Archived: Radis Community Care (Surrey Court ECH)

Updated 12 August 2022

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 completed by one 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 service.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. 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 nine people who used the service and three relatives about their experience of the care provided. We spoke with 11 members of staff including the area manager, support manager, team leader, human resources, and seven care staff.

We reviewed a range of records. This included three people’s care records and multiple medicines records. We looked at four staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records.

Updated 12 August 2022

About the service

Surrey Court provides care and support to people living in ‘extra care’ housing. People using the service live in their own flats within a shared building containing 70 flats. The building also houses the offices used by the registered manager and staff.

Not everyone living at Surrey Court 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. At the time of this inspection 31 people received personal care from Radis staff.

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

Relevant recruitment checks were not always safe. For three staff members application forms were not fully completed which meant the service could not check the staff members employment history to make sure they were of good character and had the necessary skills.

Systems were in place to protect people from abuse. However, we received concerns that these were not always taken seriously. Staff we spoke to were not always aware of how to identify, prevent and report abuse. Sufficient staff were deployed to meet people’s needs. However, the service was using a high amount of agency staff and people felt they didn’t always meet their needs.

Medicines were not always managed safely. We found the lack of record keeping meant medicines were not always managed safely.

Governance systems were not always effective in promoting a person-centred culture. People and staff had felt unsupported due to the lack of management at the service and didn’t always feel listened to. A new manager had recently started and were working alongside management to ensure improvements were in place.

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 and update

The last rating for this service was good (published 06 August 2021).

Why we inspected

The inspection was prompted in part due to concerns received about safeguarding concerns. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

We have found evidence that the provider needs to make improvements. Please see the safe and well led sections of this report.

You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Radis Community Care (Surrey Court ECH on our website at www.cqc.org.uk.

Enforcement and Recommendations

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to risks to medicines, staff recruitment practices and good governance at this inspection.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.