Archived: Radis Community Care (Tamworth)

Radis community Care Tamworth provides personal care and support to older people, people living with a learning disability, including some with physical disabilities.

People’s experience of using this service:

People told us they felt safe and were supported by staff who had been recruited safely and had the knowledge and skills to provide effective support. Staff knew how to report concerns relating to people’s safety. Risks were assessed and managed to reduce the risk of avoidable harm. People received support to take their medicines safely. People received timely support by a consistent staff team.

People were supported by staff who promoted choices in a way that people understood and had control and choice over their lives. Staff received training relevant to their role and understood people’s individual needs well.

People were supported by a staff team who understood their needs and preferences. People, and those close to them, were involving in the assessment and planning of their care. People knew how to raise a concern if they were unhappy about the service they received, and systems were in place to action and respond to any concerns.

People, relatives and staff felt the service was well managed. The registered manager and provider had made improvements since the last inspection. People and staff were given opportunities to share their views about the service. The registered manager and provider carried out regular auditing to ensure the quality of care provided and to ensure people received their care when they needed it.

Rating at last inspection: The service was last inspected on 19 March 2018 and rated Requires Improvement overall (report published 19 May 2018) With a breach of Regulation 17. 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 was a planned inspection based on the rating from our last inspection.

Enforcement: No enforcement action was required.

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

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

The provider was given seven working days’ notice of our inspection to arrange and seek people’s permission for us to telephone people on 12, 13 and 14 March 2018 and to visit some people in their home on 19 March. We visited the provider’s office on the 22 March and 11 April 2018. At the time of our inspection there were 128 people receiving this service.

There was a registered manager for the service. 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 personal have legal responsibility for meeting the requirements of the Health and Social Care Act 2008 and associated Regulations about how the service is run.

At our last inspection in February 2017, we rated the service as requires improvement because systems were not in place to ensure people received their medicines when they needed these; the staff had not always taken action to ensure any safeguarding investigation could take place and people did not always receive their support at the time they expected and for the agreed length of time. People also had mixed views about how caring the staff were and decisions were made, that may not be in their best interests. People were not always confident that they would be listened to and improvements would be made and quality monitoring systems had not always been effective. Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the service provided to at least good.

At this inspection, we saw further improvements were still required. This was because people did not always receive their care at the right time and for the right length of time. The quality monitoring systems had not ensured that improvements were made in this area. Information was not always available in an accessible format. People were asked for their views about the service but the feedback had not been developed to ensure this was in a suitable format. This is the third consecutive time the service has been rated ‘Requires Improvement’.

Providers should be aiming to achieve and sustain a rating of ‘Good’ or ‘Outstanding’. Good care is the minimum that people receiving services should expect and deserve to receive and we found systems in place to ensure improvements were made and sustained were not effective.

People were protected from abuse because staff now understood what action to take if they were concerned someone was being abused or mistreated. Risks associated with people's care and living environment were effectively managed to promote their safety. People were helped to take their medicines and this was recorded. There were suitable numbers of staff employed and recruitment checks were carried out to ensure new staff were suitable to work with people.

Staff received training and support to enable them to fulfil their role and they were encouraged to develop their skills. People retained responsibility for their health care and staff supported them, where needed, to access healthcare services.

We found people were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. People made decisions about their care and staff knew how to respond if people no longer had capacity to make some specific decisions. People were actively involved in making choices and decisions about how they wanted to live their lives.

People retained their independence and staff respected this. People were helped to prepare meals and staff took an interest in what they ate, to ensure their welfare. Staff developed caring relationships with the people they supported which were respectful and staff were kind and patient. People’s privacy and dignity was maintained and people felt comfortable with staff.

People felt confident that any concerns they raised with the registered manager would be resolved. The registered manager was approachable and provided support to the staff team.

We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.

At our last inspection in November 2015, we identified concerns with how incidents and accidents were monitored to lower the risks and ensure that people were protected from further occurrences. Improvements were needed to ensure that the records were completed after medicines had been administered and care plans needed to include information about people’s preferences. On this inspection we found that further improvements were needed.

The service provides care and domiciliary support for older people and people with a learning disability who live in their own home in and around Tamworth. At the time of the inspection 160 people were receiving a service.

There was a registered manager in the service. 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 2008 and associated Regulations about how the service is run.

Some people needed support to take their medicines. Where medicines were administered, systems were not in place to ensure people received them when needed.

People were not always protected from the risks of abuse. The staff knew how to recognise the signs of abuse and would report their concerns, although action had not always been taken to ensure any investigation could take place and protect people from potential future harm.

People did not always receive their support at the time they expected and for the agreed length of time. People had mixed views about how caring the staff were as some people felt rushed. This information was shared with commissioners of the service.

Where people needed support to help them make a decision, assessments had not been completed to ensure the right people helped them to make decisions in their best interests. People knew how to make a complaint or raise a concern if they needed to. People were not always confident that they would be listened to and improvements would be made. There were processes to monitor the quality of the service provided although these systems had not identified these concerns and action had not been taken to make improvements.

People received care and support from staff who were trained and knew how people liked things done. Where risks had been identified, staff knew how to provide support to keep people safe. Systems were in place to ensure that newly recruited staff were suitable to work with people who used the service.

Staff received supervision and had opportunities to develop their skills to meet people’s needs. New staff were supported through their induction and given opportunities to meet people before they provided any support. People received care that was individualised to their personal preferences and needs. The provider was flexible and responsive to changes for support times.

People were supported to express their views about the service within quality monitoring calls and through a survey. People were provided with information about how the provider had responded.

We found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.

The people we contacted were positive about the service. They told us the carers were kind and reliable. They mostly arrived on time and when they could not, the office would alert them. People said they got the service they needed, delivered in the way they wanted.

People had given informed consent to their care. Care plans were detailed and personalised. Care workers told us they were well supported by senior staff.

There had been a number of medication errors made by Radis staff earlier in 2013. We were satisfied that the managers had put strategies in place to reduce the risk of mistakes occurring in the future. The provider had systems in place to ensure the service met people's needs.

In this report the name of a registered manager appears. They were not in post and not managing the regulatory activities at the time of the inspection. Their name appears because they were still a Registered Manager on our register at the time of the inspection.