Radiant care services LTD

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• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

This means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question Requires Improvement. We also identified a breach of Regulation 12 (Safe care and treatment), Regulation 18 (Staffing) and Regulation 19 (Fit and proper persons employed). At this assessment the rating has changed to Good and the service was no longer in breach of Regulation 12. This meant people were safe and protected from avoidable harm.

This service scored 69 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a proactive and positive culture of safety, based on openness and honesty. People felt comfortable raising concerns in the knowledge they would be dealt with appropriately. One person told us, “I feel comfortable in raising concerns. They are very considerate, and they make sure they attend to them. They don’t push them to one side.” A relative added, “Honestly if I had any concerns, I would raise them with them.”

Staff listened to concerns about safety and reported safety events. Lessons were learnt to continually identify and embed good practice. A staff member told us, “Thorough investigations of incidents help identify root causes. Providing feedback to staff fosters a culture of continuous learning and improvement. This is usually done during meetings, through phone calls and also, we discuss policy reviews with our line managers.” The registered manager added, “We do follow up training from incidents and receive training from professionals. We did an eight-week training course with the At Home team and it was an eye opener. Such as the fire risks, which caused us to make referrals to the fire safety team for some service users.”

The provider’s accident and incident tracker included information such as what had occurred, and what action was taken to prevent reoccurrence.

The provider worked with people and healthcare partners to establish and maintain safe systems of care. They made sure there was continuity of care, including when people moved between different services. Pre-assessments were completed before people started using the service to ensure their needs could be met. These included information regarding people’s mobility and nutritional needs. When people’s needs changed or increased, referrals were made to appropriate health and social care professionals. One person told us, “I just came out of the hospital recently and wanted physiotherapy and the lady in charge has been liaising with the GP on my behalf.” The registered manager told us, “We tell people what we can help them with or what needs additional support like the district nurses for skin breakdown. We have a good relationship with them. For instance, someone developed a sore, so I sent a referral email and informed them she needed support and then followed it up with a phone call to give them further information.”

Staff confirmed they were given time to read people’s care plans before delivering care to them. One staff member said, “We are given a care plan to go through before attending to the client. We also go through the notes of the previous carer, and we talk to the service user involving them with their care.”

Steps had been taken to ensure a smooth transition of care for people who had live in carers. The registered manager told us that staff were asked to arrive an hour before their shift was due to start as a live in carer. This hour was unpaid. A staff member explained to us, “It's okay because it gives me ample time to receive the hand over. This also ensures the [person] is less anxious about that change at is smooth. I am okay with arriving an hour early without pay as it makes my work smooth.”

The provider had a proactive and positive culture of safety, based on openness and honesty. People felt comfortable raising concerns in the knowledge they would be dealt with appropriately. One person told us, “I feel comfortable in raising concerns. They are very considerate, and they make sure they attend to them. They don’t push them to one side.” A relative added, “Honestly if I had any concerns, I would raise them with them.”

Staff listened to concerns about safety and reported safety events. Lessons were learnt to continually identify and embed good practice. A staff member told us, “Thorough investigations of incidents help identify root causes. Providing feedback to staff fosters a culture of continuous learning and improvement. This is usually done during meetings, through phone calls and also, we discuss policy reviews with our line managers.” The registered manager added, “We do follow up training from incidents and receive training from professionals. We did an eight-week training course with the At Home team and it was an eye opener. Such as the fire risks, which caused us to make referrals to the fire safety team for some service users.”

The provider’s accident and incident tracker included information such as what had occurred, and what action was taken to prevent reoccurrence.

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them. Care plans and risk assessment contained information on people’s individual care needs and any risks involved with these, such as their mobility or skin integrity. Staff felt care plans contained enough information for them to deliver care to people safely.

However, we identified there were no care plans in place for people’s health conditions to support staff to know how each condition effected people and what symptoms to look out for. Despite there being no incidents of where this had caused harm to people, we recommended to the provider that these were implemented as soon as possible. We have since received evidence that these are now in place.

Care plans were regularly reviewed and updated and when people’s needs changed. People were included in reviews of their care, or their family members when needed. One relative told us, “They always involve me in decisions about my wife’s care. My opinion is included in the care plan, they type it out and it goes to the office.” Another relative said, “When needs change, you are informed straight away.” One staff member explained to us, “If a [person] has been hospitalised and they return home we assess further and review any risks.”

We did not look at Safe environments during this assessment. The score for this quality statement is based on the previous rating for Safe.

People received care at the times they required and were updated if there was any unavoidable lateness. One person told us, “They are very good with time keeping. They always come on time. They inform me if there are any emergencies, or they come late. You are always informed. You are kept in the loop and you know what’s happening.” A staff member confirmed, “Sometimes if I feel I am not able to make it on time I communicate to the office so they can update the service user of my arrival time. This safeguards the people we support as they are involved. No day is the same in this industry, there are so many variables on the road and our clients are understanding once informed of any changes.” However, we did identify from staff rotas that staff were not always given travelling time between care calls. The registered manager told us, “We have thought about travelling times and we try to include them where possible. We do care runs where staff stay in one geographical area.” Following our assessment, the registered manager provided evidence that travelling time had now been included within staff rotas.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support and supervision. They worked together well to provide safe care that met people’s individual needs. One person told us, “I mostly get the same carers assisting me. They know me well. I had some new people coming in and they have the same skills as the regular ones. They learn quickly.” Staff were on the whole up to date with training that was relevant to their role, such as safeguarding and supporting people with dementia. Staff received regular supervision and spot checks to ensure their conduct was appropriate and they were delivering a good standard of care.

Staff were recruited safely. This included carrying out a Disclosure and Barring Service (DBS) check. This ensures any potential staff were safe to work with vulnerable people.

The provider assessed and managed the risk of infection. People confirmed that staff promoted safe infection prevention and control (IPC). One person told us, “They wear aprons and gloves and wash their hands. They are very clean.” A relative added, “The carers are very clean. They put gloves on and the mask on their face. They are very good, washing their hands.” The registered manager told us, “Staff receive regular training on infection control measures, and personal protective equipment (PPE) is readily provided. Staff are encouraged to take up vaccinations of preventable infections and to acquaint themselves with the IPC policy.” The provider’s training matrix confirmed that staff had received training in IPC.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened. One person confirmed, “They are very good at managing medication. The area manager is administering medication and [the registered manager]. They are very good.” The registered manager told us, “Medication management at Radiant Care Services is a model of precision and safety. Robust processes ensure that medicines are prompted, administered, and monitored effectively, reducing the risk of errors.”

Staff confirmed they had received training in medicine management and had regular competency checks. One staff member said, “We have proper training in medication administration and regular competency assessments are crucial for safe practice.” Another staff member confirmed their competency had been checked within the last 6 months and they received annual refresher training in medicine management.

Documentation around medicine management was safe. People had medication profiles in place which stated how they liked to receive their medications and if they had any allergies. For people who were prescribed as and when medication (PRN), protocols were in place to confirm to staff when these should be given and how often. Medicine administration records (MARs) had been completed in full with no gaps.