Archived: Radnor House

Updated 5 October 2019

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 Care Act 2014.

Inspection team

The inspection was undertaken by one inspector.

Service and service type

Radnor House is a ‘care home’. People in care homes receive accommodation and personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Notice of inspection

This inspection was unannounced.

What we did before 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. However, no feedback was received. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke with one person who used the service and two relatives about their experience of the care provided. Other people did not engage with the inspector verbally. However, we observed the support provided to them in communal areas. We spoke with three care staff and the registered manager and area manager.

We reviewed a range of records. This included two people’s care records and multiple medication records. We looked at one staff file in relation to recruitment and staff supervision records. A variety of records relating to the management of the service were reviewed.

After the inspection

We looked at training data and information on actions the registered manager had taken after the inspection.

Updated 5 October 2019

About the service

Radnor House is a residential care home providing personal care for four people with learning disabilities or autism. The service can support up to six people.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

There were no identifying signs, cameras, industrial bins or anything else outside to indicate it was a care home. Staff did not wear a uniform or anything that suggested they were care staff when coming and going with people. The service was provided in a large building near to the centre of the village in a house that was similar to other properties in the area.

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

People were happy living at the service and relatives told us that they wanted their loved ones to remain living there.

However, there continued to be areas where the service needed to make improvements. Checks on the quality of the service had not identified some of the issues we found at inspection, other issues had not been addressed in a timely manner. However, we did not find any impact on people’s safety or wellbeing.

People were invited to feedback on their care and their views were listened to. However, the registered manager needed to improve how they gathered feedback from relatives. Relatives views on the management of the service was mixed.

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. However, best interest decisions were not always recorded when they needed to be.

People had positive behaviour support plans in place and we observed that staff followed these. However, staff had not yet completed training in positive behaviour support. This was an area for improvement.

People had been involved in choosing the decorations for the service and their rooms and flats were personalised. However, repairs needed to one person’s kitchen had not been completed in a timely manner.

Relatives told us that people had good support to access healthcare services and were supported to maintain their health. However, one relative said that dental hygiene support could be improved.

When people moved in to the service their needs were assessed. Support plans were updated when people’s needs had changed. The service had identified where people needed more or less support and supported people to move on from the service appropriately.

People continued to be provided with appropriate support to eat and drink well. People were supported to go shopping for themselves and cook where this was appropriate. Support to people was individualised and staff knew people well. People were supported to achieve goals, increase their independence and participate in a range of activities of their choice.

Risks to people from health conditions and the environment were managed appropriately. Staff understood how to protect people from abuse and knew how to report concerns. Medicines were administered safely, and people received their medicines on time and as prescribed.

There was enough staff to support people and staff were recruited safely. Staff were appropriately managed and had the support they needed.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence. The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

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 Requires Improvement (published 27 July 2018). At the last inspection there were no breaches of the regulations. The service remains rated requires improvement with one new breach of regulation. This service has been rated requires improvement for the last three consecutive inspections.

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified breaches in relation to the governance 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.