Radis Community Care Coventry is a domiciliary care agency which provides personal care to people in their own homes. At the time of our inspection the agency supported approximately 230 people with personal care and employed 130 care staff.

Part of the service provided by Radis Community Care Coventry was a short term enablement service. This was a time limited service, for up to six weeks that supported people so they could come out of hospital, return to their own homes and regain skills during the enablement period.

Following our last comprehensive inspection of the service in June 2015 we found the provider was not providing the standard of service we would expect, in three key areas, and we rated the service ‘Requires Improvement’. During our comprehensive inspection in January 2017 we found the required improvements had been made.

We visited the offices of Radis Community Care on 26 January 2017. We told the provider 48 hours before the visit we were coming so they could arrange to be there and for staff to be available to talk with us about the service.

The service had a registered manager. 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 using the service and staff understood how to protect people from abuse and keep people safe. There were processes to minimise risks to people’s safety. These included procedures to manage identified risks with people’s care and for managing people’s medicines safely. The character and suitability of staff was checked during recruitment procedures to make sure, as far as possible, they were safe to work with people who used the service.

There were enough staff to deliver the care and support people required. Staff received an induction when they started working for the service and completed regular training to support them in meeting people’s needs effectively. People told us staff had the right skills to provide the care and support they required.

The registered manager and staff understood the principles of the Mental Capacity Act (MCA). Staff respected people’s decisions and gained people’s consent before they provided personal care.

People told us staff were kind, respected their privacy, and promoted their independence. Care plans provided guidance for staff about people’s care needs and instructions of what they needed to do on each call. Staff visited the same people regularly and knew how people liked their care delivered.

Staff felt supported to do their work effectively and said all the management team were approachable and knowledgeable. There was an out of hours’ on call system in operation, which ensured management support and advice was always available for staff.

People knew how to complain and information about making a complaint was available for people. People and staff said they could raise any concerns or issues with the management team, knowing they would be listened to and acted on.

The management team checked people received the care they needed by monitoring the time staff arrived at people’s homes, reviewing people’s care records and through feedback from people and staff.

Quality assurance systems were in place to assess and monitor the quality of the service. These included asking people for their views about the service through telephone conversations, visits to review their care and annual questionnaires. There was a programme of other checks and audits which the provider used to monitor and improve the service.

This inspection took place on 23 June 2015. The inspection was announced. The provider was given two days’ notice of our inspection to ensure the manager was available when we visited the agency’s office, and staff were available to talk with us about the service.

Radis Community Care (Coventry) is a domiciliary care agency providing care for people in their own homes in Coventry and Bedworth. People received support through several visits each day. In addition to long term care packages, they also provided short term care packages to enable people to recover from injuries or illnesses and regain their independence. On the day of our inspection the agency was providing support to 108 people.

A requirement of the provider’s registration is that they have a registered manager. 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. At the time of our inspection there was not a registered manager at the service. The service was being managed by a new manager, as the previous registered manager had left the service two months prior to our visit. We refer to the new manager as the manager in the body of this report.

People and their relatives told us they felt safe with staff and staff treated them well. Staff understood how to protect people they supported from abuse. People and their relatives thought staff were kind and responsive to people’s needs.

The management of medicines required improvement, medicine records were not always consistently completed by staff, and medicines audits had not identified areas that required improvement.

Staff were supported by managers through regular meetings. There was an out of hours’ on call system in operation which ensured management support and advice was always available for staff.

Staff felt their training and induction supported them to meet the needs of people they cared for.

Staff understood the principles of the Mental Capacity Act 2005 (MCA), and supported people in line with these principles. However, people did not always have a current mental capacity assessment in place, where people lacked the capacity to make all of their own decisions. This meant staff were not always provided with the information they needed to care for people in accordance with the MCA.

People told us they knew how to make a complaint if they needed to. The provider monitored complaints to identify any trends and patterns, and made changes to the service in response to complaints. However, some people were not satisfied with the way their complaints had been managed previously.

Staff, people and their relatives felt the manager was approachable. Positive communication was encouraged and identified concerns were acted upon by the manager and provider.

There were procedures in place to check the quality of care people received. However, audits did not always identify were improvements needed to be made. Where issues had been identified, the provider acted to make improvements. The manager had identified care records were not always up to date, and had started work to review records.

We visited the offices of Radis Community Care (Coventry) to check that improvements had been made since our last visit in November 2013, when we found the service non-compliant in two of the areas we looked at. These concerned the administration of medication and the service’s effectiveness in checking the quality of its work. We looked at a sample of medication records as well as auditing, monitoring and customer survey forms. We spoke with the branch manager and two staff (care co-ordinators) at the office. The registered manager was not present. We spoke with an area manager who was present that day and spoke by phone with four people who used the service.

We saw quality monitoring was now taking place to a far greater degree than previously. We saw the service was now regularly doing and recording ‘spot checks’ on care, and were conducting regular telephone contacts with people who used the service. The parent organisation had identified that the service needed additional support and was giving this by providing a representative from the organisation to audit services and having an area operational manager to advise and support in resolving identified issues.

We saw medication administration had improved. One person who had previously raised concerns about medication told us “Things have improved, they are making progress.” We saw individual medication forms in place that gave clear guidance on medication for the person supported.

We spoke with a sample of fifteen people who used the service and six care staff employed by the service. We visited the office where the service was based, looked at service records and spoke with the branch manager and a care co-ordinator.

People we spoke with who used the service were generally very positive about it.

“No complaints,” “Very happy” and “Staff are lovely” were some of the things people told us. People were very complimentary about individual staff. Any negative comments concerned a small number of specific visits where different staff were used and agreed times were not kept. We spoke with the manager about these, particularly the need to ensure people were kept informed if there was a problem.

Staff told us they felt well supported and trained. Several staff said they were not happy with frequent changes in their rotas. This tallied with the concerns of some clients that they had too many different staff. Many staff also felt unhappy with the recent changes to travel allowances. One person who used the service was concerned that “good staff leave because they are not rewarded properly.”

We looked at the complaints log and saw that complaints were responded to.

We noted that improvements were needed in the administration and recording of medications and in monitoring this to ensure it was done correctly.

We visited the offices of the service without advance notice. We spoke with the deputy manager and three staff who came into the office. We also spoke by phone with ten people who used service and/or their relatives.

Staff were very positive about the service and the support they were given to carry out their roles. One staff member told us “It’s well-organised, they treat staff very well.”

The people we spoke with who use the service were generally positive about it. “Quite satisfied” “very good” and “very happy” were among the things people said to us about the service.

Where people had concerns, it was usually to do with the different staff used when their ‘regular’ care staff was not working. One person said “It’s fine when she (usual care staff) is here; some of the others don’t come on time, and don’t know what to do.”

Other people who used the service were very happy with a team of staff who provided the care. One person told us “They’re regular, work as a team, comfortable with them.”