We carried out a review of the data available to us about Richardson Court on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Richardson Court, you can give feedback on this service.
Richardson Court is a care home that provides personal care for up to nine people with a
learning disability. At the time of the inspection eight people lived at the service. The service was split between a main house which six people lived in and a cottage within the grounds of the main house which two people lived in. The main house was split over two floors, all bedrooms were single occupancy, one with ensuite facilities and other people had a private hand wash basin. The cottage was split over two floors and had three bedrooms. People living in either the Court or Cottage had access to communal bathrooms, lounge, dining room, kitchen and garden.
The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them. People's participation within the local community was encouraged and enabled.
People’s experience of using this service and what we found
Since our last inspection maintenance work had been carried out to improve the environment. Some further cosmetic work was required. However, the service was warm, safe and had homely touches throughout. People were supported to stay safe. Risks were assessed, monitored, reviewed and staff understood how to recognise abuse and the processes to follow should they have any concerns. Accidents and incidents were recorded and analysed to identify any patterns or trends so any lessons could be learnt. There were enough staff to meet people's needs and staff had a good knowledge of the people they supported. Medicines were managed safely, and staff were competency checked to ensure mistakes were minimised.
Peoples needs were assessed before they moved in to the service and further assessments made to meet people’s needs. Peoples capacity to make specific decisions was assessed and best interest decisions made with the involvement of other important individuals. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence. People chose their own food and drink and staff knew how to support people with specific eating and drinking requirements. Staff were trained and knowledgeable about their roles. People were supported to remain well and healthy.
People’s privacy and dignity was respected, people were encouraged to be independent. Peoples diversities were considered and respected. We observed people being encouraged and supported to make their own choices and decisions. Staff spoke to people in a kind and considerate way, people appeared relaxed in their home and freely moved around the service.
Care plans reflected people’s needs, guidance was implemented so staff knew how to offer support in a consistent way. Relatives were communicated with and involved in their loved one’s care. People took part in various activities and outings. Peoples communication needs were assessed, and staff knew how to communicate with people in their preferred way. No complaints had been made since the last inspection. A complaints procedure described how people could make a complaint or raise a concern, an easy read version was available.
There was an open and inclusive culture in the service. The registered manager encouraged staff and other individuals to feedback what could change so the service could improve. Monitoring of staff performance was more robust. Auditing was in place which identified any areas of concern and action was taken in response to this.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was requires improvement (published 19 March 2019) and there were four breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
People’s experience of using this service:
Although auditing processes were in place to analyse risk and the delivery of care, audits had failed to identify the issues we found during our visit. The provider had failed to effectively monitor and act upon identified shortfalls.
The provider had not responded in a timely way to maintenance issues around the service which impacted on people and staff.
Some parts of the service were cold due to maintenance issues. This did not demonstrate a caring approach to people’s needs.
People were not always supported safely around eating meals and staff did not have clear guidance to follow to help people manage behaviours which could challenge.
Some records were confusing and contradictory which meant staff could not rely on documentation to guide their practice.
The registered providers had not always followed up on risk and their processes for monitoring this were not robust.
There were enough staff to support people with their needs.
People were communicated and supported in a person-centred way which considered communication adaptive needs.
Peoples medicine was managed safely.
Staff were supported and trained to carry out their roles.
People had access to health care professionals as required.
Staff worked together and with other healthcare professionals to ensure people received joined up care and support.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. The service was compliant with the Mental Capacity Act 2005.
People were treated with respect and compassion. Staff spoke to people with kindness and in a patient way.
People received personalised care that promoted their independence.
People and their relatives could make complaints to improve the quality of care.
The service had a registered manager who promoted an open and fair culture.
More information is in the detailed findings below.
Rating at last inspection: Requires improvement (report published February 2018)
Why we inspected: This was a planned inspection based on the rating at the last inspection. We found that the service continued to meet the characteristics of Requires Improvement. The overall rating is now Requires Improvement. This is the fourth time the service has been rated Requires Improvement.
Follow up: We will continue to monitor intelligence we receive about the service until we return to visit in line with our re-inspection programme. If any concerning information is received we may inspect sooner.
This service is a care home. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
Richardson Court is registered to provide accommodation and personal care for up to nine people with a learning disability. The accommodation was split between a main house which six people could live in and a Cottage within the grounds of the main house which three people could live in. At the time of our inspection there were five people living in the main house, Richardson Court and there were three people living in Richardson Cottage. The main house Richardson Court was split over two floors, all bedrooms are single occupancy, one with ensuite facilities and other people have a private hand wash basin. Richardson Cottage was on one level and had three bedrooms. People living in either service had access to communal bathrooms, lounge, dining room, kitchen and a garden.
At our last inspection, in September 2016, we found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This breach related to the management of risk to individuals' safety within the main house, tins of paint had been left in a person’s bedroom and the service was using electric heaters without the potential risks to people being assessed. This inspection took place to check that the registered provider had made improvements to meet the regulation. We found that improvements had been made and the breach had been met.
There was a registered manager based at the service who was supported by a recently appointed deputy manager. 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.
Staff were not always effectively deployed to ensure people were enabled to increase their independence and receive a personalised service. There were enough staff to keep people safe and observations showed people were comfortable with staff and peers. Safe recruitment procedures were in place to ensure staff were suitable to work with vulnerable people. People were kept safe by staff who understood safeguarding procedures and knew the action to take in the event of any concern.
Staff did not always feel supported in their role by the registered manager. We have made a recommendation about this.
Staff were given the training they needed to meet people’s needs including any specialist needs. Staff had access to and followed a range of policies and procedures to enable them to fulfil their role.
Risk assessments were individual to people’s needs and minimised the risk to people, staff and others. Appropriate checks of the environment were made to the environment to keep people safe. Procedures were in place to promote people’s safety in the event of an emergency. People who displayed behaviour that could challenge themselves or others did not always have access to the support they required. We have made a recommendation about this.
People’s needs had been assessed and recorded prior to moving into the service. People’s support plans were person centred and contained information and guidance for staff to meet people’s needs. People were enabled to use different forms of communication to make their wishes known. Staff knew people well and understood how people communicated their needs and preferences. People were not always supported to take part in activities to meet their needs and interests. We have made a recommendation about this.
People were supported to maintain their nutrition and hydration with the support and guidance from health care professionals. Staff supported people to maintain their health and have regular health appointments.
People were treated with kindness by staff who understood the importance of protecting people’s privacy and dignity. People were offered choices in accessible ways. Staff understood the principles of the Mental Capacity Act 2005 and the act had been followed when people had been assessed as not having capacity, decisions had been made in the persons’ best interests.
Medicines were managed safely. Staff had been trained and had the competency assessed prior to administering people’s medicines. People received the medicines as prescribed by their GP. Staff followed guidelines or people who required ‘As and when’ (PRN) medicines. Systems were in place to monitor infection control and procedures were in place to reduce the risk to people, staff and others.
People and others feedback was not always actively sought and acted on. We have made a recommendation about this.
A series of audits took place by the management team to monitor the quality of the service that was provided to people. Systems were in place to monitor, investigate and respond to any complaints or concerns that were raised.
Richardson Court was last inspected on 19 August 2015 where two breaches of our regulations were identified, an overall rating of requires improvement was given at that inspection. The provider had resolved the issues raised at the previous inspection which were no longer a concern at this inspection.
Each person had a single room; some rooms had en-suite facilities. People had access to shared bathrooms, kitchen, laundry room, dining room, and a large communal lounge. There was a well maintained, secure garden and outside area that people could access freely. There was off street parking within the grounds.
The service did not have 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 2008 and associated Regulations about how the service is run. The registered manager had de-registered with the Commission in February 2016; the provider had appointed a manager to manage the service in March 2016. They had submitted an application to register with the Care Quality Commission (CQC) at the time of our inspection. The manager was present throughout the inspection.
Risks to people were not always managed safely, this put people at potential risk of harm. Paint had been left in a person’s bedroom and portable, electric fires used in peoples rooms were unguarded and had not been risk assessed.
Regular supervisions had not been established for all staff, the manager had not checked the competency of a staff member who worked alone.
There were enough staff to meet people’s immediate needs, agency staff and the manager covered any gaps in the rota. The provider was in the process of recruiting more staff.
Appropriate checks were made to keep people safe. Safety checks had been made regularly on equipment and the environment.
The manager had good oversight of monitoring people’s support needs. People had behavioural guidelines in their care plans to help staff manage incidents. When incidents occurred the manager and staff discussed how things could change to improve outcomes for people.
Staff had a good understanding of how to keep people safe. Contact names and numbers of who to contact within the service and outside of the service were available should concerns about people’s safety need to be raised.
There were safe processes for storing, administering and returning medicines. Medicines were administered by trained staff. Regular audits were conducted on medicines to check errors had not occurred.
Staff had appropriate training and experience to support people with their individual needs and demonstrated a clear understanding of the people who lived there.
New staff underwent an induction which prepared them for their role and did not work unsupervised until assessed as competent to do so. Safe and robust recruitment process were in place to ensure people were supported by appropriately checked staff.
The service was good at responding to people who needed help to manage their health needs. People were supported to access outside health professionals.
The manager had a clear understanding of the principles of the Mental Capacity Act 2005 (MCA). People were offered advocacy services and the service had taken the appropriate steps to meet the requirements of the legislation.
People had choice around their food and drink and could choose alternative meal options when they wished. People with individual dietary requirements were catered for and advice was sought from healthcare professionals to help people to manage this.
Staff demonstrated caring attitudes towards people and showed concern for people’s welfare. People’s choices were respected and staff spent time engaging people in communication in their preferred way. When people required to be supported with their anxieties staff did this in a patient and compassionate manner. People felt confident and comfortable in their home and staff were easily approachable.
People were supported in a person centred and individual way. People’s care files were written in an easy read format which included pictures to help people understand its content. Each person had a key worker who regularly reviewed if the person’s current needs were being met or had changed.
People were helped to make complaints and staff supported people who were unable to use the easy read complaints policy by understanding what their body language meant if they were unhappy.
The service had been without a registered manager since February 2016 which is a requirement of the provider’s registration with the Commission; the manager had been in post since March 2016 and had applied for their registration with the Commission.
The manager understood the key challenges of the service and had started to make changes to improve the service people received. Staff said they felt well supported by the manager and commented that the service had improved since their appointment.
We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we have asked the provider to take at the end of this report.
This inspection took place on 19 August 2015 and was unannounced. The previous inspection was carried out in December 2013 and there were no concerns. Richardson Court is registered to provide accommodation and personal care for up to six people who have a learning disability or autistic spectrum disorder. Some people display behaviour which may challenge others.
At the time of the inspection six people were living at the home each having their own bedroom either on the ground or first floor, and some rooms had en-suite facilities. People had access to a large communal lounge, dining area, kitchen, laundry room and shared bathrooms. There is a well maintained, secure garden and outside area with chickens in a run and a polly tunnel for growing vegetables. There is off street parking within the grounds. People could move freely between the inside and outside areas of the home.
The service is run by a registered manager, who was present on the day of the inspection visit. 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.
Apart from one radiator, all other radiators around the service were unguarded posing a risk to the people who live there. The house was generally clean; however we found shortfalls in the maintenance of the equipment and refurbishment of the premises. This resulted in areas of the home being impossible to clean adequately by staff and safe infection control practices could not be met. Although systems for reporting maintenance concerns were in place follow up action had not been taken for prolonged periods of time. Some people had been left with broken equipment in their personal rooms and in communal areas.
Although quality assurance monitoring was in place to improve the outcomes people living at the service received, action was not always being taken to improve the areas identified as needing improvement. The views of people outside of the service such as relatives had been sought, however questionnaires were not clearly dated and action plans to improve on the comments made were not evident. The provider had failed to respond to areas of improvement that they had internally flagged as being in need to improve. This meant people would not benefit from receiving better care and support and be able to live in and environment which is safe and comfortable.
Staff told us they felt confident that they could speak to the management of the service if they required support and guidance. There were safe systems in place for the recruitment of new staff. New staff underwent a full induction and were asked to sign up to complete their level two or level three health and social care diploma at the start of their employment. Existing staff supported new recruits who shadowed them on shifts. Further training was offered to staff covering specialised areas such as autism awareness and Makaton. Staff were supported to carry out their duties effectively and were offered further support through one to one supervision, team meetings and could request further training in areas they felt they needed more knowledge and confidence in.
People had personalised care plans, risk assessments and guidance in place to help staff to support them in an individual way. We saw that staff members actively encouraged people to be fully involved and feel included in their environment. Where people required space to manage their behaviours this was respected and staff approached people in a kind a caring manner. Staff spoke about the people who lived at the home in a respectful way which demonstrated they cared about the people’s welfare. We observed throughout our inspection people interacting positively with staff smiling and wishing to be involved in conversations.
People were offered a full time table of activities and were able to participate in educational and social activities of their choice. People were supported to pursue individual interests and hobbies such as horse riding or athletics club. Staff communicated with people in a way which showed understanding and knowledge of the person, communication aids were used around the home to help people to express themselves.
People were supported to make their own decisions and choices and these were respected by staff. Staff were aware of the principles of the Mental Capacity Act and Deprivation of Liberty Safeguards (DOLs). The MCA provides the legal framework to assess people’s capacity to make certain decisions, at a certain time. When people are assessed as not having the capacity to make a decision, a best interest decision is made involving people who know the person well and other professionals, where relevant. We found that the registered manager had made DOLs applications for some people which had been granted, and was waiting for the remainder to be returned. The registered manager had notified the Care Quality Commission (CQC) of the applications which had been granted which is a statutory requirement.
People were encourage to eat and drink enough and were offered choices around their meals and hydration needs. We observed people being supported to have drinks on their request and be encouraged to choose what food they would like. Some people went out for a fish and chip lunch on the day of the inspection.
We found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we have asked the provider to take at the end of this report.
We saw that people received care that met their individual needs. There was an effective system in place to manage people's medicines and money. We saw that there was also an effective system to manage consent, working with people, their families, social services and the relevant professionals.
We saw that the spacious environment allowed people to have plenty of room to choose interaction or personal time.
We saw that staffing levels and skill mix were appropriate to need. The home manager told us that there was a monthly allocation of hours assessed against need. One person's care allocation was being re-assessed six weekly to ensure adequate 1:1 time. The person had recently been assessed by the Occupational therapy team, who had agreed the need for more 1:1 time. This should ensure an increase in the care hours.
We saw a clean and well maintained home with systems in place to monitor quality and safety of the service.
We saw that people were involved in making day to day decisions. The environment promoted people's independence and people were supported to cook, clean and do their own washing.
We saw that people received care that met their individual needs and it was reviewed regularly. We saw that people were protected from the risk of abuse because staff knew how to recognise potential abuse and what action to take. However, we noted an example where a staff member had not followed the procedure. There was an effective system in place to manage people's medication and money.
Staff were supported in their role by undertaking training, attending regular supervision and staff meetings.
There were systems in place to regularly monitor service delivery and the health and safety of the service.
using single words, sounds, signs and pointing to objects. They indicated that staff treated
them with respect and that they were supported to be as independent as possible.