25th August 2015
During a routine inspection
This unannounced inspection took place on the 25th August 2015.During our inspection May 2013 we made a compliance action as the environmental standards in the service were non-compliant with the regulations in place at that time. We followed up this inspection in March 2014 and found this standard had been met and the service was fully compliant with the standards we inspected during the two inspection visits.
There is a registered manager in post. 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.
We found at this inspection that there was a breach of Regulation 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was because there were not sufficient numbers of support staff to meet the assessed needs of people living in the home and in emergency situations.
We found at this inspection there was a breach of Regulation 13 of the Health and Social Care Act 2008(Regulated Activities) Regulations 2014. This was because the registered provider had not made sure that suspected or alleged abuse was acted upon quickly and in line with local safeguarding arrangements to keep people safe.
We found at this inspection there was a breach of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 because appropriate arrangements were not in place to demonstrate that people received all their medicines appropriately.
We found at this inspection there was a breach of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 because appropriate arrangements were not in place to protect people from cross infection.
We found at this inspection there was a breach of Regulation 9 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was because the assessments of people’s care, treatment and support needs were not in detail to support person centred care and did not include all their needs and possible risks that needed to be managed.
We found at this inspection there was a breach of Regulation 14 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was because people were not supported to have adequate nutrition and hydration.
We found at this inspectionthere was a breach of Regulation 11 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 because people who used this service had not been properly supported to make decisions about their care and welfare.
The Care Quality Commission (Registration) Regulations 2009 require that the registered provider notifies the Commission without delay of allegations of abuse and accidents or incidents that had involved injury to people who used this service. This is so that CQC can monitor services responses to help make sure appropriate action is taken and also to carry out our regulatory responsibilities. The sample of people’s records that we looked at showed examples of incidents and accidents that had occurred that should have been reported to CQC. Our systems showed that we had not received these notifications. This was a breach of Regulation 18 of the Care Quality Commission (Registration) Regulations 2009.
You can see what action we told the provider to take at the back of the full version of the report.
We spoke to people who lived in Richmond Park and they all talked positively about living in the home. They said, “I feel safe you are well looked after here” and “Staff come in regularly during the night to see how you are, and they will have a little chat with you if you are awake.” Every person we spoke to told us they felt safe, well looked after, and respected. Relatives praised the attitude of the staff and were happy with the care provided.
We spent time in all parts of the home and observed staff caring for people in a warm and friendly manner.
We found there was a period during the day and also at night when there was insufficient staff to safely care and support people.
We found that some people were not fully supported to take suitable or sufficient nutrition and hydration.
The provider had safe systems for the recruitment of staff to make sure the staff taken on were suited to work with adults at risk.
The records pertaining to topical medicines and creams were not up to date and in some cases not recorded at all. Medicines liable to misuse were recorded and stored correctly.
People knew how they could complain about the service they received and information on this was displayed in the home. People we spoke with were confident that action would be taken in response to any concerns they raised.
Internal audits or checks were completed in order to monitor the service provided.