Richmoe Healthcare

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

Well-led – this means we looked for evidence that leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture. This is the first assessment for this service. This key question has been rated good. This meant the service was consistently managed and well-led. Leaders and the culture they created promoted high-quality, person-centred care.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a shared vision, strategy and culture. This was based on transparency, engagement, and understanding challenges and the needs of people.

The registered manager had clear aims and objectives for the service and demonstrated a commitment to delivering person-centred care within the local community. As both the registered manager and provider, they drew on their previous experience in community nursing as motivation to establish the service. They explained this was driven by their understanding of the challenges within domiciliary care and the need for high-quality community-based support, as well as the key role such services play in supporting the wider healthcare system.

Staff described the registered manager and senior staff as supportive, responsive and professional. Senior staff worked alongside care staff to provide support or cover absences, which helped them understand challenges and promote a positive team culture.

People and relatives consistently expressed the view that the service’s leadership was responsive to their feedback and made changes needed when issues occurred. This reflected a culture within the provider that listened and valued people’s perspective and was motivated in improving their experiences of receiving care.

The provider had inclusive leaders at all levels who had the skills, knowledge, experience and credibility to lead effectively. They did so with integrity, openness and honesty.

The registered manager was suitably qualified and experienced. They maintained their nursing registration and intended to use these skills if more complex healthcare packages were commissioned in the future. The registered manager was aware of their responsibilities regarding the duty of candour and made statutory notifications to relevant bodies, as required by regulations. Senior staff had clear roles in maintaining effective oversight of the service. They had a good understanding of their responsibilities and were motivated in sustaining and improving the quality of the service.

The registered manager was committed to their own professional development. They completed training, accessed local authority learning, attended provider forums, and engaged with professional networks to stay up to date with best practice.

Staff reported that senior staff were supportive. They explained senior staff provided training and practical support when issues arose or when they felt uncertain about aspects of their role.

The provider fostered a positive culture where people felt they could speak up and their voice would be heard.

Staff told us they felt comfortable raising issues with senior staff and were confident their concerns would be addressed. Policies and procedures around whistleblowing were in place. This helped to ensure staff understood how and to whom they could report concerns. One staff member said, “If I had issues, I just tell the (registered) manager. I could always call safeguarding (local authority) or you (CQC) as well.”

The provider valued diversity in their workforce. They worked towards an inclusive and fair culture by improving equality and equity for people who worked for them.

The provider had policies and procedures in place to promote workforce equality and diversity. Staff told us they were treated fairly at work. The registered manager had recognised the practical and emotional demands on staff associated with care work. They supported individual staff with their personal circumstances, to promote their wellbeing at work.

The provider had clear responsibilities, roles, systems of accountability and good governance. They used these to manage and deliver good quality care and support.

There were effective governance processes to oversee quality and safety. This included systems to ‘live monitor’ care delivery via the electronic system, providing senior staff with assurance that care was being delivered as planned. Senior staff completed thematic audits to gain a deeper understanding of the quality-of-care people received. These covered care records, medicines, care plans, incidents and complaints. Audit findings were followed up with relevant staff to ensure any issues were addressed and appropriate actions implemented. This demonstrated that the provider’s governance systems effectively identified key risks and supported continuous improvement.

The provider had systems to promote effective information governance. This included systems to ensure records were stored securely and only accessed by appropriate individuals. For example, access to systems and confidential information was kept under constant review to help ensure only appropriate parties could access records and confidential information.

The provider understood their duty to collaborate and work in partnership, so services worked seamlessly for people. They shared information and learning with partners and collaborated for improvement.

Staff worked in partnership with other professionals when needed to help make sure people received personalised care and support. For example, where people had complex care needs, they worked in partnership with stakeholders to plan and review people’s care. We received feedback from a health and social care professional, who confirmed effective collaborative working practices were in place. This joined up approach helped to ensure that people received timely and appropriate input from health and social care professionals.

The provider focused on continuous learning and improvement across the organisation.

The provider used feedback from families, along with information from audits and incidents, to drive improvement. Learning was shared with staff and used to improve working practices through additional training, staff meetings, and supervision. For example, following concerns about confidence in providing catheter and dementia care, the registered manager arranged updated training for all staff. This increased staff’s confidence and provided assurance for the provider regarding staff’s competence. In another example, the provider had taken steps to improve the live monitoring of care. They identified that, at times, staff experienced difficulties logging into care visits due to limited mobile data coverage. The provider was working to resolve these issues to ensure staff could use the system as needed. This helped to improve monitoring systems and ensure staff’s safety and whereabouts could be accounted for.