Archived: Radis Community Care (Brunel Court)

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question inadequate. At this assessment the rating has changed to good.
This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

The provider was previously in breach of the legal regulation in relation to need for consent. Improvements were found at this assessment, and the provider was no longer in breach of this regulation.
 

This service scored 62 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider did not always make sure people’s care and treatment were effective. Although they discussed people’s health, care, wellbeing and communication needs with them, the provider did not always check this met their needs.

The provider completed initial assessments of people’s needs when care packages commenced. This was based on information from people and professionals; to help ensure they reflected the care required. However, staff said not all the information was always available when they first started people’s care calls. This was due to a delay between assessing a person’s needs on their first call to this being updated in their care plans and on the care system. The manager said they would look to improve this.

The provider’s assessment processes were not always comprehensive in identifying and reducing all risks related to people’s care such as fire and choking risks. Care plans contained information about people’s medical conditions. However, they did not always include details of how these conditions affected people’s everyday lives or care needs. Although reviews of care were taking place, some people told us they were not aware of their care plan or when they last had a review. The manager had increased the frequency of care reviews and was working to address this with people. Reviews of care help to ensure care arrangements remain appropriate and reflective of people’s current needs.
 

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. However, they did not always follow current evidence-based good practice and standards when assessing and planning people’s care.
Not everyone at risk of choking had an appropriate risk assessment in place. The provider had worked with people to plan and deliver their care, this included referral to the speech and language team (SaLT) for an assessment where a person was at risk of choking. Not all staff we spoke with understood the International Dysphagia Diet Standardisation Initiative (IDDSI) framework describing texture modified foods and thickened liquids for people with eating, drinking and swallowing problems which is current best practice.

The provider worked well with district nurses to manage skin integrity once a pressure ulcer had been identified. However, they did not use universally recognised tools to assess and identify people at risk of skin deterioration so precautions could be taken to prevent skin breakdown. When people fell their risk assessments had not been reviewed to ensure risk mitigation plans remained effective. This meant preventative measures might not always be in place to reduce risk. The manager told us they were not currently using recognised assessment tools to support staff to identify and escalate concerns when people’s health deteriorated. They planned to investigate its use in the future where current evidence-based good practice was not followed.

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

People’s care plans included where other stakeholders had input into their care, such as GP, occupational therapists or district nurses. The manager told us they had a good rapport with social workers, and a good relationship with the palliative care team. One example of collaboration with professionals was the use of a new technique to aid mobility shown by a physiotherapist.
There was a strong emphasis on staff working as a team to support each other, highlighted by the manager through team meetings. One staff member told us, “Definitely us carers all work together and help each other.”
 

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

People’s healthcare needs were identified in their care plans. This included the level of support they needed to maintain good health. Senior staff told us they monitored daily logs of care to help recognise when people’s needs were changing and whether care needed adjusting. The manager also said they rely on staff alerting them to changes in people’s healthcare needs as they know people well. Where people had specific health conditions, staff had training in line with these conditions, although thy felt they could benefit from knowledge updates. Staff we spoke with told us how they identified a deterioration on people’s health. One staff member said, “New thing in (people’s) flats for things to look out for such as temperature, urine colour.”
 

The provider did not always routinely monitor people’s care and treatment to continuously improve it. They did not always ensure that outcomes were positive and
consistent, or that they met both clinical expectations and the expectations of people themselves.

People’s care plans identified specific goals and outcomes related to their care. However, the lack of comprehensive risk assessment information made it difficult for the provider to evaluate the care people received to determine if it was effective in reducing risk and meeting people’s needs. It was also unclear when or if the provider had carried out regular reviews with people to help ensure preferred outcomes of care were relevant, agreed by all parties and being met.
 

Improvements had been made following our previous inspection. The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.
There were policies and procedures in place to ensure valid consent to care was obtained. People told us staff sought their consent before delivering care. The manager had identified where some staff struggled with knowledge of the Mental Capacity Act 2005 (MCA). In response, the manager had appointed an MCA champion to be able to better support staff.

The provider undertook mental capacity assessments to determine if a person had capacity to make a decision about their care. Where a person lacked capacity, the provider obtained consent from either the power of attorney or through a best interest decision meeting. This helped to ensure the provider was following the correct procedures around gaining consent to care. One consent form was in a person’s own language where English was not their first language. Flash cards were also being used to aid communication and decision making.