Radis Community Care (Redwood House)

Updated 25 November 2021

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

The inspection was carried out by two inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats. This service also provides care and support to people living in specialist ‘extra care’ housing. Extra care housing is purpose-built or adapted single household accommodation in a shared site or building. The accommodation is bought or rented and is the occupant’s own home. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for extra care housing; this inspection looked at people’s personal care and support service.

The service did not have a manager registered with the Care Quality Commission. This means the provider alone is legally responsible for how the service is run and for the quality and safety of the care provided. The manager who was appointed on 1 September 2021 was completing the CQC process to become the registered manager. They are referred to as the manager throughout this report and together with their two team leaders as the management team.

Notice of inspection

We gave the service 48 hours’ notice of the inspection. This was because we needed to be sure that the provider or manager would be in the office to support the inspection.

Inspection activity started on 28 September 2021 and ended on 18 October 2021. We visited the office location on 29 September 2021. On 18 October 2021 we met with the manager and area manager to review quality assurance audits.

What we did before the inspection

We reviewed information we held and had received about the service since the last inspection. We sought feedback from the local authority, safeguarding team and other health and social care professionals who work with the service. We checked information held by Companies House and the Information Commissioner’s Office. We checked for any online reviews and relevant social media, and we looked at the content of the provider’s website. We asked the manager to prepare some documents in advance of visiting the service’s office. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used this information to plan our inspection.

During the inspection

We spoke with three people and eleven relatives about their experience of care and support provided by the service. We spoke with the manager, area manager, two team leaders and three care staff. We reviewed a range of records, including three people’s care records and medicines administration records and three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were also reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found and spoke with three community health and social care professionals who engage with the service. We requested and received further records, quality assurance documents, and were provided with a variety of additional evidence for consideration.

Updated 25 November 2021

About the service

Radis Community Care (Redwood House) is a service which provides support to people living in specialist ‘extra care’ housing. Not everyone using the service receives personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided. Whilst the service does not provide care and support to everyone living at Redwood House, staff respond to all the residents if they activate their personal pendant alarms seeking assistance. At the time of this inspection 18 people were receiving personal care.

People’s experience of using this service and what we found

The governance structure of the service had not always ensured there were robust measures to monitor quality, safety and the experience of people within the service. Recent audits, including a baseline audit by the new manager, identified that some staff supervisions, appraisals, competency assessments and care plan reviews were overdue. However, the manager had risk assessed the deficiencies and prioritised completion of the necessary work in September/October 2021. The provider has produced evidence to demonstrate this work has been completed.

The management team promoted a caring, person-centred culture where people and staff felt valued. The manager understood their responsibilities to inform people when things went wrong and the importance of conducting thorough investigations to identify lessons learnt to prevent reoccurrences. The manager had developed effective partnerships to ensure people experienced the best possible outcomes.

People experienced safe care, protected from avoidable harm by staff who had completed safeguarding training and knew how to recognise and report different types of abuse. Staff assessed risks to people, which were managed safely. There were enough staff deployed with the right mix of skills and knowledge to deliver care and support to meet people’s needs, in line with their risk assessments and support plans. Staff had completed a robust recruitment process which explored gaps in their employment history and conduct in previous care roles, to assure their suitability to support people living in their own homes. People received their prescribed medicines safely from staff who had been trained and assessed to be competent to do so, in accordance with recognised guidance. Staff demonstrated high standards of hygiene and cleanliness whilst delivering care and support.

Staff holistically assessed aspects of people’s physical, emotional and social needs and ensured these were met, to consistently achieve good outcomes for them. Staff were enabled to develop and maintain the required skills and experience to support people effectively. Staff were aware of the importance of eating and drinking well and reflected best practice when supporting people to maintain a healthy balanced diet. Staff collaborated closely with community professionals to ensure people received appropriate care and treatment to meet their changing needs. Staff supported people to make choices and worked effectively with other partners, to ensure specialist or adaptive equipment was made available to enable improved care and support.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People experienced caring relationships with staff, who treated them with kindness and compassion in their day-to-day care. Staff supported to people to make decisions about their care and respected their choices. Staff promoted people’s independence and encouraged them to direct their own health and care support.

People received personalised care, which achieved good outcomes for them. People were provided with information in a way they could understand, allowing for any sensory impairment. People were supported to keep in touch with family and friends, which had a positive impact on their well-being. People knew how to make complaints and were confident the management team would listen and address their concerns. The service worked closely with community professionals and had sensitively explored people’s end of life care wishes.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

Due to our inspection methodology during the pandemic, the first inspection of this newly registered service only inspected the key questions of safe and well led. Although the service was not rated overall (report published 11 January 2021), we found there was a breach of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

We have found evidence that the provider needs to make improvements. Please see the well-led section of this full report.

Why we inspected

This was the first comprehensive inspection of Radis Community Care (Redwood House) covering all key questions since the location was added to the provider's registration in October 2019.i

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.