Archived: Radis Community Care (Caroline Square)

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.

This is the first assessment for this service. This key question has been rated Inadequate. This meant there were widespread and significant shortfalls in people’s care, support and outcomes.

The provider was in breach of legal regulation in relation to consent.

This service scored 29 (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 make sure people’s care and treatment was effective because they did not routinely check and discuss people’s health, care, wellbeing and communication needs with them.

Information about people’s care needs was not up to date or readily available to staff. One person told us, “They did not do my risk assessment until the day before the inspectors came.” There were inconsistencies between different assessments and care plans. Care information had not been updated to reflect significant changes such as bereavement requiring an increased level of support and number of care calls, someone having a catheter in place or changes to a person’s food and hydration support needs to minimise choking risk. This could lead to inappropriate care being given to people.

Staff did not maintain accurate records of the support given or reliably escalate concerns. This meant people’s changing needs could not be effectively assessed or met.

Staff reported a lack of competency checking and told us they felt ill-equipped to meet the needs of some people, for example those with distressed behaviours or specific support needs related to long term health conditions.

The provider explained they were revisiting each person’s care plan. They were also in the process of rolling out an electronic system, which they anticipated would improve the quality and availability of information to staff.

People were not sufficiently involved in planning their care and support. The provider did not follow legislation and current evidence-based good practice and standards. For example, the provider failed to demonstrate compliance with the Mental Capacity Act 2005 and recognised tools to help identify the risk of malnutrition or pressure injury were not used. A representative of the provider told us these tools would be in place with the introduction of their new digital care records system.

The provider did not work well across teams and services to support people. They could not share an effective assessment of people’s needs when moving between different services because there was an absence of clear information and monitoring of people’s needs.

However, the manager described how they were working with a person and their social worker to review the person’s needs and placement and ensure they received appropriate support.

The provider did not always support people to manage their health and wellbeing, so people could not always maximise their independence, choice and control. Staff did not always support people to live healthier lives, or where possible, reduce their future needs for care and support.

Staff did not consistently follow guidance from healthcare professionals. Some healthcare professionals told us they had to repeat the advice given to staff. One staff member said, “I feel some staff will give out medical advice to people themselves, because they weren’t getting responses from the office.” They added, “District nurses are saying the carers should wash and dry and apply Medihoney on each visit and the carer is telling her what creams to use rather than following the care plan.” The lack of consistency and adherence to professional advice may have hindered people’s recovery.

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

Our review of people’s records and discussions with staff confirmed a lack of clear risk assessment, care planning and risk monitoring. The provider could not have effective oversight of people’s needs and wishes, and staff did not have reliable information or guidance to refer to. Whilst people had recently been asked for feedback on their support, there had been a significant lapse in both seeking and effectively recording feedback to ensure appropriate changes in people’s support were made.

The provider did not tell people about their rights around consent or respect these when delivering care and treatment. The records in place did not demonstrate the provider was working in line with the principles of the Mental Capacity Act 2005. Where people had a diagnosed impairment to the mind or brain at the time a decision was made, mental capacity assessments and, if appropriate best interest decisions, had not routinely been completed. In some cases, the specific decision being considered was unclear. Furthermore, guidance had been taken from family members without evidence this was the person’s express wish or documentation to demonstrate they held the appropriate legal authority to do so.