Richmond Heights

Richmond Heights is a residential care home providing personal and nursing care to up to 51 people. Some people using the service were living with dementia. At the time of our inspection there were 44 people using the service.

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

The provider had systems in place to monitor the quality of the service. These systems had not identified all the issues we found on inspection. Where issues had been noted as a result of internal audits, actions to rectify them had not been completed in a timely way. There was little evidence to show people had been involved in the development of the service or had been asked their views and opinions.

Whilst staff were kind, they were task orientated and interactions sometimes lacked a person-centred approach. Care plans also lacked detail about people's preferences and how they liked to be supported. We were informed care plans had been changed from a paper format to an electronic system and some information had not been transferred.

There was a lack of social activities and stimulation to meet people's needs. Most people were cared for from bed with very little to stimulate them throughout the day.

Risks associated with people's care were not always managed to ensure people's needs were met safely. People received their medicines as prescribed. However, a tally of medicines in stock was not available and some temperatures of the medicine room and fridge had not been documented.

There were enough staff available to meet people's needs. People were safeguarded from the risk of abuse. Staff were recruited safely. Accidents and incidents were analysed, and action was taken to mitigate future incidents.

People's needs were assessed and staff knew people well. People received a healthy balanced diet which met their needs and considered their preferences. There was no menu on display, only a picture menu which did not display the meal options available on the day of inspection.

The provider had identified some areas of the home that required decoration and/or refurbishment and they were in the process of carrying out this work.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

This service was registered with us on 26 August 2021 and this was the first inspection.

The last rating for the service under the previous provider was good, published on 3 June 2019.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Enforcement and Recommendations

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. Please see the action we have told the provider to take at the end of this report.

We have identified breaches in relation to risk management and good governance at this inspection.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. 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.

We found the following examples of good practice.

There were measures in place to prevent any visitors from spreading infection at the entrance and on entering the premises. These included well-stocked supplies of PPE and hand sanitisers throughout the building.

Staff supported people to minimise close physical contact with others and to maintain social distancing wherever possible.

People living at Richmond Heights and staff were tested regularly in line with government guidance. People were supported to self-isolate as appropriate.

The premises were clean and well maintained. The registered manager was in the process of developing enhanced cleaning schedules.