Archived: Radian Support Limited - 14 Drayton Road

We considered the evidence we had gathered under the outcomes we inspected. We used this information to answer the questions we always ask:

' Is the service safe?

' Is the service effective?

' Is the service caring?

' Is the service responsive?

' Is the service well led?

If you want to see the evidence supporting our summary please read our full report.

Is the service safe?

CQC monitors the operation of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DOLS). At the time of our inspection there was no person with a DOLS application in place. Staff had been trained in the Mental Capacity Act 2005 and DOLS and understood when a DOLS application would be required. We saw mental capacity assessments and best interest meetings had taken place to ensure that decisions for people who lacked capacity to consent were made within the legal framework.

We looked at care plans and spoke with staff. We found there were risk assessments in place to identify and manage risks to people's health, safety and welfare.

We saw records had been reorganised. This meant they were organised, accessible and up to date. This ensured staff worked to the latest guidance and provided safe care.

These findings demonstrated to us that the service was safe.

Is the service effective?

We looked at two care plans. We saw they were detailed, specific and informative as to how people were to be supported with all aspects of their care. We saw communication diaries were in place for individuals. These provided staff with clear guidance on how to communicate with people. Guidance from other professionals was referred to in care plans and we observed staff supported people in line with the guidance. We saw people's health needs were met.

These findings demonstrated to us that the service was effective.

Is the service caring?

Throughout our visit we observed staff engaging with people in a positive way. Staff were kind, caring, gentle, encouraging and reassuring, whilst promoting people's independence. They called people by their preferred names, they sat next to them whilst supporting them with their meal and offered positive encouragement to eat their meals. We saw people were provided with aids and equipment and they were encouraged to feed themselves. People's privacy was promoted and they were offered choices and their choices were respected.

These findings demonstrated to us that the service was caring.

Is the service responsive?

We saw the manager carried out visual observations of staff practice. Records were maintained of their findings and action taken to address any concerns identified. We saw team meetings took place and staff were informed of various guidance and policy changes which they had to read.

We saw the compliance actions from the previous inspection had been complied with. The provider was proactive in addressing those and had increased their monitoring of the service.

These findings demonstrated to us that the service was responsive.

Is the service well led?

Staff told us they felt the home was well run and managed. We saw that a range of audits took place and issues highlighted in the audits were addressed. We saw the provider carried out checks on the home and action was taken to address their findings.

These findings demonstrated to us that the service was well-led.

We observed positive interactions between staff and people who used the service. We also observed negative interactions which did not promote people's dignity and choices.

We saw improvements had been made which ensured a decision around a person's care and treatment was made within a best interest meeting to safeguard the person who lacked capacity. However, we saw additional areas of non compliance where decisions were made in relation to people's care and treatment which were not made within a legal framework to safeguard them.

Care plans were not effective in identifying people's needs and risk assessments were not in place to manage risks. This had the potential to put people at risk of not receiving safe and consistent care.

Some quality monitoring systems were in place. However these needed to be developed to enable the provider to satisfy themselves the service was being effectively managed and monitored.

Records were not easily accessible and well maintained. This meant people were not protected against the risk of unsafe or inappropriate care and treatment arising from a lack of proper information about them.

The registered manager was not available for us to speak to on the day of our inspection. We spoke with two care staff and looked at everyone's care records. We looked at the provider's policies and quality assurance records.

We found that the provider did not have systems in place to gain the consent to care and treatment of people who used the service.

We found that staff had an understanding of the needs of people who used the service. We found that care and treatment was planned and delivered in a safe way, which met people's individual care needs.

We found that the provider worked well with other services to ensure the health and wellbeing of the people who used the service.

We found the provider had appropriate arrangements in place to manage medicines.

We found that systems were in place to deal with complaints.

The staff where friendly and communicated with the people they supported in a meaningful and respectful way. Their approach to involving people was excellent and this was done in a courteous and consistent manner. We saw that people were encouraged to express their views about the quality of care in the home. They were also involved in planning their care, making decisions about their support and treatment, and how they spent their time.

Due to the varying levels of communication that the three people currently using the service had, it was difficult to discuss their care with them in any depth. However, within the care files we saw that people and or their families had been involved with, and agreed with the particular care needs that had been identified for them.

We were also able to see a comment from a relative that was made on the most recent annual customer satisfaction survey in 2012. This said, 'All the staff are excellent. They make 14 Drayton Road a real family home not an institution'.