Background to this inspection
Updated
18 January 2024
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.
Inspection team
The inspection was undertaken by 1 inspector and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
This service 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. CQC does not regulate premises used for extra care housing; this inspection looked at people’s personal care and support.
Registered Manager
This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.
At the time of our inspection there were 2 registered managers in post.
Notice of inspection
We gave the service 24 hours’ notice of the inspection. This was because we needed to be sure that the provider or registered manager would be in the office to support the inspection.
Inspection activity started on 18 April 2023 and ended on 19 May 2023. We visited the service on 18 April, 20 April, 26 April and 2 May 2023.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection.
During the inspection
We spoke with 9 people who use the service or their family members, 6 members of staff, including the 2 registered managers. We also received feedback from 3 external professionals.
We reviewed a range of records. This included care records and associated documents of 13 people. We reviewed 5 staff files in relation to recruitment and supervision. We also reviewed a variety of records relating to the management of the service, including policies and procedures.
Updated
18 January 2024
About the service
Radis Community Care (Brunel Court) provides personal care services for people living in 55 self-contained flats in an extra care housing scheme. Not everyone who lived in the service 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.
Brunel Court is one of four extra care housing schemes in the city which Radis Community Care manage along with an agency providing personal care in people’s homes. The service provides support including for people living with dementia, physical disability, and older and younger adults. At the time of our inspection there were 33 people using the service.
People’s experience of using this service and what we found
Service users were not protected from abuse and improper treatment. Risks to people using the service were not consistently assessed or mitigated. Medicines were not managed safely. People were not consistently cared for by staff who were safely recruited. Staff files did not consistently include all necessary information to ensure safe recruitment practices were followed to keep people safe.
Where people had specific health conditions, there was not always an associated management plan for staff to follow. This meant staff did not have access to information to safely care for people.
Safeguarding concerns were not consistently identified, investigated, and reported. Themes and trends were not consistently identified and learnt from. This placed people at risk of harm.
Staff did not complete training or receive competency assessments, supervision or spot checks on a proactive basis. This meant appropriate action had not been taken to ensure fit and proper persons were employed to care for people.
Quality monitoring and oversight of the service was not effective. For example, audits in place had not identified concerns found during inspection which meant lessons could not be learned and embedded across the service.
People were not consistently involved in their care and their feedback was not consistently sought by the provider. As part of the inspection, people who used the service gave feedback which indicated inconsistency in staffing ability, knowledge, and professionalism. This had not been identified by the provider.
Analysis and learning from accidents and incidents was limited. This meant the provider was not continually striving to improve standards of care people received.
People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the provider’s ‘Mental Capacity Act and Decision Making’ policy was not up to date to support this in practice.
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 service registered with us on 12 August 2021 and this is the first inspection.
The last rating for the service under the previous provider was Good, published on 10 January 2019.
Why we inspected
The inspection was prompted in part due to concerns received about neglect of a person using the service and poor medicines management. A decision was made for us to inspect and examine those risks.
We have found evidence the provider needs to make improvements. The overall rating for the service is inadequate based on the findings of this report.
Enforcement and Recommendations
We have identified breaches in relation to safe care and treatment, safeguarding, staffing, fit and proper persons employed, consent and good governance at this inspection.
Please see the action we have told the provider to take at the end of this report.
Follow up
The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.
If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions of the 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.