Archived: Radis Community Care (Leeds)

Radis Community Care (Leeds) is a domiciliary care agency which provides personal care to people living in their own homes and provides support to people to help them maintain their independence.

At the time of our inspection there was a registered manager in post. 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.

Although we concluded that medicines were managed well overall, PRN or ‘as required’ medicines were not managed in line with national guidance and the service’s own medicines policy.

We have made a recommendation around the management of some medicines.

There were enough staff to complete visits and meet people’s needs. Staff were recruited in a safe way, with appropriate background checks carried out. People told us they were satisfied that staff were able to make visits in a timely way. For example, we saw that 100% of planned visits were made and 88% of these were made within an acceptable time frame in November 2017.

Risks to people were assessed and mitigated appropriately. People told us they felt safe in the care of staff.

Staff were given an effective induction into the service and were well supported with frequent spot checks and competency assessments.

Staff were given an appropriate level of training and staff skills and knowledge was monitored and maintained through re-training.

People were supported to maintain their health by staff who provided encouragement to ensure they were eating and drinking enough.

People told us they were cared for by kind and compassionate staff who knew how to protect and promote their dignity and privacy.

Care plans were written in a person centred way and reviews of people’s support were carried out with them to make sure they were continuing to meet people’s needs effectively. People knew how to make a complaint and there was an effective complaints process in place.

Staff told us they were confident in the leadership of the service and that the registered manager was approachable and transparent.

The service monitored the quality of the service people received and the manager had good support from the provider to ensure continuous improvement of the service.

The service asked people’s opinions and feedback through surveys and quality calls to ensure they had a role in the continuous improvement of the service. Where issues were identified, they were acted upon by the registered manager.

Radis Community Care (Leeds) is a domiciliary care agency which provides personal care to people living in their own homes and provides assistance and support to people to help them maintain and improve their independence.

At the time of our inspection the service did not have a registered manager, although in March 2016 a branch manager had been recruited to the post and was in the process of becoming registered with the Care Quality Commission (CQC). A registered manager is a person who has registered with the CQC 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.

The inspection concluded the administration of medicines was not always safe as staff competency checks had not been carried out. Protocols for ‘as and when required’ (PRN) medicines were not in place and there were some gaps in the recording on medication administration records (MAR’s). However, a sample of daily notes showed people were receiving their medicines and staff had received medication training.

Staff were able to confidently describe how they would identify a person was being harmed and felt confident the management team would take appropriate action. They were aware of the registered provider’s whistleblowing policy and knew how to report abuse externally. Safeguarding notifications had been submitted by the branch manager to CQC and the local safeguarding authority.

Recruitment processes were effective which meant people were protected from individuals identified as not suitable to working with vulnerable adults. Risks to people had been identified, assessed and reviewed.

People received visits at expected times and when this was not possible they were kept informed of any delays. People were supported by regular staff members who were familiar with them and their needs. Positive feedback was given from people and relatives regarding the staff who provided their care and support. Staff knew how to protect people’s privacy and dignity and people confirmed this happened.

Staff received effective support through their induction, supervision sessions and ongoing training. A programme of appraisals had also commenced. Quarterly staff meetings were held and staff confirmed they were able to express their views. Staff liked the branch manager and there was a positive culture amongst the staff team.

Staff had received training in the Mental Capacity Act (2005) (MCA) and knew how this applied to their work. Staff told us about the importance of offering people choice and people confirmed this happened.

Appropriate guidance was in place to ensure people received enough to eat and drink. Staff were able to recognise and report when people’s healthcare needs changed. When this happened, referrals were made to healthcare services to ensure people received the necessary assistance. Examples of staff ensuring vulnerable people were protected from harm were evident.

Complaints were effectively managed and most people knew how to complain if they were dissatisfied. Quality management systems used by the registered provider did not always ensure appropriate checks were being made to improve service delivery. We found there was no record of the area manager’s visits to evidence their oversight of the service.

We spoke with 15 people who used the service and with two relatives. People told us they felt involved with their care. People told us the staff treated them with dignity and respect. Comments included:

“The staff are polite and really respectful.”

“They are absolutely marvellous and they really cheer me up.”

We asked three members of staff how they offered choices to people who were unable to communicate their preferences. Staff told us they showed people options, such as clothes and food choices. The staff we spoke with gave good examples of how they treated people with dignity and respect and how they involved people in their care.

We looked at a sample of four care records and saw each person had a care plan and risk assessment which covered their needs. We saw evidence to show that the care records were reviewed when required but as a minimum on an annual basis. These reviews helped in monitoring whether care records were up to date and reflected people’s current needs so that any necessary actions could be identified at an early stage.

Staff received regular supervisions and the provider had a system in place to ensure mandatory training was kept up to date.

The provider monitored the quality of the service by obtaining people’s views through telephone monitoring, annual service user questionnaire, spot checks and care record reviews.

People told us that staff were usually on time but on the rare occasion they were running late they were informed of this. One relative commented that staff at the office informed them if the carers were going to be late but sometimes the carer had arrived by then.

People told us they did not feel rushed by the carers, that the carers were aware of their needs and had enough time to meet those needs. One person said; “They know exactly what my needs are.” One relative told us; “They have quality time with my wife and make her laugh.” The five staff we spoke with told us there were enough staff to meet people's needs and that they had enough time to support people in the way they wished.

All the people we spoke with were aware of their care plan and told us they had agreed it. People said they can change things in their care plan if they wanted. Although people told us that their needs were being met and the staff we spoke with demonstrated a good understanding of the needs of the people they cared for, we found that this was not reflected within the care record documentation.