Archived: Radis Community Care (Rowan Court ECH)

Rowan Court provides care and support to people living in ‘extra care’ housing. People using the service live in their own flats within a shared building containing 21 flats. The building also houses the offices used by the registered manager and staff. Not everyone living at Rowan Court 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. At the time of this inspection 12 people received personal care from Radis staff.

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

Staff recruitment records did not always demonstrate that thorough processes were followed when checking staff for suitability before being employed by the service. Staff training continued to be an issue with gaps in the training records for most staff and staff overdue for training.

Systems for monitoring and improving the quality and safety of the service were not always effective. A system of audits was in operation but there was a lack of evidence to demonstrate how this was used to monitor and improve the service.

There was mixed feedback from relatives about the effectiveness of raising concerns and getting feedback. This included about being able to contact the office when they needed to.

Improvements had been made to the systems for managing people’s medicines. However, annual refresher training was overdue for most staff.

Staffing levels were determined by the number of people receiving care and support and their needs. People and their relatives confirmed staff turned up on time, stayed the correct length of time, and did not rush people.

Systems were in place to protect people from abuse. Appropriate procedures were in place for the prevention and control of infection.

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. Care needs were delivered in line with their individual assessment and regularly reviewed. People were supported to access health care services.

People and their relatives confirmed staff knew people well, respected people’s daily routines and were flexible to meet people’s needs.

A new manager had recently started and were working alongside management to ensure improvements were in place.

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 4 July 2019) and there were breaches of regulation. 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 and the service remains rated requires improvement. This service has been rated requires improvement for the last two consecutive inspections.

Why we inspected

We carried out an unannounced comprehensive inspection of this service on 13 and 14 March 2019. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment, staffing, good governance, fit and proper persons employed, and notification of other incidents.

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, Effective 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 remains 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 Radis Community Care (Rowan Court ECH) on our website at www.cqc.org.uk.

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.

At the time of our inspection the service was providing a service for 18 older people with a variety of care needs, including people living with physical frailty or memory loss due to the progression of age.

People’s experience of using this service:

People were treated with kindness and respect. People’s comments included: “They are very nice to me” and “The manager and staff are lovely”.

People using the service told us they felt safe. Staff contacted healthcare professionals when they had concerns about people’s health and wellbeing.

Staff understood and followed guidance to enable them to recognise and address any safeguarding concerns about people.

Risks relating to people’s health and welfare were assessed and these were recorded along with actions identified to reduce those risks. There were plans in place for foreseeable emergencies.

People were supported with their nutritional needs when required.

Records did not all contain clear guidance or information to support the safe administration of people’s medicines. Not all staff had received an assessment of their competency to administer medicines in line with best practice guidance.

Staff recruitment records did not always demonstrate that thorough processes were followed when checking staff for suitability before being employed by the service.

Staff demonstrated knowledge of people’s individual needs, but were not always supported to perform their roles. Records showed one to one supervisions had fallen behind and training was not always kept up.

There were systems in place to monitor the quality and safety of the service provided, however these were not always effective. The provider did not always notify us of incidents or complete required documentation when requested. Lessons were not always learnt following inspections at other services run by the provider.

Care plans contained some records that needed to be reviewed and updated to ensure they remained accurate and supported the delivery of person centred care.

We have made a recommendation about the management of complaints.

Radis Community Care (Rowan Court ECH) met the characteristics of Good in some areas and of Requires Improvement in others. Overall, we have rated the service as Required Improvement.

During our inspection we found four breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and one breach of the Health and Social Care Act 2008 (Registration) Regulations 2009.

More information is in the full report.

Rating at last inspection: This was the first inspection of Rowan Court since the new provider took over the running of the service on 28 June 2017.

Why we inspected: This was a planned inspection.

Follow up: We have rated this service as Requires Improvement and have requested an improvement action plan that will be reviewed to ensure that improvements have been made.

We will follow up on this inspection as per our re-inspection programme, and through ongoing monitoring of information received about the service.

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