Radis Community Care (Reading Supported Living)

Not everyone using Radis Community Care (Reading Supported Living) receives a regulated activity. The service supports other people who do not receive personal care. CQC only inspects the service being received by people provided with 'personal care'; help with tasks related to personal hygiene and eating. Where they do, we also take into account any wider social care provided. The service is also registered to support older people, younger people, people living with dementia, learning disabilities, mental health needs and misuse of drugs and alcohol.

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

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

The service was able to demonstrate how they were meeting some of the underpinning principles of right support, right care, right culture. However, they needed to make improvements to fully meet these.

Right Support:

People did not always experience good quality care with good outcomes. There were not always enough staff with the right mix of skills and experience to meet autistic people's care and support needs. Staff had not completed required training to support people living with autism and other associated complex needs, including eating disorders. People did not always receive care from staff who they knew and trusted, which had an adverse impact on their mental health and wellbeing. Staff had not always been recruited safely, which meant the provider could not be assured all staff were safe to work with vulnerable people.

People were not always supported to have maximum choice and control of their lives. however, staff supported people in the least restrictive way possible and in their best interests; the policies and systems in the service supported least restrictive practice.

Staff had training in safeguarding and knew how to report any concerns. People's risks were clearly assessed, and clear guidance given to staff to minimise and manage risks safely. People were supported to manage and take their medicines safely and on time.

Right Culture:

The ethos, values, attitudes and behaviours of leaders and care staff did not always ensure people lead confident, inclusive and empowered lives. The provider had not promoted a positive culture within the service that was person-centred, open, inclusive and empowering, which achieved good outcomes for people. People and staff consistently told us they did not feel valued or listened to by the registered manager. The registered manager had failed to consistently assess and monitor the quality of the service and effectively operate systems and processes to ensure compliance with the regulations. This meant the provider could not be assured that required learning and improvements had been identified and implemented.

Right Care:

People did not always experience person-centred care which promoted people’s dignity, privacy and human rights. People were not always supported to express their views and be involved in making decisions about their care. The registered manager did not always make sure that staffing was organised so that people consistently received care and support from familiar staff. People told us that agency staff did not always understand how they wished their privacy and dignity maintained. This resulted in people not always feeling they were respected or valued. The service did not always understand the importance of ensuring that staff had the skills and time to recognise when and how to give people compassionate support when they need it. People were not always enabled to make choices for themselves by the provider. Relatives and social care professionals were concerned that autistic people were not supported by staff who were trained to the right level to meet their complex needs.

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

The last rating for this service was good (report published 19 October 2018).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

Enforcement

We identified breaches in relation to recruitment, staffing and quality assurance of the service.

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.

The service operates as a domiciliary care agency. It provides personal care to 18 people living in their own homes in the community. It also provides 24-hour care and support to two people living in 2 ‘supported living’ settings, so that they can live in their own home as independently as possible. People’s care and housing are provided under separate contractual agreements. The Care Quality Commission (CQC) does not regulate premises used for supported living; this inspection looked at people’s personal care and support. It provides a service to older adults, younger disabled adults and disabled children.

Not everyone using Radis Community Care Supported Living Reading, receives a regulated activity. The service supports a further 50 people who do not receive personal care. CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

A registered manager was in place as required. 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.

People and relatives were happy with the care and support provided by the service. People were safe and told us staff treated them with kindness and respected their dignity and privacy. Where safeguarding issues had arisen, they had been addressed openly by the service and any lessons learned. People and, where appropriate, their representatives, were involved in planning and reviewing their care. Care plans and associated documents were detailed and provided staff with the information they needed to deliver personalised care.

People felt listened to and said the registered manager was accessible and approachable. Where complaints or issues had been raised, they had been addressed. People’s views about the service had been sought via surveys, telephone calls and during spot check visits.

People’s cultural and other diverse needs were identified and supported where appropriate within the support provided. People were enabled to access activities in the community when this was part of their care plan.

The service helped keep people as safe as possible by having a robust system of recruitment checks to ensure as far as possible the suitability of potential staff. People’s medicines were safely managed on their behalf where relevant.

Risks to people and staff were identified through thorough risk assessments and action taken to minimise risk wherever possible. People’s legal rights and freedom were supported by the service.

Staff received thorough induction training using a nationally recognised programme and were provided with regular updates to mandatory training. Additional specialist training was also provided where necessary. Ongoing support was provided to staff via regular one-to-one supervision and annual performance appraisals.

The registered manager maintained effective oversight of the service through various monitoring systems. Regular team meetings helped ensure effective communication with all staff.