Radis Community Care (Woodland Court)

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm.

At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people were safe and protected from avoidable harm.

This service scored 63 (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 have a proactive and positive culture of safety based on openness and honesty. Staff did not always listen to concerns about safety and did not always investigate and report safety events. Lessons were not always learnt to continually identify and embed good practice.

Staff recorded accidents, incidents and falls, which were collated into a central document for management review. However, the review process focused on whether immediate actions had been taken in response to incidents and did not include analysis to identify trends or themes which might help in reducing incidents .

There was limited evidence of lessons learned or of learning being embedded into practice to reduce the risk of recurrence.
 

The provider did not always work well with people and healthcare partners to establish and maintain safe systems of care. They did not always manage or monitor people’s safety. They did not always make sure there was continuity of care, including when people moved between different services.

Pre-assessments were completed and used to inform care planning. Information was shared appropriately when people accessed external health services, such as hospital admissions.

However, communication with district nurses was not sufficient to promote continuity of care. Documentation of wound care and treatment was not consistently maintained, which presented a risk to continuity of care and meant staff may not always have clear guidance to safely manage wounds between visits.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately.

A safeguarding log was in place, and records showed appropriate safeguarding and referrals to the Care Quality Commission had been made where required. An audit process was also in place; however, its effectiveness in identifying improvements was limited. Despite this, there was no evidence that people were not protected from immediate harm, and appropriate action had been taken to keep people safe when concerns arose.

Staff had received training in safeguarding and were able to explain what actions they would take should they have any safeguarding concerns for people. People and relatives told us they felt safe in the service and felt staff were trained sufficiently to keep them safe.

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

Risk assessments were in place for most people and were up to date, reflecting their current needs. Staff demonstrated a good understanding of risks and were able to describe how they delivered care in line with these assessments. Additional guidance was available to staff in the form of condition-specific information held within the office. However, some risks were not consistently documented. For example, 1 person prescribed high-risk medication did not have an associated risk assessment or protocol in place. This was addressed promptly during the assessment, with appropriate guidance added and incorporated into the person’s care plan.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

People had personal emergency evacuation plans in place which were accessible to staff.
All staff had received appropriate training to manage fire safety and risks within people’s homes.
 

The provider did not always make sure there were enough qualified, skilled and experienced staff. They did not always work together well to provide safe care that met people’s individual needs.

There were enough staff to meet people’s needs, and feedback from people and relatives confirmed care calls were delivered as planned. People and relatives told us they received care from a consistent staff group. Relatives told us, “[Person] has the same carer every day, it’s ideal for [person],” and “[Person] has a regular carer to come and help wash and dress [person]. They know [person] really well.”

Staff had completed training relevant to most areas of their role. However, we were not assured all staff were up to date with key training at the time of assessment, including end of life care, catheter care and pressure area care, which were important to meet the current needs of peoples in the service. The training matrix provided to us did not capture the details of this training, so the provider had no record of staff compliance in these areas.

The provider took immediate action to book the relevant training courses for staff and prioritised their attendance.
 

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

Systems were in place to support infection prevention and control (IPC). Spot checks were carried out on staff which included an assessment of their compliance with personal protective equipment (PPE) and IPC practices. Staff had received the relevant IPC training and no one we spoke with reported any concerns with poor staff practices relating to PPE.

 

The provider did not always make sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff did not always involve people in planning.

Medicines records included relevant personal and allergy information. Topical medicines were managed appropriately using body maps and Topical Medication Administration Records, and protocols were in place for ‘as required’ medicines. There were no unexplained gaps in Medication Administration Records, indicating medicines were generally administered consistently as prescribed.

However, time-specific medicines were not always recorded accurately, meaning we could not be assured they were given in line with prescribing guidance. Immediate action was taken to address this, including the introduction of an early morning medicines call, and staff were instructed to record the exact time these medicines were administered.