Radis Community Care (Eden Place ECH) provides care and support to people living in specialist ‘extra care’ housing. Extra care housing is purpose-built or adapted single household accommodation in a shared site or building. The accommodation is bought or rented, and is the occupant’s own home. People’s care and housing are provided under separate contractual agreements. The Care Quality Commission (CQC) does not regulate premises used for extra care housing; this inspection looked at people’s personal care and support service.People using the service lived in a single building with 55 ordinary flats in the town of St Ives. Not everyone using Radis Community Care (Eden Place ECH) received the regulated activity ‘personal care’. CQC only inspects the service being received by people provided with ‘personal care’, that is help with tasks related to personal hygiene and eating. Where they did, we also took into account the wider social care provided. There were 22 older people, receiving the regulated activity of personal care at the time of this inspection.
This inspection took place on the 5 February 2018 and was announced. We gave the service 48 hours’ notice as we needed to make sure that staff would be available. This is the first inspection carried out at this service since they registered with the CQC on 27 January 2017.
The CQC records showed that the service had a registered manager. However, they were unavailable during this inspection. 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.
Staff had an understanding of the Mental Capacity Act 2005 (MCA). People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. Staff knew how to report any suspicions of harm and poor care practice.
People were assisted to take their medication as prescribed. Processes were in place and followed by staff members to ensure that infection prevention and control was promoted and the risk of cross contamination was reduced as far as possible when supporting people.
Staff assisted people in a caring, patient and respectful way. People’s dignity and privacy was promoted and maintained by the staff members supporting them.
People and their relatives were given the opportunity to be involved in the setting up and review of their or their family member’s individual support and care plans.
People were supported by staff to have enough to eat and drink.
People were assisted to access a range of external health care professionals and were supported by staff to maintain their health and well-being. Staff and external health care professionals, would, when required, support people at the end of their life, to have a comfortable and as dignified a death as possible. However, people’s end of life wishes were not documented for staff to use as guidance should they need this and staff had not received training relating to end-of-life care.
People had individualised care and support plans in situ which documented their needs. These plans informed staff on how a person would like their care and support to be given, in line with external health and social care professional guidance.
There were enough staff to meet people’s individual care and support needs. Individual risks to people were identified and monitored by staff. Plans were put into place to minimise people’s risks as far as possible to allow them to live as safe and independent a life as practicable.
Accident and incidents that occurred at the service were recorded. However, these records were not always complete. This meant that there was information missing such as, whether an injury had been sustained following the incident and what actions had been taken to reduce the risk of recurrence. This meant that these records did not demonstrate that they were reviewed as part of the on-going quality monitoring of the service, to reduce the risk of recurrence and drive improvements forward.
There was a recruitment process in place and staff were only employed within the service after all essential checks had been suitably completed. However, not all staff recruitment files evidenced that all of the checks had been completed. Staff were trained to be able to provide care which met people’s individual needs. The standard of staff members’ work performance was reviewed through spot checks, medicines competencies, supervisions and appraisals. However, some staff told us that the registered manager was not approachable at times. This meant that some staff did not always feel supported in their role.
Compliments about the care and support provided had been received. Complaints received were investigated. However, these records did not always show that the provider’s procedure for recording all complaints was followed; as not all complaints received were documented. This meant that there was an increased risk that this missing information would not form part of the governance of the service to show any repeat trends, learning, and any actions taken to prevent reoccurrence.
The registered manager sought feedback about the quality of the service provided from people. There was an on-going quality monitoring process in place to identify areas of improvement needed within the service. A recent audit undertaken by the provider’s quality assurance manager showed that areas of improvement required were around accurate documentation not always being available. An action place to address these concerns was in the process of being written.
Since registering with the CQC, the provider’s records showed that there had been no incidents that the provider was legally obliged to notify the CQC of.
Further information is in the detailed findings below.