Richmond House

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• 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

This means we looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture.

At our last assessment we rated well-led as good. At this assessment the rating has remained good. Leaders had the skills, knowledge and experience to perform their roles. Staff knew and understood the provider’s vision and values and how they applied to the work of their team. Staff felt respected, supported and valued. Governance processes operated effectively. Performance and risk were managed well. Teams had access to the information they needed to provide safe and effective care. Staff collected and analysed data about outcomes and performance. They used this to identify improvement.

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.

We scored the service as 3. The evidence showed a good standard. The service had a shared vision, strategy and culture. This was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and understanding challenges and the needs of people and their communities.

Staff knew and understood the provider’s vision and values and how they were applied in the work of their team. Staff told us the values of Priory were putting people first, being supportive, acting with integrity, striving for excellence and being positive.

The provider’s senior leadership team had successfully communicated the provider’s vision and values to the frontline staff in this service.

Staff had the opportunity to contribute to discussions about the strategy for their service, especially where the service was changing, through regular team meetings. Senior leaders visited the services regularly and staff described them as supportive, approachable, and responsive. Staff development was encouraged through regular supervision.

We scored the service as 3. The evidence showed a good standard. The service had inclusive leaders at all levels who understood the context in which they delivered care, treatment and support and embodied the culture and values of their workforce and organisation. Leaders had the skills, knowledge, experience and credibility to lead effectively. They did so with integrity, openness and honesty.

Leaders had the skills, knowledge and experience to perform their roles and they had a good understanding of the services they managed. They could explain clearly how the teams were working to provide high quality care.

There was a clear and stable leadership structure in place. The registered manager had oversight of 3 services and spent part of their week on-site, where they maintained a strong presence and had a positive relationship with staff and patients.

The team had access to 2 nurses with learning disability qualifications, but the provider made sure all staff, received training on learning disabilities. This gave everyone the knowledge to meet patients’ needs and provide safe, high-quality care.

We scored the service as 3. The evidence showed a good standard. The service fostered a positive culture where people felt they could speak up and their voice would be heard.

Carers had opportunities to give feedback on the service they received in a manner that reflected their individual needs. There were no actions required for the 2024 results. Historically, action that has been taken following carers feedback has been the introduction of the quarterly newsletters, open day events, and letters sent to family members with multidisciplinary team (MDT) contact details.

Patients and carers were involved in decision-making about changes to the service. This included patients being involved in staff interviews.

The provider encouraged staff to give feedback through consistent supervision structures and provided staff with opportunities to raise concerns about any matters relating to patient care. For example, the provider had a whistleblowing helpline and an established network of freedom to speak up champions and a freedom to speak up guardian.

We scored the service as 3. The evidence showed a good standard. The service valued diversity in their workforce. They work towards an inclusive and fair culture by improving equality and equity for people who work for them.

There were equality and diversity champions within the provider, for example for lesbian, gay, bisexual and transexual staff (LGBT+) and black and minority ethnic staff (BAME). Leaders promoted an inclusive culture and maintained a zero-tolerance approach to bullying and harassment. They ensured all staff, including those less frequently heard, had opportunities to contribute to service development. Equality, Diversity, and Inclusion (EDI) were clearly embedded within the organisation’s values, policies, and strategic priorities. Overall, 100% of staff had completed diversity and inclusion training.

Managers put reasonable adjustments in place for staff members to help them carry out their role. For example, pregnancy risk assessments, flexible working agreements and occupational health referrals. Adjustments had been made to meet recommendations such as completing individualised risk assessments for staff. Leaders could give personalised examples where reasonable adjustments had been made for staff.

We scored the service as 3. The evidence showed a good standard. The service had clear responsibilities, roles, systems of accountability, and good governance. They used these to manage and deliver good quality, sustainable care, treatment, and support. They act on the best information about risk, performance and outcomes, and share this securely with others when appropriate.

There was a clear framework of what must be discussed at a ward, team or directorate level in team meetings to ensure that essential information, such as learning from incidents and complaints, was shared and discussed.

Staff undertook or participated in local clinical audits. The audits were sufficient to provide assurance and staff acted on the results when needed. There was an audit schedule in place that staff and leaders adhered to, and leaders carried out a monthly quality walk around of the service.

Staff had access to the equipment and information technology needed to do their work. The information technology infrastructure, including the telephone system, worked well and helped to improve the quality of care. Information governance systems included confidentiality of patient records.

Team managers had access to information to support them with their management role. This included information on the performance of the service, staffing and patient care.

We scored the service as 3. The evidence showed a good standard. The service understood their duty to collaborate and work in partnership, so services work seamlessly for people. They share information and learning with partners and collaborate for improvement.

The provider maintained community partnerships and worked with local organisations to support patient care and learning opportunities. Patients were encouraged to participate in community activities promoting wellbeing and social inclusion including exercise groups and knit and natter sessions within the local community and leisure activities such as going to the gym and swimming pool.

Patients and staff could meet with members of the provider’s senior leadership team and commissioners to give feedback.

We scored the service as 3. The evidence showed a good standard. The service focused on continuous learning, innovation, and improvement across the organisation and local system. They encouraged creative ways of delivering equality of experience, outcome, and quality of life for people. They actively contribute to safe, effective practice, and research.

The service participated in the Quality Network for Inpatient Learning Disability Services (QNLD) accreditation programme and received QNLD status for 2023 – 2025. The QNLD, led by the Royal College of Psychiatrists, aims to improve learning disability services.

Richmond House was part of the RADiANT Network. RADiANT (Research in Developmental Neuropsychiatry) is a clinical and research network which launched in 2019 and is a network of NHS service providers which works in collaboration with academics in several universities. It seeks advice from service users, patients, families, charities, community leaders and a range of statutory bodies and organisations.

The service demonstrated a commitment to learning from both local and national provider wide incidents, with lessons shared openly among staff. There was evidence of reflective practice and collaborative problem-solving to improve care and prevent repeat issues.