Archived: Radiant Care Home

Updated 9 February 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

We inspected the home on 17 and 24 August 2017. The inspection was unannounced and the date of this was brought forward in response to concerns we had received. The inspection team consisted of two inspectors, a pharmacist specialist who is a member of our medicines team and an expert-by-experience. The expert-by-experience had personal experience of caring for someone who used this type of service.

Prior to our inspection visit we reviewed information we held about the service. This included previous inspection reports, information received from the provider and statutory notifications. A notification is information about important events which the provider is required to send us by law. We sought feedback from health and social care professionals who have been involved in the home and commissioners who fund the care for some people who use the service. The Local Authority shared information of concern with us.

During our visits we spoke with six people who lived at the home and two visiting relatives to understand their views of the service.

We also spoke with three members of staff, the deputy manager and the registered provider, who was also the registered manager. We looked at three people’s care records, nine people’s medicines records, staff training records, and a range of records relating to the running of the home including audits carried out by the registered provider.

Updated 9 February 2018

We inspected this home on 17 and 24 August 2017 and this inspection was unannounced. The provider had been directly involved in two substantiated safeguarding concerns as people did not always receive appropriate safe care and treatment when they needed it and medicines were not managed safely. We brought this inspection visit forward in response to those concerns.

The home is situated in the Bulwell area of Nottingham and offers accommodation for to up to 18 people who require personal care. On the day of our inspection, 13 people lived at the home, some of whom lived with dementia.

The home was last inspected on 10 January 2017 and was rated ‘requires improvement’ overall. We found two breaches of the regulations in relation to how people’s consent was sought and how the home was run. Since the previous inspection, we received information of concern from the local authority safeguarding team regarding the management of risks to people. We undertook this inspection to check whether improvements had been made since our previous visit, and to check the concerns raised by the local authority. We found some little improvement had been made and there were still some significant improvement required.

The overall rating for this service is 'Inadequate' and the service is therefore in 'special measures'.

Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the provider's registration of the service, will be inspected again within six months. The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe. If not enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve.

This service will continue to be kept under review and, if needed, could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement so there is still a rating of inadequate for any key question or overall, we will take action to prevent the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration.

For adult social care services the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.

There was a registered manager in place at the time of our inspection who was also the registered provider. 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.

The provider’s governance arrangements were not effective in monitoring, assessing and improving the service for people who lived at the home to ensure they received safe, compassionate and high quality care. Where their systems had identified shortfalls in provision, these had often not been acted on, or not acted on in a timely way. Improvements made had often not been sustained and the provider has been in breach of the regulations in five of the six inspections we have undertaken at this home.

The provider did not always notify us of events they were legally obligated to do, therefore we were not always able to monitor the service provided at the home.

People were not protected from risks associated with the premises and equipment. Since our last visit the fire service found the provider had not kept the premises safe from the risk of fire and had required action from the provider to improve fire safety. Shortly following our inspection visit the fire service found that sufficient action had not been taken and people were placed at potential risk. We continued to have concerns about the provider’s response to the risks of legionella in the home.

People were not supported by enough staff to ensure they received care and support when they needed it.

People, who were able to, were supported to make decisions, however the provider did not follow the Mental Capacity Act principles when people's decision making ability was in doubt.

People were supported to maintain their nutrition and staff monitored and responded to people’s health conditions; however this was not always recorded in people's care plans. People were supported by individual staff members who had the knowledge and skills to provide safe and appropriate care and support.

People told us they lived in a home where they felt staff listened to them and knew how to complain if they were unhappy however the provider did not always take action when concerns were raised.

People’s emotional needs were recognised and responded to. People were supported to enjoy activities. However activities for people who lived with dementia required improvement.

People's privacy was not always promoted by staff, as some staff did not knock on people's bedroom doors or seek permission before entering. However people felt staff treated them with respect.

People were supported to maintain relationships with people that were important to them. Visitors were made to feel welcomed and there were no restrictions on visiting times.

The provider had displayed the rating of our last inspection within the home for people and visitors to see. They had also displayed their rating on their website.

We found five breaches in the legal requirements and regulations associated with the Health and Social Care Act 2008. (Regulated Activities) Regulations 2014 and one breach in relation to the Registration Regulations.