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Inspection carried out on 21 November 2017

During a routine inspection

This inspection was carried out on 21 November 2017 and was unannounced. At their last inspection on 25 April 2017, they were found to not be meeting the standards we inspected. This was in relation to staffing.

Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key questions is the service safe, effective, responsive and well led to at least good. At this inspection we found that they had made the required improvements and were meeting all the standards.

Richard Cox House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The service accommodates up to 29 people in one adapted building. At the time of the inspection there were 29 people living there.

The service had a manager who was in the process of becoming registered with the Care Quality Commission (CQC). A registered manager is a person who has registered with the CQC 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.

People and staff were positive about the running of the home. Their views were sought and they were consulted in relation to the running of the home.

There were systems in place to monitor the quality of the home, listen to people and value staff. There was a complaint’s process which people knew how to use and were confident they would be acted upon.

People were supported in a safe way and staff knew how to recognise and report any risks to people’s safety. Medicines were administered in accordance with the prescriber’s instructions.

The manager planned for sufficient staff who were recruited safely and people told us that their needs were met appropriately. We found that staff were trained and felt supported.

People were encouraged and supported to make choices and staff were aware of the principles of the Mental Capacity Act 2005. There was a variety of food available and people were supported to live a healthy and balanced life.

People were treated with dignity, respect and kindness. We found that people were supported in accordance with their preferences and wishes and that confidentiality was promoted.

People received person centred care and enjoyed activities provided and they were involved in planning their care.

Inspection carried out on 25 April 2017

During a routine inspection

This inspection was carried out on 25 April 2017 and was unannounced. At their last inspection on 23 April 2015, they were found to be meeting the standards we inspected. However, staffing was an area that required improvement. At this inspection we found that they had continued to meet all the standards however, staffing was an area that still required improvement.

Richard Cox House provides accommodation for up to 29 older people, including people living with dementia. The home is not registered to provide nursing care. At the time of the inspection there were 29 people living there.

The service had a manager who was registered with the Care Quality Commission (CQC). A registered manager is a person who has registered with the CQC 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.

People told us, and we saw, that in the mornings they needed to wait for assistance for using the toilet or getting washed and dressed. We discussed this with the management who were making arrangements to resolve these issues.

People felt safe and we saw there were Individual risk assessments in place and these adhered to by staff. People’s medicines were managed safely.

People were supported by staff who were trained and supported. People were asked for their consent and staff adhered to the principles of the Mental Capacity Act 2005.

People enjoyed a varied diet and received support appropriately. There was regular access to health and social care professionals and confidentiality was promoted.

People were treated with kindness, dignity and respect and had developed relationships with the staff who worked there. People’s needs were met and their care plans were clear and updated regularly. People enjoyed a range of activities and complaints were responded to appropriately.

Inspection carried out on 23 April 2015

During a routine inspection

This inspection took place on 23 April 2015 and was unannounced. This visit was carried out by two Inspectors.

Richard Cox House provides accommodation for up to 29 older people, including people living with dementia. Richard Cox House is not registered to provide nursing care. There were 29 people living at the home when we inspected.

The service was found to be meeting the required standards at their last inspection on 18 July 2013.

There was a registered manager in post at this home. 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.

The CQC is required by law to monitor the operation of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS) and to report on what we find. DoLS are in place to protect people where they do not have capacity to make decisions and where it is considered necessary to restrict their freedom in some way, usually to protect themselves or others. The registered manager and staff were aware of their responsibilities under the MCA 2005 and DoLS. The manager was in the process of submitting DoLS applications to the local authority for people who needed these safeguards.

We found that, where people lacked capacity to make their own decisions, consent had been obtained in line with the MCA 2005.

We found that there was not always enough staff available to meet people’s needs on the units with only one staff member during busy times.

People were protected from the risk of abuse and felt safe at the home. Staff were knowledgeable about the different types of abuse and reporting procedures. Safe and effective recruitment practices were followed which included appropriate background and employment checks.

There were suitable arrangements for the safe storage, management and disposal of medicines.

Incidents and risks were managed well and reported appropriately and people were supported to take risks safely.

People were supported by staff that knew them well and were involved with decisions about the home, and their own care. Their independence and dignity was promoted by staff that had access to appropriate training and who were knowledgeable about their care needs.

People and their relatives felt cared for and supported by the manager, they felt listened to and that their views were taken into account. There were regular resident and staff meetings for people to express their views and any concerns were acted upon and responded to. The service had a complaints procedure in place.

The service was well led by a manager that supported an open culture. There was support for the manager. There was a quality assurance system in place that included audits to identify where improvements could be made.

Inspection carried out on 18 July 2013

During a routine inspection

During our visit on 18 July 2013 we observed that staff provided care in a way that showed people were being treated with respect and given choice about how they received their care.

We spoke with seven people living in the home and with two relatives. People were very complimentary about the care provided. The relatives we spoke with told us they had chosen Richard Cox through recommendations of other people and were very happy with the care so far. They told us the staff are very helpful, caring and nothing is too much trouble.

We found that the care records provided staff with the information they required to meet people’s needs.

Medication administration and storage was well kept.

Recruitment procedures were being followed and staffing levels were appropriate to meet the needs of the people living at Richard Cox.

Inspection carried out on 14 August 2012

During a routine inspection

The people we spoke with told us that staff members were polite and that they felt their privacy and dignity was respected at all times. They told us that they were asked about the care and support that was provided although they said that hadn’t seen their care plans but were aware they had one.

One person told us the staff members provided the care and support they needed to live as independently as possible. One quoted, “They are wonderful and always help us whenever we need it”

People confirmed that they felt safe living at the home. They were able to talk to staff members if they had any concerns.

Reports under our old system of regulation (including those from before CQC was created)