All inspections: The Richmond - Care Quality Commission

The Richmond is situated in Sprotborough on the outskirts of Doncaster. The service provides nursing and personal care for up to 50 older people and people living with dementia. At the time of the inspection there were 47 who used the service.

This inspection took place on 4 November 2014 and was unannounced. This meant that the provider did not know when we were inspecting the service. The home was previously inspected in December 2013, when no breaches of legal requirements were found.

There should be a registered manager for the service. 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 and associated Regulations about how the service is run. The service did not have a registered manager. The provider had appointed a manager, who had been running the service. Before the inspection the manager told us they intended to apply to be registered.

People who used the service and their visiting relatives said positive things about the service, particularly the staff, the management team and the food. One person who used the service said, “Quite happy. Staff are lovely. I have a great relationship with them.” People told us that they enjoyed the range of activities available in the home, and staff we spoke with and observed understood people’s needs and preferences.

There were effective systems in place to make sure people were kept safe. Staff had a good knowledge about safeguarding people from abuse and neglect, and up to date risk assessments were in place. The way staff were recruited was safe and thorough pre-employment checks were done before they started work. One person’s relative told us they felt their family member was, “Safe, warm and well cared for.”

We saw evidence of people’s healthcare and nutritional needs being met and people’s medicines were stored and handled safely.

People and those who mattered to them were involved in the assessment about their care, support and health needs and involved in producing their care plans, but there was not always evidence that people were involved in the monthly reviews, so that their views about care and support could continue to be incorporated into the care plans.

Throughout the inspection most staff showed people respect and took steps to maintain their privacy and dignity. People told us that staff always knocked on their bedroom door. One visitor said, in regard to their family member, “They talk to him like a grown up. Treat him with respect.”

Overall, we found that staff received a good level of training and support, but not all staff had undertaken formal training in the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS).

The management team asked people to give feedback about their care and support to see if there were any improvements they needed to make and we saw several instances where their feedback had been used to improve the service. There was a system for the managers to review the quality of care being provided, and the staff team learned from incidents and accidents.

There was information available about how to make a complaint and people were confident they would be listened to. One visitor said, “The deputy manager is brilliant. If I have a problem she will deal with it without a moan or grumble.”

We spoke with four people who used the service. We saw staff including people in their conversations even if they were not able to respond fully. We saw people were given choices and they were respected by staff. We observed staff to be kind and caring in their approach.

People expressed their views and were involved in making decisions about their care and treatment. We spoke with staff who told us that people were involved in their care. One care worker said, 'All we do is centred round the individual person and we consider preferences and choices.'

People's needs were assessed and care and treatment was delivered in line with their individual care plan. We looked at five people's care records. They showed that care was planned to meet people's needs. We spoke with people who used the service and one person said, 'The staff are lovely, simply the best you could wish for. They know exactly what I need.'

People's health, safety and welfare was protected when more than one provider was involved in their care and treatment. This was because the provider worked in co-operation with others.

There was an effective recruitment and selection policy in place. We looked at four staff recruitment files and found them to be robust with the selection of staff.

People were protected from the risks of unsafe or inappropriate care and treatment because accurate and appropriate records were maintained.

We gathered evidence by observing people who were unable to speak with us. We also spoke with two people who used the service and four relatives. People who used the service told us they received good care and the staff were polite and kind. One relative also told us: "I'm very happy with the home. It's a positive place with a can do attitude. People are encouraged to be as independent as possible."

Evidence showed before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes. Where people did not have the capacity to consent, the provider acted in accordance with legal requirements.

We found people experienced care, treatment and support that met their needs or protected their rights. People's care and treatment was being planned and delivered in line with their individual care plans.

We found people were protected from the risks of inadequate nutrition and dehydration. People we spoke with told us the food was very good and they had plenty of choice.

People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines.

There were enough qualified, skilled and experienced staff to meet people's needs. We observed staff were able to meet people's needs in a timely way.

There was an effective complaints system available. Comments and complaints people made were responded to appropriately.

As part of our inspection we spoke with a number of people who use the service. They spoke positively about the care and support they received. They told us they liked living in the home and confirmed that they were well supported to make choices and decisions about the care they received. We received comments such as: 'I'm getting good care'

'I'm happy here' and 'Staff treat me well.'

People living in the home, confirmed they felt safe and said they liked the staff. One person told us: 'I feel safe here.' Another person said: 'The staff speak nicely to me and respect my wishes.'

During the visit we spoke with relatives who expressed their satisfaction with the standards of care at the home. They told us the staff were very good and they were kept informed of any changes. Some of the comments we received included: 'I am very happy with the care my husband is receiving, the staff take good care of him and I can see a positive difference.' and 'The care my mum receives is outstanding I am very happy with the service.'

Archived: The Richmond

All Inspections

04/11/2014

During a routine inspection

19 December 2013

During a routine inspection

27 February 2013

During a routine inspection

5 January 2012

During a routine inspection