Radis Community Care (Reading Supported Living)

Updated 27 June 2023

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

This inspection was carried out by one inspector.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own homes.

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 was a registered manager in post.

Notice of inspection

We gave the service 48 hours’ notice of the inspection. This was because the service is small, and we needed to be sure that the provider or registered manager would be in the office to support the inspection.

Inspection activity started on 26 April 2023 and ended on 8 June 2023.

What we did before the inspection

We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We reviewed notifications and information we had received about the service since the last inspection. We sought feedback from the local authority quality assurance and safeguarding team, and other professionals who work with the service. We checked information held by Companies House and the Information Commissioner’s Office. We checked for any online reviews and relevant social media, and we looked at the content of the provider’s website. We took this into account when we inspected the service and made the judgements in this report. We used all this information to plan our inspection.

During the inspection

We visited the site office on 27 April 2023, during which time we reviewed various material in connection with the management of the service. We also arranged to complete home visits on 2 May 2023, with two people and a hospital visit with another person who was undergoing a review of their prescribed medicines. We revisited the site office on 3 May 2023 to review further material relevant to feedback received during the home visits.

We spoke with 3 people who use the service and 3 relatives of 2 different people. We spoke with 10 staff, including the registered manager, the area operations manager, 3 team leaders and 5 support workers. 4 support workers chose not to engage with the inspection process.

We reviewed a range of documents, including people’s care records and daily notes. We looked at 5 staff files in relation to recruitment, staff training and supervision. These included the most recently appointed staff within the service. We examined a variety of records relating to the management of the service, including the provider’s policies, procedures, accidents and incidents and quality assurance audits.

After the site visit, we continued to seek clarification from the registered manager to validate evidence found and received additional documents and information to inform our inspection. We received feedback from 6 health and social care professionals who engaged with the service.

Updated 27 June 2023

Radis Community Care (Reading Supported Living) is a domiciliary care agency and supported living service, which provides personal care to people living in their own homes in the Reading area. This includes 24-hour care and support to people living in 2 'supported living' settings, so they can live in their own home as independently as possible. At the time of inspection, the service was supporting 3 autistic people, with associated complex needs, including eating disorders. In supported living services 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.

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.