Archived: Richmond Residential Care Limited

Updated 7 January 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection was unannounced and took place on 30 October 2015. The inspection team included two inspectors and an expert by experience, with experience of caring for an older person. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Before our inspection we reviewed relevant information, including notifications sent to us by the provider. Notifications are changes, events or incidents that providers must tell us about. We also spoke with representatives from the local authority.

We spoke with six people who used the service. We also completed a Short Observational Framework (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us. During the inspection we also spoke with two relatives of people who used the service. We spoke with four members of staff, as well as the registered manager. We looked at four people’s care plans and we reviewed other records relating to the care people received and how the home was managed. This included some of the provider’s checks on the quality and safety of people’s care, staff training and recruitment records. We also spoke with two social care professionals.

Updated 7 January 2016

This inspection took place on 30 October 2015 and was unannounced.

The service is registered to provide residential care for up to 40 older people. At the time of our inspection 27 people were using the service, including some people living with dementia.

There was a registered manager in place at Richmond Residential Care Home at the time of our inspection. 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 were not fully protected from the risks associated with medicines as procedures designed to reduce risks to people were not followed and sufficient stocks of medicine were not always available. We also found individual risks associated with people’s care and support were not always identified in care plans and risk assessments.

In addition, care plans did not always reflect the care and treatment people needed, and where care plans were accurate, staff did not always follow them. This resulted in people not always receiving the responsive and personalised care they required.

When people lacked the capacity to consent to their care and treatment we found that decisions had not been taken in line with the Mental Capacity Act (MCA) 2005. Information about people’s day to day needs was not always recorded and used effectively to update staff as to any changes in people’s care and treatment.

Systems to check on the quality and safety of service provided had not yet been fully embedded, and had not identified all shortfalls in the service. Care plans and other records associated with the service were available, however, sometimes not all records were kept confidentially.

People had their views and choices respected and were included in making decisions about their care and support. People knew how to raise concerns, suggestions and complaints. People could take part in organised afternoon activities and some people could pursue their own interests. However, when the activities coordinator was not present, people experienced varying levels of engagement and stimulation because staff members varied in how much they engaged people in everyday conversation

People received care and support from staff who showed respect for people’s privacy and dignity. Overall, the staff team’s approach to people was caring. Staff received support, supervision and training to help them understand the needs of people using the service. People enjoyed their meals and choices of food and drink were provided which met their dietary requirements. People’s health care needs were supported by other professionals when required.

Sufficient numbers of staff were available, however at certain times of the day they were not always effectively deployed to meet people’s needs. Staff were aware of how to raise concerns to keep people safe and staff working at the service had been subject to pre-employment checks that helped ensure they were suitable to work there.

The registered manager had an open and approachable management style. The registered manager was coordinating a number of improvements planned for the service, including updating furnishings as well as management and information systems.