We carried out a review of the data available to us about Richmond Residential Home on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Richmond Residential Home, you can give feedback on this service.
Richmond Residential Home is a 'care home'. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Richmond Residential Home is registered to provide accommodation for up to 20 people who require support due to mental health needs. At the time of our inspection, there were 17 people living in the home.
People’s experience of using this service and what we found
Improved systems had been implemented to monitor the quality and safety of the service. Regular internal and external checks were also completed to ensure the building and equipment remained safe. Although most risks to people had been assessed, not everyone had their risk from COVID-19 assessed. Staff had stopped monitoring people’s temperature, in order to early identify possible COVID-19 symptoms, after people had been offered vaccinations. This was recommenced straight away in line with current government guidance. Staff supported people following accidents and incidents, but records were not always robustly completed, and it was not recorded if medical advice was sought. We made a recommendation about this in the main body of the report.
Staff were aware of the government guidance in relation to COVID-19 testing and told us they completed tests in line with this. However, records were not always robustly completed to reflect this. A new system was implemented before the end of the inspection to improve this. Staff had access to enough PPE and used this appropriately. An infection prevention and control (IPC) policy was in place and regular cleaning schedules to help prevent the spread of infection.
People told us they felt safe living at Richmond. They were supported by sufficient numbers of safely recruited staff, that were aware of safeguarding procedures and how to raise any concerns. Medicines were stored and managed safely, and people told us they received their medicines when they needed them.
The registered manager was aware of their responsibilities and had notified CQC of events providers are required to inform us about. They worked with other professionals to help maintain people’s health and wellbeing and feedback regarding the care provided to people was positive.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was requires improvement (published 21 May 2019) and there were breaches of regulations identified. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
We undertook this focused inspection to check the provider had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the key questions Safe and Well-led which contain those requirements. The inspection was in part prompted by a monitoring call completed with the registered manager, which suggested that significant improvements had been made.
The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion, were used in calculating the overall rating at this inspection. The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.
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.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Richmond Residential Home on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
People’s experience of using this service: Risks to people within the home had not always been managed safely. Not all equipment had been maintained to ensure it was safe and risks identified within the environment had not been addressed. Since the inspection, the registered manager evidenced that some of the required improvements had been made.
The systems in place to monitor the quality and safety of the service were not always effective as they did not identify all the issues that we found on inspection and action had not always been taken in a timely manner to address the issues found. Notifications regarding incidents and events that had occurred within the home, were not always submitted to CQC as required.
People told us they felt safe living in the home; that they received their medicines when they needed them and that the home was always clean and tidy.
Staff had been recruited safely and had a good awareness of safeguarding procedures. They knew how to raise any concerns they had and we found that appropriate referrals had been made to the local safeguarding team.
There were enough staff available to support people both in the home and in the community. Staff were supported in their role through supervisions and regular training.
People’s dietary needs were known and met by staff, including their individual preferences. When there were concerns regarding people’s intake, this was monitored by staff and timely actions taken, such as referrals to the dietician.
People’s consent to their care and treatment was sought and recorded in line with the principles of the Mental Capacity Act 2005.
People told us staff were kind and caring and always treated them with compassion. Staff knew people well and they used this knowledge to ensure people had detailed, accurate and person-centred plans of care in place.
Staff supported people in ways that protected their privacy and dignity and encouraged their independence.
A range of activities was available based on people’s interests and hobbies. A minibus was also available that enabled people to go out on trips as a group.
The registered manager was described as approachable and staff told us their door was always open if they needed to discuss anything.
Rating at last inspection: Good (last report published September 2016)
Why we inspected: This was a planned comprehensive inspection based on the previous rating.
Enforcement: Please see the ‘action we have told the provider to take’ section towards the end of the report.
Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk.
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.
We previously inspected the service on 23 June 2015 when we found breaches of three regulations of the Health and Social Care Act 2014 and that overall the home required improvement.
When we visited, there were 18 people living at the home. The manager told us that two bedrooms that were previously used as double rooms were now for single occupancy and unlikely to be shared in the future. Most people had lived at the home for a considerable length of time but two people had gone to live there during 2015, one of whom had since left the home. Another person we met was having a temporary stay at the time of the inspection. The home accommodated both males and females and people’s ages ranged from 40 to 80 years.
People we spoke with said they felt safe and well cared for and information about safeguarding was available. We found that since our last inspection, all staff had received training about how to recognise abuse and their responsibility for reporting any concerns.
There were enough staff to meet the needs of the people living at the home. Safe recruitment practices had been followed when a new staff member of staff was employed and they had completed a full induction process. The staff team had made good progress towards completing a comprehensive programme of training and had received regular supervision from the manager.
Regular health and safety checks were carried out and improvements to the environment had continued to ensure that people had a comfortable environment to live and work in.
People’s health was monitored and people had access to medical professionals as needed. Medicines were stored securely.
People’s individuality was respected and staff encouraged and supported people to participate in the social activities they enjoyed. Some progress had been made in supporting people to develop independent living skills.
The manager had made significant improvements to working practices and to the standard of record keeping in all areas.
We carried out this comprehensive inspection on 23 June 2015. Richmond Residential Home is a care home registered to accommodate up to 20 people who do not require nursing care. The people who use the service require 24 hour support due to mental illness. 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.
When we visited, there were 19 people living at the home and one person had been admitted to hospital. Most people had lived at the home for a considerable length of time but two people had gone to live there during 2015. The home accommodated both males and females and people’s ages ranged from 40 to 80 years.
People we spoke with said they felt safe and well cared for and information about safeguarding was available. However, we found that not all staff had received training about how to recognise abuse and their responsibility for reporting any concerns.
There were enough staff to meet the needs of the people living at the home, however not all staff had received the training and support required to carry out their work. Safe recruitment practices had been followed when new staff were employed.
Regular health and safety checks were carried out and improvements to the environment had continued to ensure that people had a comfortable environment to live and work in.
People’s health was monitored and people had access to medical professionals as needed. Medicines were stored securely and new procedures had been introduced for the administration of medication.
People’s individuality was respected and staff encouraged and supported people to participate in the social activities they enjoyed. There were no plans in place to support people to develop independent living skills.
The manager had made improvements to working practices and people told us they were listened to. Some auditing tools were in use but there was scope for further development of quality assurance processes.
The specialist professional advisor commented “By and large, Richmond provides a ‘homely’ environment where people feel safe, cared for and looked after.” The expert by experience wrote “I felt the home was reasonably well maintained and had a nice atmosphere around the residents and staff.”
During this inspection we found breaches of Regulations 11, 13 and 18. You can see what action we have asked the provider to take at the back of this report.
A single inspector carried out this inspection. The focus of the inspection was to answer five key questions; is the service safe, effective, caring, responsive and well-led? Below is a summary of what we found. The summary describes what people using the service and the staff told us, what we observed and the records we looked at.
Is the service safe?
People were protected against the risks of unsafe premises because regular safety checks were carried out and an up to date fire detection system was in place.
People were protected against unsuitable staff because appropriate checks were carried out before people started working at the home.
Is the service effective?
People experienced care, treatment and support that met their needs and protected their rights. Monitoring systems were in place to ensure that people received the medical and personal care that they required.
Is the service caring?
People were encouraged and supported to take part in social and recreational activities of their choosing. People told us: “I have lived here for 17 years, it’s a smashing place.” and “We get well looked after.”
Is the service responsive?
We saw evidence that people who lived at the home were consulted about issues that were important to them, for example what they would like to eat and where they would like to go, and satisfaction questionnaires had been completed in 2013.
Is the service well led?
The provider took an active part in the day to day running of the home. He was present in the home most days and spoke with people who lived there and staff who worked there. A new manager was appointed in March 2014. She had previous experience working as a team leader and was working well with the provider and the administrator to improve the quality of life of the people who lived at the home.
We observed that the home was clean and free of unpleasant odours. People we spoke with considered that the cleaning staff were very good. We looked around the building and found that many bedrooms were in need of redecoration and had shabby, damaged furniture. The provider told us that he intended to refurbish one bedroom per month, with the agreement of the occupant. People we spoke with did not raise any complaints about their bedrooms.
Systems to regularly assess and monitor the quality of service that people received had been introduced. Record keeping had improved to protect people from the risks of unsafe or inappropriate care and treatment.
Policies and procedures relating to safeguarding had been reviewed and rewritten in line with current guidance and staff had received training about safeguarding and about dignity in care.
The manager had been working closely with the local authority to update policies and procedures and to develop quality assurance processes, however this was not yet completed.
New staff files had been set up and training records were kept. There were no care plans or risk assessments in place for the people living at the home.