Archived: Radis Community Care (Surrey Court ECH)

About the service

Surrey Court provides care and support to people living in ‘extra care’ housing. People using the service live in their own flats within a shared building containing 70 flats. The building also houses the offices used by the registered manager and staff.

Not everyone living at Surrey Court 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. At the time of this inspection 31 people received personal care from Radis staff.

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

Relevant recruitment checks were not always safe. For three staff members application forms were not fully completed which meant the service could not check the staff members employment history to make sure they were of good character and had the necessary skills.

Systems were in place to protect people from abuse. However, we received concerns that these were not always taken seriously. Staff we spoke to were not always aware of how to identify, prevent and report abuse. Sufficient staff were deployed to meet people’s needs. However, the service was using a high amount of agency staff and people felt they didn’t always meet their needs.

Medicines were not always managed safely. We found the lack of record keeping meant medicines were not always managed safely.

Governance systems were not always effective in promoting a person-centred culture. People and staff had felt unsupported due to the lack of management at the service and didn’t always feel listened to. A new manager had recently started and were working alongside management to ensure improvements were in place.

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.

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 good (published 06 August 2021).

Why we inspected

The inspection was prompted in part due to concerns received about safeguarding concerns. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

We have found evidence that the provider needs to make improvements. Please see the safe and well led sections of this report.

You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Radis Community Care (Surrey Court ECH on our website at www.cqc.org.uk.

Enforcement and Recommendations

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to risks to medicines, staff recruitment practices and good governance at this inspection.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Surrey Court provides care and support to people living in ‘extra care’ housing. People using the service live in their own flats within a shared building containing 70 flats. The building also houses the offices used by the registered manager and staff.

Not everyone living at Surrey Court 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. At the time of this inspection 22 people received personal care from Radis staff.

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

People using the service told us they felt safe. Staff had received training in safeguarding adults and knew how to identify, prevent and report abuse.

Risks relating to people’s health and welfare were assessed and these were recorded along with actions identified to reduce those risks.

Relevant recruitment checks were conducted before staff started working at the service to make sure they were of good character and had the necessary skills. Sufficient staff were deployed to meet people’s needs.

Medicines administration records (MAR) confirmed people had received their medicines as prescribed.

Staff received support and one to one sessions or supervision to discuss areas of development. They completed training and felt it supported them in their job role.

People were supported to maintain their health and staff contacted healthcare professionals when they had concerns about people’s health and wellbeing.

Where people required support in relation to preparing food and drink this was recorded within their care plans and people could use the on-site restaurant or staff could support them in their home.

The provider’s quality assurance system helped the management team implement improvements that would benefit people.

There were appropriate management arrangements in place and relatives and professionals were very positive about the management of the service.

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.

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 (published 22 November 2019).

Why we inspected

This was a planned inspection based on the previous rating.

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.

Surrey Court provides care and support to people living in ‘extra care’ housing. People using the service live in their own flats within a shared building containing 70 flats. The building also houses the offices used by the registered manager and staff.

Not everyone living at Surrey Court 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. At the time of this inspection, 40 people received personal care from Radis staff.

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

At this inspection we found the provider and registered manager had made substantial improvements to the service. They were compliant with the fundamental standards set out by law although further actions were required to embed good working practices in the service.

People told us they had noticed positive changes in the service and told us they felt confident to raise any concerns with the registered manager. The new area manager was supporting the registered manager in promoting an open and inclusive culture within the service.

Several people told us they were concerned about the future and an increase in admissions of people with higher needs. The service was working with partner agencies to clarify and improve assessment and admission procedures.

People using the service told us they felt safe. Risks relating to people’s health and welfare were assessed and these were recorded along with actions identified to reduce those risks.

People were supported to maintain their health and staff contacted healthcare professionals when they had concerns about people’s health and wellbeing.

Improvements had been made in the way people’s medicines were managed and audits were carried out and recorded. There was a new facility for storing people’s medicines.

A system was in place to keep track of and record relevant checks that had been completed for staff who worked in the service.

There was an improved system for monitoring the training that staff received and further specific training was being sought that included dementia awareness.

Where people required support in relation to preparing food and drink this was recorded within their care plans.

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.

People were happy with the overall care and support being provided. We observed the registered manager and staff treated people with respect and this was confirmed by the feedback we received from people and their relatives.

The service was responsive to changes in people’s needs. Staff we spoke with demonstrated understanding of people’s needs.

A record of complaints received, and actions taken in response, was available. This was being reviewed by the provider, along with the systems for auditing the service.

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 (published 22 September 2018) and there were multiple breaches of regulation. 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.

The service remains rated requires improvement. This service has been rated requires improvement for the last two consecutive inspections.

Why we inspected

This was a planned inspection based on the previous rating.

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.

This service provides care and support to people living in specialist ‘extra care’ housing. Extra care housing is purpose-built or adapted single household accommodation in a shared site or building. The accommodation is bought or rented, and is the occupant’s own home. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for extra care housing; this inspection looked at people’s personal care and support service.

People using the service live in their own flats within a shared building containing 70 flats. The building also houses the offices used by the registered manager and staff.

Not everyone using Surrey Court ECH receives regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; such as help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

At the time of this inspection, 30 people received personal care and 22 other people received support checks from Radis staff.

The service has a registered manager. 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.

People expressed concern about staffing numbers not being sufficient and the effect this had on visit times and staff morale. This was also reflected in the feedback from staff. The care schedules did not always give time for staff to move from one flat to another between providing care, so people were not assured of receiving their full allocated care time.

The provider did not have robust procedures and processes to protect people using the service from abuse or improper treatment. Staff we spoke with knew how to report safeguarding concerns. However, not all staff had received training in safeguarding.

The proper and safe management of medicines was compromised by inadequate receipt & storage arrangements.

Feedback from the majority of people we spoke with indicated that care workers had the qualities and skills to deliver effective care. However, Staff did not all receive appropriate support and training to enable them to carry out their duties.

We received positive comments from people about the caring approach of staff. There were however also a number of comments indicating the service was not always operating in a way that treated people with respect and offered a person centred service. Staff did not feel well supported by the provider to deliver person-centred care.

The quality assurance system was not effective in identifying issues within the service. There had been a lack of effective oversight by, and feedback from, the provider. Audit trails were not complete. The culture within the service did not support the delivery of high quality care. People did not always feel listened to by the provider and that their concerns were responded to effectively. CQC was not always notified when required of incidents.

A system was in place to keep track of and record relevant checks that had been completed for staff who worked in the service.

People’s consent was sought to confirm they agreed with the care and support provided. The provider had policies and procedures for when people were not able to make decisions about their care or support.

Where people required support in relation to preparing food and drink this was recorded within their care plans.

People’s care records showed relevant health and social care professionals were involved with people’s care when required.

We found six breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and one breach of the Health and Social Care Act 2008 (Registration) Regulations 2009. You can see what action we told the provider to take at the back of the full version of the report.