The Radley Care Home

Updated 20 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.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

This inspection was carried out by 2 inspectors and 2 Experts 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

The Radley Care Home is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. The Radley Care Home is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

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

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, professionals who work with the service and Healthwatch England. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England.

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 used all this information to plan our inspection.

During the inspection

We spoke with 7 people and 16 of their relatives. We spoke with 9 staff members including the registered manager, senior care staff, care staff and housekeeping staff. We spoke with 2 professionals.

We reviewed 7 people’s care records and 9 people’s medicine records. We reviewed 2 staff recruitment records and a variety of quality assurance documentation and policies.

Updated 20 June 2023

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.

About the service

The Radley Care Home is a residential care home providing personal care to 36 people at the time of the inspection. The service can support up to 37 people. Care and support was provided to older people living with dementia as well as and people with a learning disability. The building was designed across two floors and purpose built to support people living with dementia. Each person had their own ensuite facilities and access to various shared spaces and gardens.

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

Right Support:

Staff did not always support people to monitor their medicines safely in a way that achieved the best possible health outcomes.

The service worked with people to plan for when they experienced periods of distress so that their freedoms were restricted only if there was no alternative.

Staff focused on people’s strengths and promoted what they could do, so people had a fulfilling and meaningful everyday life. Staff supported people to pursue their interests. The service made reasonable adjustments for people so they could be fully in discussions about how they received support, including support to travel wherever they needed to go.

People had a choice about their living environment and were able to personalise their rooms. The service gave people care and support in a safe, clean, well equipped, well-furnished and well-maintained environment that met their sensory and physical needs.

The building design was not typical for accommodating people with a learning disability as it was larger and focused primarily on supporting older people and people living with dementia. However, this was appropriate for the people with a learning disability who were living at the service as learning disability services had not been able to support their 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.

Staff supported people to play an active role in maintaining their own health and wellbeing. Staff enabled people to access specialist health and social care support in the community.

We made a recommendation about reviewing auditing systems to ensure they were effective in identifying any ongoing monitoring requirements for people’s health conditions and medicines.

Right Care:

Senior staff understood how to protect people from poor care and abuse. Staff had training on how to recognise and report abuse. However, not all staff had a full understanding of what different forms of abuse looked like or who they could report concerns to external to the organisation.

Staff promoted equality and diversity in their support for people. They understood people’s cultural needs and provided culturally appropriate care.

People received kind and compassionate care. Staff protected and respected people’s privacy and dignity. They understood and responded to their individual needs. One person told us, “This is a lovely place to be if you need help, because you will get it. I feel very happy here and well looked after. The food is also very good. The place is clean. I would recommend it if somebody asked because the care is very good. I love all [staff]. I don’t know where they find them, but they are all very kind and work very hard.”

People could communicate with staff and understand information given to them because staff supported them consistently and understood their individual communication needs.

People’s care, treatment and support plans reflected their range of needs and this promoted their wellbeing and enjoyment of life. People could take part in activities and pursue interests that were tailored to them. The service gave people opportunities to try new activities that enhanced and enriched their lives. Staff and people worked together to assess risks people might face and agree ways of reducing the likelihood or harm.

Right Culture:

People were supported by staff who understood best practice in relation to the wide range of strengths, impairments, or sensitivities people with a learning disability may have. This meant people received compassionate and empowering care that was tailored to their needs.

Staff knew and understood people well and were responsive, supporting their aspirations to live a quality life of their choosing. Staff placed people’s wishes, needs and rights at the heart of everything they did.

The service enabled people and those important to them to work with staff to develop the service. Staff valued and acted upon people’s views.

Staff turnover was low, which supported people to receive consistent care from staff who knew them well.

People and those important to them, including advocates, were involved in planning their care.

Staff evaluated the quality of support provided to people, involving the person, their families and other professionals as appropriate.

People’s quality of life was enhanced by the service’s culture of improvement and inclusivity.

Staff ensured risks of a closed culture were minimised so that people received support based on transparency, respect and inclusivity.

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 (published 11 April 2018).

Why we inspected

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

We received concerns in relation to the management of medicines and people’s care needs. 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 full report. You can see what action we have asked the provider to take at the end of this full report.

The provider responded immediately and took action to make the required improvements and ensure people were safe.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for The Radley Care Home on our website at www.cqc.org.uk.

Enforcement

We have identified a breach in relation to the safe management of medicines at this inspection. 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.