Radiant care services LTD

Radiant care services LTD is a homecare agency providing personal care to people of different ages who live with physical and health related support needs. The agency also supports those living with dementia. At the time of our inspection there were 81 people using the service.

Not everyone who used 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.

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

People did not always receive support as planned as there was ineffective oversight of staff rosters and staff attendance on the care visits. Although staff knew people’s needs, there was a lack of structured individual approach to risk management and care needs assessments which posed a risk to people of not receiving the care they needed consistently and safely.

Staff recruitment checks were not always in place. The provider’s governance systems and continuous improvement plans were not always effectively identifying and addressing shortfalls which posed a risk to people.

People told us they felt safe with staff and staff were caring and kind. Staff knew how to protect people from the risk of infections. People, their representatives and staff felt the culture of the service was positive, person-centred and engaging. The provider worked well with other professionals.

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 requires improvement (published 23 March 2022). 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 the provider remained 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

We received concerns in relation to staff attendance at care visits and how risks to people were managed. As a result, we undertook a focused inspection to review the key questions of Safe and Well-led only.

We carried out an announced comprehensive inspection of this service on 22 April 2021 and an announced focused inspection on 08 February 2022. A breach of legal requirements was found on 08 February 2022. The provider completed an action plan after the last inspection to show what they would do and by when to improve governance of the service.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.

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 remained requires improvement. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Radiant care services LTD on our website at www.cqc.org.uk.

Enforcement

We have identified breaches in relation to safe care and treatment, management of medicines, staffing, fit and proper persons employed and good governance.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Radiant care services LTD is a domiciliary care agency based in Redhill, providing support with personal care to people in their own homes and flats. At the time of our inspection there were 60 people using the service. People had physical support needs, some of them also lived with dementia.

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

The registered manager had a very hands-on approach to overseeing the care provided to people. However, the service grew significantly in the recent year and the governance systems did not always support them to have an effective oversight. Hence, not all quality and safety improvement needs around people’s and staff records and processes in the service were identified and addressed.

The registered manager ensured appropriate action was taken to address people’s individual risks and to provide them with support when their needs had changed. However, people’s care records did not always reflect those changes.

Where people required support to take their medicines, staff supporting them were trained in medicines and their practice was checked by management during spot check visits. Staff also received induction when they first started and the registered manager ensured they were competent for their roles before supporting people on their own.

There were enough staff to support people and the registered manager supported staff hands-on which minimised risks to people who had consistent support allocated. Staff told us they felt supported in their roles and people and their relatives found staff competent and kind.

People felt safe with staff who knew how to recognise and report any concerns, including concerns around their health, wellbeing, risk of abuse or neglect.

People, their relatives and staff commented that the service had a positive culture and management were approachable and acted on their feedback to improve 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 25 May 2021)

Why we inspected

The inspection was prompted in part due to concerns received about risk management and safety of people’s care. A decision was made for us to inspect and examine those risks.

We have found evidence that the provider needs to make improvements. However, we found no evidence during this inspection that people were at immediate risk of harm from these concerns. Please see the Safe and Well-Led sections of this full 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 Radiant care services LTD 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 a breach in relation to good governance at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Radiant Care Service Ltd is a domiciliary care agency providing personal care to people in their own homes in Redhill and Epsom area. The service supported 32 people at the time of the inspection, most of whom lived with physical support needs and/or dementia.

Not everyone who used 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.

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

People told us they felt safe with staff who knew how to protect them from abuse, neglect and what support they required to minimise individual risks around their care. The registered manager closely monitored people’s care visits and ensured they were provided timely and as planned.

People received safe support with their day to day needs, medicines and eating and drinking if required. Staff supported people to access healthcare services and were competent for their roles. Staff felt supported by the registered manager to provide people with safe and quality care.

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 received personalised care provided by staff who knew them well, and treated them kindly and with respect. People and their relatives were involved in their care, felt listened to and encouraged to be as independent as possible.

The registered manager had a good oversight of the quality and safety of the service and was said to be a compassionate and caring leader. The management team continuously improved the service, acting on people’s feedback and effectively working in partnership with other professionals which achieved good outcomes for people.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

This service was registered with us on 14 August 2019 and this was its first inspection.

Why we inspected

This was a planned inspection based on the length the service was operational since its registration.

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.