Background to this inspection
Updated
11 May 2019
The inspection:
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
Inspection team:
The inspection was carried out by one inspector.
Service and service type:
Radcliffe Meadows is a 'care home'. People in care homes receive accommodation and nursing or personal care under one contractual agreement. Care Quality Commission (CQC) regulates both the care and the accommodation provided, both were looked at during the inspection. This home provides accommodation for up to 12 people, there were 11 people receiving a service at the time of the inspection. The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection:
The inspection was unannounced
.
What we did:
Before the inspection we reviewed information, we held about the service such as notifications. These are events which happened in the service that the provider is required to tell us about. We sought feedback from the local authority who monitor the care and support people receive. We used all this information to plan our inspection.
During the inspection we spoke with five people using the service and three relatives. We spoke with the manager, the clinical lead (the person responsible for managing nursing outcomes) and four staff. Following the inspection, we spoke with the fire officer from Warrington fire service and an advocate who visited the home regularly. We observed support being provided in the communal areas of the service. We reviewed a range of records about people's care and how the service was managed. This included two people's care records. We also looked at associated documents including risk assessments and a sample of medicine records. We looked at records of meetings, staff training records and the recruitment checks carried out for two members of staff. We looked at a recent quality assurance audit completed by the management team. Following the inspection, we asked the provider to send us evidence of completed work in relation to the fire risk assessment.
Updated
11 May 2019
About the service:
Radcliffe Meadows is a single storey building that provides accommodation and nursing care for up to twelve adults who have a learning / physical disability and /or mental health needs. Radcliffe Meadows was providing personal and nursing care to 11 adults at the time of the inspection. This home is larger than current best practice guidance and did not fit with the guidance contained in the Registering Right Support review document. The home was clearly identifiable as a care home with large signage at the top of the road and outside the premises, four large industrial size bins were visible at the front of the property. However, staff were not required to wear uniforms so there was no suggestion they were care staff as they were coming and going from the property.
People’s experience of using this service:
People told us that they liked living in Radcliffe Meadows and many of people had lived there many years. People were complimentary about the staff who cared for them. Relatives told us that they were satisfied with the care their loved ones received.
However, we found some areas of concern.
Improvements were needed to the environment, which have proved difficult to implement by the provider. In part due to a covenant on the property and the materials used in the original construction of the building.
There were sufficient staff to meet people’s needs. There was a high dependency on agency staff. This could mean people are unfamiliar with the staff working with them. Improvements were needed to recruit permanent staff. Agency staff were not always appropriately trained in fire evacuation procedures, which could put themselves and others at risk.
Ineffective systems were in place for people to raise complaints and concerns and for the service to consult people living in the home, family and stakeholder, including staff.
Risks were identified and managed to minimise harm. Appropriate recruitment checks were carried out to ensure staff were suitable to work in the care environment. Medicines were managed safely by trained staff in the home. However, there was insufficient overview and effective monitoring of the service.
The home complied with the principals of Mental Capacity Act 2005 (MCA), measures were in place to ensure consent to care and treatment. People were well cared for by staff who treated them with respect and dignity.
You can see what action we told the provider to take at the back of the full version of the report.
Rating at last inspection:
The rating was good at the inspection dated 17 May 2016.
Why we inspected:
This inspection was scheduled/planned inspection in accordance with our inspection schedule. The rating is now Requires Improvement.
Follow up:
We will continue to monitor any intelligence we receive about the service until we return to visit as per our inspection schedule. If any concerning information is received we may inspect sooner.