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Richmond Village Painswick DCA Good


Inspection carried out on 4 September 2019

During a routine inspection

About the service

Richmond Village Painswick DCA provides care and support services to people living in their own homes within the Richmond Village retirement complex. People live in the independent living apartments or in the assisted living building known as “suites”. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where services provide this help, we also consider any wider social care provided.

People’s experience of using this service and what we found

People told us they felt safe with the staff. The staff had attended safeguarding of abuse training and were aware of the procedure to follow when there were concerns of abuse.

Systems were in place to manage risk. Where risks were identified individual risk assessments were in place. Risks were reviewed and updated when people’s needs changed. There was an overarching register of people at greatest risk of potential harm which ensured their needs were kept under review.

Environmental risk assessments were in place and detailed. We recommend copies of personal evacuation plans to be kept in people's homes to ensure their awareness of the emergency plans.

Medicine systems were safe. Medicines were audited and action plans were developed where gaps were identified.

People told us there were sufficient staff on duty. They said their visits were not missed and the staff stayed for the agreed times.

There was an online system of recording accidents and incident. Reports were analysed and follow up action taken as required. The staff discussed accidents and incidents to ensure there was learning to prevent re-occurrences or to better manage situations of the same nature. The staff were positive about the team and that they were able to learn from shared experiences.

People needs were assessed before the agency agreed to deliver personal care.

Staff were supported with their roles and responsibilities. New staff had an induction when they started work at the agency. There was mandatory training set by the provider which staff attended.

The staff were supported with their performance and development. Performance was monitored through one to one supervision, observations and annual appraisals.

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.

Some people had nominated a lasting power of attorney (LPA) for finance or care and treatment. However, copies of the LPA were not kept on file. The manager had not checked to confirm the validity of the LPA. This meant the manager was unclear on who were the decision makers to participate in best interest decisions when people lacked capacity. We recommend the manager ensures LPA were accurately documented

Care plans were person centred and reflected people’s personal care needs. Peoples care needs were reviewed six monthly to ensure their needs were met as they changed. Where people lived with mental health needs their care plans were not updated when there were signs of deterioration. The manager took appropriate action to review the care needs of people with mental health care needs.

People arranged their own healthcare. Where health care visits had taken place, the staff recorded the nature of the visits and their outcome in the communication book.

People said the staff were caring and kind. The staff knew the importance of developing relationships with people. Their comments showed they knew people's preferences and had an insight into people's life stories.

Quality assurance systems were effective. There was a wide range of audits undertaken and action taken where there were shortfalls. Complaints were investigated and resolved to a satisfactory level.

The staff said they felt valued by the manager and there were opportunities for personal development.

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Inspection carried out on 1 February 2017

During a routine inspection

The inspection was unannounced and was carried out by one adult social care inspector. The previous inspection of the service was in August 2014. At that time there were no breaches of the legal requirements.

Richmond Village Painswick DCA provides care and support services to people living in their own ‘purchased’ homes, within the Richmond Village retirement complex. People live in the independent living apartments (ILU) or the assisted living suites (ALU). People pay a monthly service charge and this covers the provision of all meals, or food items to prepare meals plus housekeeping services. At the time of the inspection the service were supporting 20 people, (three people in the ILU and 17 in the ALU), The service had 14 care staff and one team leader.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.

The registered manager and care staff were knowledgeable about safeguarding issues and knew what to do if there were concerns about a person’s safety. All staff received safeguarding adults training. Robust recruitment procedures were followed to ensure only suitable staff were employed. Appropriate steps were taken to protect people from harm.

Any risks to people’s health and welfare were identified and then managed to either reduce or eliminate the risk. The level of support people needed with their medicines was identified in their care plan. Staff received safe medicines administration training to ensure they were competent to undertake the task. The competency of each staff member was re-checked regularly to ensure they continued to follow best practice.

Care staff had a mandatory training programme to complete which enabled them to carry out their jobs well. They received support from the registered manager and the team leader and were regularly supervised. New staff had an induction training programme to prepare them for their role and then completed the Care Certificate. All care staff had either already completed a qualification in health and social care (formerly called a national vocational qualification), at least at level two, or were working towards the award.

Staff understood the principles of the Mental Capacity Act 2005 (MCA). The MCA provides the legal framework to assess people’s capacity to make certain decisions. Whilst the arrangements for receiving a service were being put in place, people signed their agreement to the plan of care. Care staff ensured that people consented before any care or support was provided each time they visited.

People were provided with support with meals and drinks where this care and support need had been identified. People may be supported to go to the restaurant to have their meals or the care staff would support them with food and drink preparation in their own home. People were supported to see their GP and other healthcare professionals as necessary.

The care staff had good, kind and friendly working relationships with the people they were looking after. Staff ensured people’s privacy and dignity was maintained at all times.

The service had good processes in place to assess people’s care and support needs and then to plan the delivery of their care. They received the care and support they needed and were looked after in the way they preferred. This was because they were involved in making decisions about how they wanted to be helped. People were encouraged to express their views and opinions and say whether the service was meeting their expectations.

The provider had quality assurance measures in place to monitor the quality and safety of the service. This meant people received the service they expected and it was safe, effective and caring, responsive and well-led. The service used any feedback from people to make improve

Inspection carried out on 13 August 2014

During a routine inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, and to pilot a new inspection process being introduced by CQC which looks at the overall quality of the service.

The inspection was announced. We gave the manager 48 hours’ notice of the inspection because the service is small and the manager is often out of the office. We needed to be sure that they would be in.

Richmond Village Painswick DCA provides domiciliary care services to people who live in their own home. They currently only provide services to people who live within the Richmond Village complex. The village consists of 42 apartments within the main building or flats and houses on the same site. At the time of this inspection 18 people were receiving personal care support from the service.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.

People told us they felt safe when receiving care and because they could call for help if needed. Staff on duty responded to these calls. Systems were in place to protect people from harm. Staff were recruited following robust recruitment procedures and received training to be familiar with safeguarding issues. Where risks had been identified management plans were put in place to manage that risk.

People received the service they expected and had agreed upon. Staff were knowledgeable about the people they were supporting and received the appropriate training and support to enable them to undertake their roles effectively. Where required people were supported to eat and drink. People were supported to access health care services if needed.

People told us they had good relationships with the staff who were supporting them, were treated with kindness and respect. People were involved in having a say about the support they received and how their service was delivered.

Assessment and care planning processes ensured that each person received the service they needed and met their individual needs. Their preferences and choices were respected and they were provided with copies of their plans and timetables so they knew what service was provided.

People told us that the service was well-led and they were encouraged to provide feedback. The quality and safety of the service was regularly monitored and used to make improvements. The service had a clear vision of where improvements were required.

Inspection carried out on 26 July 2013

During a routine inspection

This was a follow up inspection to assess whether the provider was now compliant with Outcome 21; Records.

We looked at a sample of peoples care files that included needs assessments, care plans and risk assessments. We also spoke with staff and people receiving a service.

Staff told us that care files and documents were easier to use and understand. People receiving a service said, “It’s impossible to find utopia but this is very close”, “The staff are very nice and very helpful”, “Staff are always available when I need them”, “There’s a good choice of food and it’s very nice”, “It’s a happy place”.

The provider was assessed as compliant.

Inspection carried out on 20 March 2013

During a routine inspection

There was a happy, relaxed atmosphere at Richmond Village. We visited some people in their own flats and spoke with them individually. We also spoke with people in communal areas of the building and saw staff interacted in a caring way that people responded to.

People talked with us about the quality of the service they received. Individuals told us "they (staff) make you well cared for and help me to maintain my independence", "I am really satisfied with the care", " It is not Utopia here, but it is as close as we could ask for, very good, wonderful care".

We asked people about the staff. Comments included: "they make you feel special, not like you are just another person needing help" and "I am very pleased with the care staff, the staff are very friendly and treat you with respect". Another person told us that the staff were "friendly and nothing was too much trouble".

Staff had been recruited appropriately and people were cared for and supported by, suitably qualified, skilled and experienced staff.

We saw the results from the most recent satisfaction questionnaires which had been completed by people who used the service. The results were positive with high levels of satisfaction and 100% positive responses in relation to questions about being treated with dignity and respect by staff.

People were not fully protected from the risks of unsafe or inappropriate care and treatment because accurate and appropriate records were not being maintained.