular telephone contact throughout our visit with staff enquiring after their relative’s health. Care plans showed that people have access to health care professionals who support staff in promoting people’s health.

The service needs to improve the opportunities for people to comment and influence the care and service they receive and improve its quality assurance system by providing greater support to its staff and looking at the effectiveness of staff training.