Archived: Radis Community Care (Fernhill Court ECH)

Fernhill 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 27 flats. The building also houses the offices used by the registered manager and staff. Not everyone living at Fernhill 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 told us they received care and support in line with their preferences and needs.

Systems were in place to protect people from abuse. Procedures were in place for the prevention and control of infection.

People and their relatives confirmed there were sufficient staff on duty to meet their needs and preferences. Staffing levels were determined by the number of people who were in receipt of personal care and their needs. The majority of people living at Fernhill court received support with the medicines only.

There was a system in place to ensure the safe management of people’s medicines and people confirmed they received their medicines in the way they preferred.

There was an ongoing system of audits to monitor the quality and safety of the service. The manager had an ongoing improvement plan to work to but it was not always clear what action had been taken in response to feedback.

The service had been working in partnership with the local authority and with the housing association on improving 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

The last rating for this service was good (published 21 May 2020)

Why we inspected

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

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 remains good.

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

Follow up

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

Fernhill court provides personal 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 services.

Not everyone using 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. At the time of our inspection the service was providing personal care for 20 older people with a variety of care needs, including people living with physical frailty or memory loss due to the progression of age.

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

At this inspection we found the provider and registered manager had made 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.

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. People’s comments included: “The staff are all good”, “You can’t fault the carers” and “The team leader and (registered manager) do a fantastic job.”

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. A system was in place to track and record relevant checks for staff employed to work in the service. The registered manager was continuing to work on updating records for staff who had transferred from the provider’s other services.

Improvements were continuing to be made to the 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.

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.

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 13 February 2019) and there were multiple breaches of regulation. We requested an action plan from the provider after the last inspection to show what they would do and by when to improve. We did not receive the action plan.

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 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.

Fernhill court provides personal 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 services.

Not everyone using Fernhill Court receives regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; such as help related to personal hygiene and eating. Where they do we also take into account any wider social care provided. At the time of our inspection the service was providing a service for 20 older people with a variety of care needs, including people living with physical frailty or memory loss due to the progression of age.

A registered manager was not in post at the time of our inspection. 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. A new manager had started with the service and will be applying to register with the commission. We refer to them as the ‘manager’ throughout the report.

People’s Medication Administration Records (MARs) were not always recorded appropriately and not all staff had been assessed as competent to administer medicines. There were no guidelines in place to support staff with the administration of ‘when required’ (PRN) medicines.

People felt staffing levels were not always consistent but felt it had improved recently. Relevant recruitment checks were conducted before staff started working at the service to make sure staff were of good character and had the necessary skills. However, there were unexplained gaps in staff employment histories.

Most people we spoke with felt staff had the skills and qualities and skills to deliver effective care. However, staff did not feel supported. Records showed one to one supervisions had fallen behind and training was not always in place to support staff.

People did not always feel listened to and felt that complaints were not dealt with effectively. People felt the service was not well led and raised concerns with us. The provider did not complete required documentation when requested.

Care plans showed some records needed to be updated and we could not see if records had been reviewed with people to ensure they were delivering person centred care.

People using the service and their relatives told us they felt safe. Staff understood and followed guidance to enable them to recognise and address any safeguarding concerns about people.

People were treated with kindness and compassion. Staff were able to identify and discuss the importance of maintaining people’s respect and privacy at all times.

People were supported with their nutritional needs when required. Heath professional were contacted were involved with peoples care when required.

During our inspection we found five breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.