Radiant Life Care

Radiant Life provides care and support to people living in a supported living' setting, so that they can live as independently as possible. People's care and housing are provided under separate contractual agreements, the accommodation was provided by a separate landlord. CQC does not regulate premises used for supported living. At the time of this inspection, the service was providing personal care to 15 people. The service provides support people who had a learning disability and older people.

The service also provides domiciliary care to people in their own homes. 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

Quality assurance and monitoring systems in place were often not effective. The provider had not always notified CQC of safeguarding concerns.

Risks to people were assessed and monitored. Recruitment processes were robust and there were enough staff working at the service to support people safely. Staff received inductions before starting work, so they knew what to do when they started working with people.

Medicines were managed safely. Staff were provided with personal protective equipment (PPE) to protect people from the risk of cross infection.

Care plans were person centred and staff knew how people liked to be cared for and supported. People's communication needs were met. People were supported with their health care needs and staff communicated with each other to ensure people received effective care.

People and relatives told us staff were caring and that they treated people with respect. Staff understood how to support people in a way that promoted their privacy, independence and dignity. The service sought to meet people's needs in relation to equality and diversity.

Systems were in place for dealing with complaints, and complaints had been dealt with accordingly. People and staff told us there was an open and positive culture at the service. People were supported to express their views. The provider was aware of their legal obligations and worked with other agencies to develop best practice and share knowledge.

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 inadequate, published 09 November 2021 and there were breaches of Regulations 12 (safe care and treatment), 13 (safeguarding people from of abuse), 9 (person centred care), 11 (need for consent), 18 (staffing), and, 17 (good governance). The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection enough improvement had not been made and the provider was still in breach of Regulations 13 and 17.

This service has been in Special Measures since 12 November 2021. This meant we kept the service under review and, we re-inspected the service within 6 months to check for significant improvements.

During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. It is therefore no longer in Special Measures.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection in 03 September 2021. The overall rating for the service has changed from inadequate to requires improvement. This is based on the findings at this inspection.

Enforcement

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 continued to identify breaches in relation to safeguarding service users from abuse and good governance at this inspection

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

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.

Radiant life care is a domiciliary care agency providing personal care to adults in their own homes. At the time of this inspection, the service was providing personal care to 174 people.

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

People were not always supported in a way that was safe. We found concerns with the management of risks to people including risks associated with medical conditions such as epilepsy and diabetes. People were also not always protected from the risks arising from safeguarding issues. Medicines administration records (MARs) were poorly maintained and not in line with best practice. Office staff were not trained in MAR auditing system.

Staff timekeeping and attendance was being monitored. However, we noted instances where staff visits were significantly either late, early, short or missed completely. These were not being monitored by office staff effectively.

Systems in the service did not enable suitable assessments of people's needs to be carried out when they were referred to the service at short notice. Incidents and accidents were not appropriately reviewed and analysed to prevent reoccurrence. The provider had failed to notify the Care Quality Commission of all reportable incidents as required. Providers are required to notify the CQC of certain incidents without delay.

The model of care and the environment was not suitable for all people because the service did not fully consider if their needs could be met and if it was safe for them to be placed in the service.

Care plans did not always promote personalised care and lacked information for staff to meet people's needs safely.

Staff followed infection control procedures and people were protected from the risk of infections such as Covid-19. Staff who were safely recruited and who had the relevant training and qualifications. Staff told us they were supported by the registered manager and received supervision to discuss their performance. Staff also attended staff meetings and were able to raise any concerns they had.

We found that staff were kind and supported people to maintain their independence. Staff respected people's privacy and supported them to avoid social isolation.

People and relatives told us staff were caring and they were treated with respect. People’s needs were met in relation to equality and diversity issues.

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 28 November 2017).

Why we inspected

The inspection was prompted in part due to concerns received about missed and late visits, training, and monitoring. A decision was made for us to inspect and examine those risks.

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

The provider has begun to take steps to mitigate the risks we identified. Prior to our inspection, the provider shared their service improvement plan for our assurances, and they had started to make improvements to the care and support provided to people. However, we had limited assurance that these measures were effectively reducing the risks faced by people receiving care.

Enforcement

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 discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relations to safe care and treatment, good governance, staffing, need for consent, person-centred care, safeguarding service users from abuse and improper treatment, and, meeting nutritional and hydration needs at this inspection.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Special Measures

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe. And there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it. And it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.

Radiant Life Care is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to older and younger adults. At the time of our visit, 22 people were using the service.

There was a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are 'registered persons'. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People felt safe when staff visited them. They had built a good relationship with staff who they mentioned were caring and respected their privacy and dignity and treated them well.

There were processes in place to minimise risks to people's safety. Staff were aware how to protect people from abuse and had received training in this area. They knew when they should escalate concerns to external organisations.

The recruitment procedures were thorough with appropriate checks undertaken before new staff members started working for the service. Newly appointed staff completed an induction programme which included attending some training and shadowing experienced colleagues.

There were enough staff working for the service. People were usually supported by the same group staff and helped with consistency of care.

People told us staff were friendly and had the right skills to provide the care they required. Staff received regular training and this equipped them to undertake their role. They felt supported by the management team and received regular one to one meeting with their line managers.

Staff knew the principles of the Mental Capacity Act 2005 (MCA). They respected decisions people made about their care and gained people's consent before they provided care and support.

Staff were aware of people’s needs and ensured people receive the care and support as per their care plans. We saw care plans provided clear guidance to staff about people's care needs and instructions of what they needed to do on each visit. People told us their care plans were discussed with them.

Where necessary, staff supported people to eat and drink and helped them to take their medicines safely.

People and relatives felt able to make a complaint and were confident that their complaints would be listened to and acted on. The provider ensured that any issues raised were resolved to the satisfaction of the person.

There were regular audits carried out to monitor the quality of the service and drive improvements.

The provider continually sought feedback about the service from people, relatives, staff and other professionals. Where improvements were needed, they implemented changes as necessary.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Radiant Life Care provides care and support to people living in their own homes. At the time of our visit, they were providing personal care to 40 people. The service had 26 staff in their employment.

Most people were satisfied with the service they received. However before our inspection we received information about two people who were not happy with the service.

During our inspection we noted not all care plans included personalised information about people and risks to people were not always identified.

The registered manager did not inform the Care Quality Commission of significant events that affect people's safety and wellbeing. We found the systems in place to assess and monitor the quality of the service were not effective.

Staff received training to ensure they had the skills and knowledge to support people appropriately. However, there was an inconsistent approach to the provision of staff supervision. Staff had received induction training related to their role.

There were enough staff available to meet people’s needs safely. However, there was no back up system to monitor if staff were visiting people in the event of problems with the service’s internet connection.

People‘s right to give consent and make decisions for themselves were not always encouraged or recorded.

People were supported to have a balanced diet, which took into account their preferences and were supported to access health and social care professionals. There were systems in place to ensure people received their medicines at the correct time.

Staff treated people in a caring way and showed dignity and respect when they provided support. They promoted their independence and maintained their privacy and gave them choices in how they wanted their care provided.

People were supported to maintain good health and were referred to health care professionals when needed.

Systems were in place to safeguard people from abuse and these were being appropriately used. There was system in place to handle and respond to complaints that had been made by people who used the service or their relatives.

We identified five breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.