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Richmond Care Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 1 June 2019

About the service: Richmond Care is a 'care home' that provides both residential and nursing care. The service can provide care for up to 19 people. There were 18 people with enduring mental health needs and other complex needs living at the home, although two people were in hospital at the time of this inspection.

People’s experience of using this service:

Medicines were not being managed safely. A recent medicine audit had not picked up the errors we found.

The number of staff available during the day and at night was sufficient to ensure people’s needs were met in a timely way at the time of the inspection, due to additional resources in the home. We were not confident that normal staffing levels would meet people’s needs, especially with people’s increasing dependencies.

The home was clean. Audits in this area were fit for purpose and any identified failings were rectified.

Environmental health and safety checks had been carried out but had not identified some of the issues we identified. The system for reporting and addressing repairs required to the home needed to be formalised.

Risks to people’s health, safety and well-being associated with their care needs were assessed and management plans were in place to ensure risks were mitigated as much as possible.

The management and staff understood their obligations under the Mental Health Act 1983 and worked within these legislative frameworks.

Care plans reflected that care was being delivered within the framework of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards had been applied for when necessary.

People told us they felt safe and well cared for at the home. Staff knew people well and had developed close, caring relationships. Staff were aware of their responsibilities to safeguard people.

Recruitment practices were safe and staff received the training they required for their roles.

People and their relatives were involved in making decisions about their care.

People who were independent were able to access the community and engage in meaningful leisure and social activity. There were less opportunities for people who required support from staff to do this.

Audits of the service were in place and were undertaken, although these were not always used effectively to monitor and improve the quality and safety of the home.

The manager was using available resources such as the local registered manager network and meeting with relevant health professionals for advice and guidance.

We identified two breaches of the regulations and we made three recommendations. These included introducing a formal process to determine staffing levels, improving the way required repairs were reported and dealt with and engaging people more in meaningful social activities.

The home met the characteristics of a rating of “Good” for two key questions and “Requires Improvement” for three key questions. Our overall rating for the home after this inspection was “Requires Improvement”.

Rating at last inspection: At the last inspection in October 2016 the home was rated Good (report published 31 October 2016).

Why we inspected: This was a planned inspection based on the rating at the last inspection.

Please see the ‘action we have told the provider to take’ section at the end of the report.

Follow up: We have asked the provider to complete an action plan detailing how they will make improvements to ensure the regulations are met. We will work with our partner agencies, including the local authority, to review the progress made by the provider. We will continue to monitor the intelligence we receive about the service. 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

Inspection areas

Safe

Requires improvement

Updated 1 June 2019

The service was not always safe.

Effective

Good

Updated 1 June 2019

The service remained effective.

Caring

Good

Updated 1 June 2019

The service remained caring.

Responsive

Requires improvement

Updated 1 June 2019

The service was not always responsive.

Well-led

Requires improvement

Updated 1 June 2019

The service was not always well led.