Radis Community Care (Diamond Court) Also known as Diamond Court Extra Care

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. This is the first assessment for the service. This key question has been rated requires improvement. This meant some aspects of the service were not always safe and there was limited assurance about safety. We found improvements were needed to ensure people’s care plans contained important care planning information around their diabetes care, catheter care and skin care. The service was in breach of legal regulation in relation to safe care and treatment.

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.

The provider was not always able to demonstrate a positive culture where they demonstrated incidents and accidents were investigated and safety events were reported. For example, we found staff had reported 2 incidents for a person where they had identified concerns with the person having skin wounds. It was not clear from the incident documentation what action had been taken and if referrals or advice had been sought to prevent a recurrence for happening. The provider’s incident analysis had no specific information of these incidents or if they had been reviewed. The registered manager confirmed the person was being visited by the district nursing team who were reviewing the person’s skin wounds. Although the person was being supported by visits from the district nursing team, they confirmed no referrals had been raised with the safeguarding team and no notification had been raised with the Care Quality Commission (CQC) either. We were therefore not assured there was a robust system where incidents and accidents were reviewed, along with ensuring any lessons learnt were undertaken and referrals and notifications made as required.

The registered manager and staff supported people with routine appointments although we found some improvements were needed to support people following them calling for assistance. For example, a relative raised with us where they felt staff had not adequately responded when the person had requested assistance through their emergency pendent alarm. We reviewed what first aid training staff had received along with other training provided to staff in the event of someone falling and needing assistance to get up. The provider’s training records confirmed staff had received refresher training in first aid although some staff had not received training in using equipment to assist someone following a fall. We raised this with the registered manager following our inspection so actions could be taken. Although we found some improvements to how staff responded to incidents the registered manager and staff liaised with healthcare partners to establish and maintain a safe system of care for people. They made sure people were supported by staff who knew them well and staff were available within the building to support people if needed. People were supported by staff to access routine health care support such as district nursing visits and referrals to a health care professional if needed. Staff told us they sought medical advice in the event of an emergency situation and people could request assistance through using their emergency pendent alarm.

The registered manager worked with people and healthcare partners to ensure people received good care. Although some improvements were needed to ensure actions were taken quickly and appropriately by the provider when concerns were raised. For example, we found 2 incidents where safeguarding referrals had not been made to the local authority safeguarding team as required. No notifications had been made to the CQC either. We raised this with the registered manager so actions could be taken.

The registered manager had a quality assurance system they used to monitor concerns along with any investigation including their outcome. Senior managers undertook regular reviews of any concerns raised along with if all actions were taken as required. Although the service had these systems, they had not been effective to ensure all actions were taken as required.

Staff were provided training in safeguarding adults, and they had a good understanding of who to raise concerns with should the need arise.

All people at the time of the inspection, were able to make decisions about their care and support this was documented in their care plans. All staff we spoke with told us they give people choice about how they would like their care and support. One member of staff told us, “We always ask people what support they would like, people get a choice.”

The registered manager and staff knew people and how to support them with their individual needs and risks. Although we found shortfalls in people’s care plans as there was a lack of guidance and information for staff on how to support the person safely with their diabetes care, catheter care and skin care as well as any associated risks.

For example, we found 1 person’s care plan had no guidance for staff on the risks to their skin care routine. There had been 2 recent incidents reported by staff where they had found the person with wounds/sores to their skin. The person’s care plan also had no guidance on how the persons diabetes care was being managed including what was normal for their diabetes care and what staff might need to do if they found them unwell with their diabetes. Another person’s care plan needed information on their catheter care routine, cleaning and any other associated information in how to manage their catheter care safely. We raised this with the registered manager so they could review these people’s care plans and complete any risk assessments needed.

Where people needed support with certain aspects of their care, such as medicines or mobility, information was within a risk assessment providing staff with what equipment to use and how to use it. People’s care plans contained information about how staff needed to support the person with their care visit such as if this included personal care support, medicines support or assistance and support with their a meal.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. Care plans were comprehensive and detailed important information such as what equipment people used along with any emergency and professionals contact details. People were supported by staff who were available within the building 24 hours a day. They could use their pendant alarm in the event of an emergency.

The provider made sure there were enough staff to support people and staff felt supported through supervisions. Staff completed a set of minimum training standards through the Care Certificate. They had also been provided training in autism, mental health, Parkinson’s disease, diabetes, epilepsy, infection control, first aid and the management of medicines. Although some staff needed training in how to safely use equipment should someone need assistance following a fall. Staff felt supported by the management of the service who were always available via an on call system during out of hours and they had access to regular supervisions. Competency checks were completed to ensure staff were providing medicines safely and how they were undertaking their role and responsibilities. The provider ensured staff had suitable checks to ensure they were suitable to work with vulnerable people undertaken before working in the service. This included identification checks, Disclosure and Barring Service Checks (DBS) and previous employment references.

People told us they were happy with the support provided by staff. Comments included, “I’m happy with the care” and staff are, “Very nice.” Although people felt happy with their care and support, 1 person raised with us the timing of their visit from staff could be inconsistent. This had resulted in them cancelling their visit. They were happy for us to share this with the registered manager so they could review the feedback provided.

The provider assessed and managed the risk of infection ensuring staff had access to personal protective equipment (PPE). Staff had a good understanding of when to wear their personal protective equipment (PPE) and people confirmed staff wore PPE. Comments included, “Staff wear aprons and gloves.”

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. People received their medicines safely from staff who had received training in the safe administration of medicines. People’s care plans contained medicines risk assessments and important information such as what topical creams the person had and where these were applied and how often. Daily medicines administration charts were completed by staff and any shortfalls were identified by the electronic system of medicines not administered. The quality of the completion of medicines administration charts were reviewed at the end of each month by senior staff. This ensured there was an opportunity to identify any improvement needed along with any learning.