Archived: Radis Community Care (Laburnum House ECH)

Laburnum House 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 37 flats, or in one of 14 bungalows. The main building also houses the offices used by the registered manager and staff. Not everyone living at Laburnum House 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 17 people received personal care from Radis staff.

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

People and their relatives commented positively about the management and staff and told us they received care and support in line with their preferences and needs. We received some mixed feedback about the service from one external professional. We asked senior management for a response to the feedback and received assurances.

Systems were in place to protect people from abuse and 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. 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.

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.

There was an ongoing system of audits to monitor the quality and safety of the service and a plan for continuous improvement. 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 requires improvement (published 27 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 is now good.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Radis Community Care (Laburnum House 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.

Laburnum House 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.

The service management and leadership had been inconsistent; however, the registered manager and the new area manager were working to promote an open and inclusive culture and were taking actions to improve the service where needed. Staff were being supervised and felt supported by the management team.

Since the last inspection, while some improvements had been made, training records were still incomplete. The registered manager and area manager were working with the provider’s training department to make improvements.

Staff we spoke with were aware of their responsibilities in relation to safeguarding and said they would feel confident raising any concerns. The registered manager had notified us of safeguarding concerns they had received and had taken appropriate actions in response.

Staffing levels were determined by the number of people receiving care and support and their needs. Staff were now receiving medicines competency checks, following medicines awareness training. The registered manager was working on updating these records. Assessments were undertaken to assess any risks to people and to the care workers who supported them and how risks were minimised or prevented.

People, and their relatives or other representatives if appropriate, were involved in the assessment of their needs and the planning of their care and support. Where people required support in relation to food and drink this was recorded within their care plans. Staff worked with other agencies and supported people to access healthcare services if required.

The feedback we received from people indicated they were happy with the overall care and support being provided. The registered manager and staff treated people with kindness and empathy and knew them well. People told us their privacy, dignity and independence were respected by staff.

People’s feedback indicated the service was usually responsive to their needs and staff arrived at the agreed times. Support plans contained details of people's agreed care schedules, their routines and preferences. Staff demonstrated understanding of how individuals communicated their needs, likes and dislikes.

The provider had a complaints policy and procedure. People felt comfortable to raise any concerns with the staff and management and felt they were listened to.

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 March 2019) and there was one breach of regulation. The provider did not complete 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 the regulation. The regulation was now being met but improvements will need to be embedded in practice to ensure they are sustained.

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.

At the time of our inspection the service was providing a service for 23 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:

People using the service told us they felt safe. Staff contacted healthcare professionals when they had concerns about people’s health and wellbeing.

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

There were systems in place to monitor the quality and safety of the service provided, however these were not always effective.

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.

Medication administration records (MAR) confirmed people had received their medicines as prescribed. However, 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.

There were plans in place for foreseeable emergencies. However, not all risks were in place to keep people safe and accidents and incidents were not monitored or analysed to identify and reduce the risk of reoccurrence.

People were supported with their nutritional needs when required. People received varied meals including a choice of fresh food and drinks. Staff were aware of people’s likes and dislikes.

Radis Community Care (Laburnum House ECH) met the characteristics of Good in some areas and of Requires Improvement in others. Overall, we have rated the service as Required Improvement.

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

More information is in the full report below.

Rating at last inspection: This was the first inspection of Laburnum House since the new provider took over the running of the service on 28 June 2017.

Why we inspected: This was a planned inspection.

Follow up: We have rated this service as Requires Improvement and have requested an improvement action plan that will be reviewed to ensure that improvements have been made.

We will follow up on this inspection as per our re-inspection programme, and through ongoing monitoring of information received about the service.