Archived: Radis Community Care (Stoke-on-Trent)

Radis Community Care (Stoke on Trent) is a Domiciliary Care Agency (DCA) registered to provide personal care. People were supported with their personal care needs to enable them to live in their own homes and promote their independence. At the time of the inspection the service supported 64 people with personal care.

Not everyone who used the service received 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.

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

People were protected from the risks of ill-treatment and abuse as staff had been trained to recognise potential signs of abuse and understood what to do to if they suspected wrong doing.

The provider had assessed the risks to people associated with their care and support. Staff members were knowledgeable about these risks and knew what to do to minimise the potential for harm.

When required, people received safe support with their medicines by staff members who had been trained and assessed as competent. Staff members followed effective infection prevention and control procedures when supporting people.

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

The provider supported staff in providing effective care for people through person-centred care planning, training and one-to-one supervision. People were supported to refer themselves to additional healthcare services, and staff supported them if required.

People received help and support from a kind and compassionate staff team with whom they had developed positive relationships. People were supported by staff members who were aware of their individual protected characteristics like age, religion, gender and disability.

People were provided with information in a way they could understand. The provider had systems in place to encourage and respond to any compliments or complaints from people or those close to them. The provider, and management team, had good links with the local communities within which people lived.

The management team and provider had systems in place to identify improvements and drive good care.

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.

The last rating for this service was requires improvement (24 February 2020) and there was a breach of regulation 17 (good governance). 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.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

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.

About the service

Radis Community Care (Stoke on Trent) is a Domiciliary Care Agency (DCA) registered to provide personal care. People are supported with their personal care needs to enable them to live in their own homes and promote their independence. At the time of the inspection the service supported 150 people with personal care in their own homes.

Not everyone who used the service received 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.

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

The service had a new manager who came in to post in December 2019 and were going through the registration process with the Care Quality Commission.

People’s care files were not always reviewed yearly to update their needs. Staff did not have up to date information to appropriately support people

The provider could not always evidence they had taken a full employment history of some staff to ensure safe recruitment.

People had experienced missed or late calls and staff did not always feel there was enough staff for scheduled calls and that they did not receive enough time between calls.

Where people were prescribed 'as required' (PRN) medicines, the provider did not always have protocols or guidance in place to ensure that staff knew when to administer PRN medicine.

Not all staff had completed their medication awareness annual refresher training. However, medicines administration records were accurately completed.

Staff had received some training; however, the provider had not ensured that care staff’s yearly refresher mandatory training, was up to date.

Relatives were signing consent on behalf of people without their legal authority being checked. Care files did not contain evidence of power of attorney.

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.

Complaints were managed in line with the providers policies and in a timely way.

People told us they were actively involved in the review of their care.

Care files contained evidence of communications with relevant professionals to meet people’s healthcare needs.

During our last inspection we identified systems were not in place or were not fully effective at always identifying improvements. On this inspection we found that people’s care plans had not been updated, and risk assessments had not been reviewed following an incident. The provider had audit systems in place, however, failed to establish effective systems for identifying improvements. There were no clear systems to identify any trends and oversee and improve the quality of the service where necessary.

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

Rating at last inspection

The last rating for this service was requires improvement (08 January 2019).

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified a breach of Regulation 17 HSCA RA Regulations 2014 Good governance of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The registered person had not established an effective system to enable them to assess, monitor and improve the quality and safety of the service provided.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We requested an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats. It provides a service to people with a physical or sensory disability, older adults, younger adults, those living with mental health issues or dementia or people who may have a learning disability. At the time of our inspection there were 217 people using the service.

There was a registered manager in place. 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 and associated Regulations about how the service is run.

People were not always protected from potential abuse and things were not always learnt when things went wrong as timely action was not always taken. Systems were not always in place to monitor trends in incidents and systems in place were not always effective at improving people’s experience of their care.

Notifications were not always submitted, as required by law.

Risks were not always assessed and planned for as details of risks to people and staff were not always detailed in people’s care plans. We could not be sure that people were always receiving their medicines safely as instructions were not always followed, or were not always available.

People were not always supported to have maximum choice and control of their lives; the policies and systems in the service did not support this practice. The principles of the Mental Capacity Act (MCA) 2005 were not always being followed.

Staff were recruited safely; however, there was mixed feedback about staffing levels and not all calls were on time, but action was taken to address this.

Staff received an induction and ongoing training, however this was not always effective or updated in a timely way. Staff also had mixed feedback about how supported they felt.

Staff followed infections control measures to help keep people healthy. People were also supported to have a diet of their choice and were supported to access other health professionals when necessary.

People and relatives felt staff were kind and caring and treated with dignity and respect when being supported. People were encouraged to be independent and could make choices about their care.

People were involved in developing their care plans and people and relatives were involved in reviews which contained personalised details about people’s routines.

People knew how to complain and felt able to. We saw complaints were investigated and responded to. People and relatives were able to feedback about their care and staff were able to attend meetings to discuss changes with the service. Staff felt the manager was approachable.

End of life care for people had been considered, although few people required this at the time of the inspection.

We have made one recommendation in the main body of the report to recommend steps are taken to ensure people with all protected characteristics are actively supported and protected, when necessary. We also identified two breaches of regulation and you can see the action that we have asked the provider to take at the end of this report.

We spoke to people who used the service who were happy with the care provided. One person told us, 'The carers are good they treat me well'. Another person told us, 'I can't fault the service I get'.

We found there had been some improvements in the way people's care was planned and delivered. Further improvements were required to ensure that people who used the service received care that was planned and delivered to protect their safety and welfare.

Staff we spoke with told us that they had received recent update training for medication and manual handling. The provider had made some improvements to the support and training that staff received, but further improvements were required to ensure that all staff were trained to the appropriate standards.

The provider had made some improvements to the systems in place to assess and monitor the quality of the service provided. These systems were still being implemented and further improvements were needed to ensure that these were effective and sustainable.

We saw that the provider had made improvements to their systems to notify us of allegations of abuse that had occurred to people who used the service.

We found that people were not consistently getting the care and support that they required. Some people told us they had experienced times when care staff had not turned up to provide their care. This resulted in people not receiving the medicines and food they required.

We saw there was a lack of staff training. This meant that many of the staff had not received the training required to enable them to care for people in a safe and appropriate manner.

We found that there were ineffective systems in place to manage the service. This meant the provider was not adequately assessing and monitoring the quality of the service and problems with quality were not being identified or addressed.

We found that the provider was still not notifying us of allegations of abuse that had occurred as a consequence of providing a service to people. This meant we were unaware of referrals and investigations that had been undertaken.