Richard House Care Home

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs. At our last assessment we rated this key question good. At this assessment the rating has changed to requires improvement. This meant people’s needs were not always met.

This service scored 50 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Care was not always delivered in a way that reflected people as individuals or responded to their preferences, communication needs and circumstances. This reduced assurance that people were consistently supported in a way that reflected what mattered to them. Relatives’ feedback indicated that care was not always delivered in a way that reflected people’s individual needs.

Some relatives raised concerns that people were not consistently supported with personal care in line with how they wished or required support. This included people not being assisted to wash, change clothes or maintain their oral hygiene as they wanted it done, records supported this.

Following feedback, the provider identified the need to strengthen the use of care plans and improve staff understanding of individual needs to support more consistent, person‑centred practice; however, these actions were not yet fully embedded at the time of inspection.

Care was not consistently well‑coordinated or joined‑up. While some staff showed caring attitudes, this was not always translated into coordinated, person‑centred or joined‑up care in practice.

People’s needs linked to dementia, Parkinson’s disease and communication difficulties were not always fully recognised or met. This included gaps in understanding how conditions affected mobility, behaviour, communication, eating and drinking and risk of deterioration or falls.

Joint working with relatives and other services was inconsistent. Families often described having to coordinate care themselves, identify changes in health and escalate concerns. Information sharing was not always timely or effective, and reviews of care were not consistently completed when needs changed.

People were not always provided with clear, accessible or timely information. Information about people’s care, changes in need and actions taken was not consistently communicated effectively to individuals or their relatives. Some relatives reported having to repeatedly seek information or clarification and were not always kept informed about incidents or care arrangements. This reduced assurance that people and those important to them were consistently provided with the information they needed to understand care decisions or be meaningfully involved.

Although staff were able to describe people’s individual communication needs, they were not always able to demonstrate how barriers to effective communication were reduced in practice. For example, one person who did not speak English was not always supported in a way that enabled meaningful communication. Staff could not explain how they supported the person’s understanding beyond the use of gestures, and a communication aid intended to support the person was not consistently available or maintained. This reduced assurance that the person was supported in a person‑centred and inclusive way that respected their individual communication needs and rights.

People’s views and experiences did not always influence decisions about care and support. Relatives told us they did not always feel their feedback or complaints were listened to or acted upon. Some said concerns had been raised previously but had not resulted in visible change, which reduced confidence that people’s views were influencing how care was delivered.

Records did not consistently show how feedback from people or relatives was gathered, responded to or used to improve practice. People’s views about day‑to‑day experiences were not always used to shape care. For example, while many people were satisfied with the food, some raised concerns about presentation and choice, particularly for those receiving soft or blended diets. Observations showed that meals with a changed texture were presented in a way that did not appear appetising. This indicated that feedback about dining experiences had not been used to inform improvements. Although menus and choices were discussed with some people, opportunities to routinely seek and respond to people’s views about meals and dining experiences were not consistently demonstrated. As a result, people and their relatives were less confident that their views would lead to meaningful change.

Equitable access to care and support was in place but not consistently timely or reliable. While the premises were generally accessible and some reasonable adjustments were in place, these were not consistently reflected in day‑to‑day care delivery. Delays in support occurred, particularly during periods of staffing pressure, which affected people’s access to timely care and led to variation in people’s experiences. This included a missed hospital appointment, which the provider attributed to hospital transport arrangements. However, there was insufficient assurance that alternative actions were taken to ensure the person was supported to attend the appointment, reducing confidence that access to external healthcare was reliably facilitated when needed.

Equity in people’s experiences and outcomes was not consistently achieved. While many staff demonstrated caring attitudes and an intention to support people fairly, this was not always translated into consistent practice or outcomes. People’s experiences varied depending on staffing levels and how individual needs were understood and acted upon. Care planning and delivery did not always take sufficient account of factors that placed some people at greater risk of a poorer experience, including disability or increased dependency. Feedback from people, relatives and staff indicated that concerns were not always responded to in a way that reduced inequality or improved outcomes. This reduced assurance that all people received consistently positive experiences and outcomes, regardless of their circumstances or protected characteristics.

Planning for people’s future care was not consistently effective. Systems were not in place to ensure people and their relatives were routinely supported to have timely, informed conversations about future needs, including end‑of‑life care, while people had capacity to do so.

Although some information relating to future planning was recorded within the electronic system, this was not consistently incorporated into care plans in a way that provided clear, accessible guidance for staff. Relatives reported that they were not consistently involved in discussions about people’s future care, including when people were identified as approaching the end of their lives. Some described uncertainty about whether advance care planning and decisions about future treatment and care preferences had been reviewed or updated, and said information was not always shared in a timely or proactive way. In one example, relatives were advised that a person had been identified as approaching the end of their life and that relevant care planning information would be updated; however, requests for copies and follow‑up information were delayed or not responded to. This reduced relatives’ confidence that people’s wishes were clearly understood, revisited as circumstances changed or consistently reflected in care planning and decision‑making.