Radis Community Care (Gloucester)

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

However, the service was in breach of legal regulation in relation to people’s lawful consent to care.

This service scored 62 (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 did not always make sure people’s care and treatment were effective because they did not always check and discuss people’s health, care, wellbeing and communication needs with them.

The service worked with people and their relatives and key health and social care professionals to ensure the service had the information they needed to support people safely. However, people’s individual communication needs were not always detailed in people’s care plans, this meant people’s preferences in how they wish to communicate may not be recognised by staff.

Effective assessment systems were used to ensure staff had the information they needed to support people in their own homes in an emergency for example if their primary caregiver was hospitalised. The registered manager explained and provided examples of how they collated the information they needed to support people in an emergency.

People's care needs were regularly reassessed or earlier if needed. However, it was not always clear from people's records when there had been a change in people's support requirements or a review of their support needs. This meant staff did not always have the information they needed to effectively support people.

People and their relatives told us they had been involved in discussions about their or their loved one’s needs and care when they first started receiving support. They were confident their individual needs had been appropriately assessed and were fully understood by staff. People told us they had access to their care plans. One person said, "Care Plan written and updated, tasks all completed, no complaints, I would go to the office, and they would put any worry right.”

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. However, they did not always follow legislation and current evidence-based good practice and standards. Good practices around the management of skin integrity and lawful consent to care were not fully embedded into staff practices.

The provider's representatives shared any updates or changes in legislation and guidance with the registered manager. The registered manager agreed to establish local health and social care connections to enable them to receive notifications about any changes or requirements in the local area.

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

People were supported by consistent and familiar staff who knew them well. There was evidence that referrals to specialist services were made when people needed additional support, for example with regards to skin integrity and referring people to the district nurse team. The provider and staff worked with other services to ensure continuity of care.

The registered manager provided examples of where they had supported people to receive consistent person-centred care when they moved between services. The registered manager had access to a clinical support team who could advise on any actions which needed to be taken, such as staff training to ensure people safely transferred into the service.

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

People and their relatives told us staff supported them to be independent and helped them with daily living tasks as needed. One person told us, the support from the service “Makes a difference” and helped them to remain independent in their own home.

People were supported and encouraged to live healthier lives and to seek support from health care professionals if there was a change in their health and wellbeing.

Records showed people who needed assistance with nutrition and hydration received suitable support, and snacks and drinks were provided for them between visits.

The provider did not always routinely monitor people’s care and treatment to continuously improve it. They did not always ensure that outcomes were positive and consistent, or that they met both clinical expectations and the expectations of people themselves.

People raised no concerns about the care they received. The provider had established systems to monitor and evaluate people's care and treatment with the aim of driving continuous improvement.

However, we found the recording of staff’s delivery of care was not always consistent. For example, the control measures needed to reduce risks to people such as regular repositioning of people to prevent skin breakdown or monitoring of people's bowel movements were not routinely recorded by staff.

The frequency of people's care reviews was not always determined by the person’s' needs or medical condition. For example, people with degenerative conditions which may have required more frequent reviews were not identified. This meant the registered manager could not be assured people were receiving effective care and support which reflected their current needs.

The provider had not always ensured people understood their rights around consent and taken action to ensure people's consent had been lawfully obtained. The provider had failed to ensure they had obtained lawful consent to provide care to people with cognitive impairments.

The registered manager and staff understood the importance of gaining consent prior to supporting people with personal care. However, we found shortfalls in the documentation used to evidence people living with a dementia or those people lawfully acting on their behalf, had given consent and care was being delivered in their best interest.

Staff and the registered manager had received training in the Mental Capacity Act 2005 (MCA) appropriate to their role. The registered manager and staff understood the importance of gaining consent prior to supporting people with personal care. However, we found shortfalls in the documentation used to evidence people living with a dementia or those people lawfully acting on their behalf, had given consent and care was being delivered in their best interest. This meant the registered manager had not fully embedded their training to lawfully gain consent from people with a cognitive impairment in line with the principles of the MCA and to carry out robust capacity assessments.

The provider's MCA policy was in place to guide staff on how to assess people’s capacity to make decisions in accordance with the legislation, however this had not been followed. Where required, there was minimal records that Lasting Power of Attorney (LPA) and resuscitation orders had been requested as part of people's assessments.

The registered manager explained they had identified short falls in the management of people's consent; however this had not been incorporated into the provider's service improvement plan or addressed through the provider’s audit processes.

People and relatives told us consent to care was always obtained by staff. One relative said, "Lovely bunch of carers, good English, caring and patient with him, he is a big bloke! [Staff] always treat him with dignity and respect, ask consent before personal care, he had an initial Care Plan when he came out of hospital.”