Archived: Radis Community Care (Maritime House)

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question inadequate. At this assessment the rating has changed to requires improvement. This meant some aspects of the service were not always safe and there was limited assurance about safety. There was an increased risk that people could be harmed.

This service scored 59 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Processes to review, analyse and document actions in response to incidents were not always comprehensive or consistently completed. Lessons were not always learnt to continually identify and embed good practice. We found examples of incident forms which were not fully completed to document actions or outcomes from investigations. For example, one person was discharged from hospital after an incident at the service. Their care records contained no detail of the extent of the injury, nature of treatment received or whether the person’s care plan had been reviewed in response. Therefore, it was not clear that this incident had been investigated fully or whether any measures were taken to reduce the risk of reoccurrence. Systems to review and analyse incidents required development. There was no clear system to demonstrate how incidents were periodically or thematically reviewed to identify trends or measures to reduce the risk of incidents reoccurring. In response to our feedback, the registered manager told us they would be introducing a monthly review of incidents with the deputy manager to address this shortfall.

There were not always effective systems in partnership with healthcare partners to establish and maintain safe systems of care. The registered manager told us they were experiencing ongoing issues in establishing effective communication systems and information sharing agreements with visiting stakeholders, such as pharmacies, district nurses and GP’s. This meant the provider was not always aware professionals had visited and did not always receive updates to people’s care needs or health conditions as a result. The provider had made improvements in being clear and pro-active in understanding the level of complexity of needs they could safely provide care to. The registered manager actively participated in panel meetings with other stakeholders when planning prospective admissions to the service. This helped to ensure they could meet the needs of people new to the service. The provider had improved their systems to plan ahead for people’s future care needs when they required a higher level of care to meet their needs. We saw examples where people had been supported to move to alternative care placements as their needs increased and became more complex.

People told us they felt safe receiving care from the provider. The provider had improved policies and procedures around safeguarding since our last inspection. The provider had improved processes ensuring people were not subject to restrictive practices. They had reviewed people’s care plans to ensure any restrictions to people had been assessed and agreed under the appropriate legal framework. However, some staff we spoke to were not aware or confident in identifying what may constitute a restrictive practice. Or how their own practices may put people under undue restriction. We brought this to the attention of the registered manager who acknowledged some staff may need additional support in this area. They told us they planned to assign a Mental Capacity Act (2005) champion, who would support staff to improve their knowledge and understanding. Senior staff had a good oversight of safeguarding concerns and alerts received. Records demonstrated they understood their responsibilities in reporting safeguarding concerns and investigating these in partnership with professionals.

The provider detected and controlled potential risks in the care environment. They made sure equipment, and technology supported the delivery of safe care. The provider completed environmental risk assessments of people’s homes to ensure they identified and reduced any risks related to the delivery of care. The provider assessed all care related equipment to help ensure there was guidance for staff to follow for safe use. The provider used technology to support the safe and effective delivery of care. This included the use of electronic systems to monitor care tasks and medicines administration. This helped the registered manager maintain remote oversight of the care carried out by staff.

The provider detected and controlled potential risks in the care environment. They made sure equipment, and technology supported the delivery of safe care. The provider completed environmental risk assessments of people’s homes to ensure they identified and reduced any risks related to the delivery of care. The provider assessed all care related equipment to help ensure there was guidance for staff to follow for safe use. The provider used technology to support the safe and effective delivery of care. This included the use of electronic systems to monitor care tasks and medicines administration. This helped the registered manager maintain remote oversight of the care carried out by staff.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs. The provider had improved staffing by recruiting more permanent staff and ceasing the use of agency staff. People told us this had improved the quality and consistency of care delivered. The provider had also implemented the ‘first responder’ system. The first responder was an additional member of staff, who responded to call bells to reduce the waiting time people experienced before receiving assistance. This had also been effective in boosting staffing contingency and the flexibility of how care was delivered. For example, if people declined their medicines at the planned care call time, the first responder was able to revisit this administration later. This helped to ensure people received their medicines as prescribed. The provider ensured staff received training relevant to their role. Staff received additional support through induction, supervision, spot checking and competency assessment. This helped ensure staff had the skills required to work effectively with people.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly. People raised no concerns around infection control. They told us staff had appropriate personal protective equipment (PPE) and followed good hygiene practices when delivering care. There were appropriate infection control policies and procedures in place. Staff confirmed there were sufficient supplies of PPE in place.

The provider did not always make sure medicines and treatments were safe and met people’s needs, capacities and preferences. The provider had made significant improvements in their medicines management systems since our last inspection. This included improvements in, involving people in care planning, risk assessment, and systems to ensure people received their medicines as prescribed. However, further improvements were still required to ensure systems and processes were safe and fully reflected best practice. This included, improving guidance around ‘when required’ medicines, ensuring allergies were recorded in care plans, ensuring body maps were in place for people using transdermal patches, ensuring instruction were clear for staff around the use of prescribed food and fluid thickeners. We brought these issues to the attention of the registered manager who acknowledged there were still areas for development in the areas highlighted.