Radfield Home Care Wycombe, Beaconsfield & South Bucks

Updated 10 July 2021

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 carried out by one inspector and one 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 is a domiciliary care agency. It provides personal care to people living in their own houses and flats.

The service had a manager registered with the Care Quality Commission. 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.

Notice of inspection

We gave the service 48 hours’ notice of the inspection. This was because it is a small service 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 19 May 2021 and ended on 28 May 2021. We visited the office location on 19 May 2021 and 20 May 2021.

What we did before the inspection

We reviewed information we had received about the service since it was registered with the Care Quality Commission on 29 August 2019. We also sought feedback from the local authority.

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

During the inspection we spoke with two people using the service and 10 family members. We also spoke with 11 members of staff, including the registered manager, the nominated individual, care coordinator, five senior care assistants and three care assistants. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We also received email feedback from five additional members of staff.

We reviewed a range of records. This included 10 people's care and support plans, as well as people’s medicines records where they received support with this task. We looked at five staff files in relation to recruitment, training and supervision. We reviewed a variety of records relating to management of the service including policies and procedures, quality assurance surveys, staff meeting records and evidence of auditing.

After the inspection

We continued to review records shared electronically and continued to seek clarification from the provider to validate evidence found. We sought feedback from professionals and received a response from five professionals during the inspection process.

Updated 10 July 2021

About the service

Radfield Home Care Wycombe, Beaconsfield & South Bucks is a service providing care and support to people in their own home. At the time of the inspection the service was supporting 40 people. This included both younger adults, people with physical or sensory impairments, and older people. Some people using the service lived with dementia or experienced other mental health support needs.

Not everyone who used the service 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.

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

People and families told us the service was well-managed. People indicated the management of the service was accessible, supportive and approachable. Comments from family members included, “I would definitely recommend Radfield Care to anyone”, “The management always have time to speak to you” and “The management are all really good, they are always reassuring”.

People’s needs were assessed, and care plans provided a holistic picture of people’s physical, social and emotional needs. This included information about people’s backgrounds, communication needs, protected characteristics, health and nutritional needs. Where appropriate, people were supported by family members as part of assessments and reviews of their care. One relative advised, “I do get full involvement with her care plans and I’m involved in decisions made to her care”.

People were supported by staff who were suitably inducted, trained and supported. Staff deployment aimed to provide continuity of care, enough travel time to deliver punctuality and matched staff where specific skills were required, such as knowledge of dementia, epilepsy or stoma care. People received a rota so they knew in advance who would be providing their support. People spoke positively about the punctuality of staff and standards of care. Comments included, “There are no issues with punctuality”, “The carers have always arrived on time and cover all their duties both to my satisfaction and my husbands” and “It would always say on the rota who is coming so my mother doesn’t get any surprises”.

People received person-centred care which was responsive to their needs. Staff could speak in detail about people they support, with knowledge about people’s likes, dislikes and preferred routines. People were supported to engage in activities they enjoy. Where people required additional support or their needs had changed, electronic systems enabled care plans to be quickly amended and updates were shared with staff. A relative advised, “I definitely feel the service has really allowed both of us to live life more independently…They respond to anything immediate in a hurry – for example; when my father needed support over the night, they were there straight away.”

People told us staff were caring, compassionate and provided safe care. Staff supported people to maintain their independence where possible and involved people in day to day decisions about their care and support. We received several compliments regarding the approach of staff. One relative advised, “My mother is bedbound but with the professional support she gets, she still feels she can still do all the things that independent people can do to an extent”. A second family member advised, “My father is kept very safe from the care he receives. He looks forward to the visits every day. They [staff] are like friends offering support.” A third relative told us, “Whenever they [staff] visit, they always spend time and chat before they finish their duties. They are very pleasant and lift the spirits of both my parents.”

We found safe care and treatment was provided. People were safeguarded from risks of abuse and other risks, including infection control risks in relation to COVID-19. Safe medicines practice was followed, and people told us they received safe care. Accidents, incidents and complaints relating to people using the service were monitored to identify wider learning for the service.

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 the recording did not always follow best practice. We recommended the service refer to best practice guidance to ensure written records can evidence how decisions are made and people are supported in their best interests.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

This service was registered with us on 29/08/2019 and this is the first inspection.

Why we inspected

This was a planned inspection following the service’s registration with CQC.

We have found evidence that the provider needs to make improvements. Please see the effective section of this full report.

The service was responsive to our feedback and agreed to improve recording in relation to mental capacity assessments and best interests recording. The service commenced work during our inspection and shared an example of updated and improved documentation.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.