We carried out an announced inspection of the service on 07 August 2017.

Radis Community Care Nottingham provides personal care to people living in their own homes, there were 32 people receiving personal care at the time of our inspection. The service was last inspected March 2015 and the rating for that inspection was Good.

There was not a manager registered with the Care Quality Commission (CQC). 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 supported them within their home. People were protected from harm by staff who knew how to report any concerns. Assessments of the risks to people’s safety were in place and regularly reviewed.

There were sufficient numbers of suitably qualified and experienced staff in place to keep people safe. Safe recruitment processes were in place.

People were protected from the risks associated with managing medicines. There were processes in place to ensure medicines were handled and administered safely.

Staff received sufficient training, regular supervision to carry out their roles and felt supported by the management team.

The principles of the Mental Capacity Act 2005 (MCA) were considered when supporting people. People were supported and encouraged to follow a healthy and balanced diet. People’s day to day health needs were met effectively by the staff.

People and their families had formed good relationships with the staff that cared and supported them. People were treated with respect and dignity. People were involved with decisions made about their care and support. Information was available for people if they wished to speak with an independent advocate. People were supported to live as independently as possible.

People knew how to raise concerns or complaints and were encouraged to do so if needed. The provider was reviewing their procedures to ensure all complaints and concerns were recorded and dealt with in a timely manner.

People and staff spoke highly of the staff overseeing the service in the absence of a manager along with the service provided. Systems were in place that enabled people, staff and relatives to give their views about the service.

Systems were in place to monitor and improve the quality and safety of the service. The service promoted a positive culture that was person-centred, open, and inclusive.

We carried out an announced inspection of the service on 27 March 2015. There were breaches of legal requirements at our last inspection in 2013 and we had been assured by the provider that improvements were made. During this visit we found some improvements were maintained.

Radis Community Care (Nottingham) provides personal care and support to people in the Nottingham area. There were 38 people receiving care in their own homes at the time of our visit.

There was a manager registered with the Care Quality Commission (CQC). 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 the service was safe and reliable. The provider had suitable arrangements in place to identify the possibility of abuse and to reduce the risk of people experiencing abuse. Staff were knowledgeable about how to recognise abuse and confirmed they had completed relevant safeguarding training.

Appropriate risk assessments had been undertaken to make sure the environment was safe and secure for staff to attend to people’s needs.

People were supported by appropriately skilled and trained staff because the provider had a robust recruitment process in place. There were sufficient numbers of staff to cover calls in an effective and caring way. The manager was recruiting for additional staff at the time of our visit.

People were supported to make informed choices and staff had awareness of the Mental Capacity (MCA) Act 2005, The Mental Capacity Act 2005 is designed to protect people who do not have the capacity to make certain important decisions for themselves, because they may lack the capacity to make such decisions due to permanent or temporary problems such as mental illness, brain injury or learning disability. We found that the MCA was being adhered to.

Care plans contained individual information relevant to the person. People were encouraged to be independent and received relevant information on how the service was run. People felt that they could express their views about the service that they received.

People knew how to raise any concerns, they knew who they should contact and raise the concern with.

People received good care which met their needs. They were treated with respect and the staff provided the care in a caring way.

People and their families were involved in decisions related to their care and support. Care plans contained information relevant to the person and were individualised to reflect people’s needs.

Complaints and concerns were logged and monitored to ensure they were dealt with in a timely manner. Outcomes were reviewed to improve the practise and to reduce the risk of reoccurrence.

The service was monitored regularly by the provider and registered manager to make sure a quality service was provided.

People were encouraged to express their views and comment on how the service was run.

The management team worked well and supported staff accordingly. The service worked well with other professionals and the care commissioners.

As people were not contactable, or had communication difficulties were only able to speak with two people who used the service. There was a mixed message. People were generally satisfied with the care they directly received from staff. However, there were comments that calls had been missed, had not been at the time they needed help or had been late.

A person told us that staff were good at their jobs. She said; ‘’staff are friendly but they rush sometimes’’.

We spoke with the relatives of six people. They all told us that care was good and staff seemed to be well trained. There were concerns about staff not always turning up in time, a high turnover of staff which did not provide consistency of care and staff not always following practical instructions.

One relative said; ‘’I have no problem with staff. But I think the agency needs to be better organised. There are too many missed calls’’.

This was a mixed positive inspection. People we spoke with thought care staff were caring. However, they did not always receive the care they needed. This was also the general view of their relatives. The essential standards we inspected with regard to the agency providing consistent care, comprehensive staff training and dealing with complaints were not met.

There were other suggestions made; better staff teamwork amongst care workers and always providing information to people about what care they would receive.