Richmond Village Coventry

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last inspection we rated this key question Good. At this inspection the rating has remained Good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 71 (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 made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

People’s needs were assessed before they came to live at the home. The registered manager told us, “We go out to wherever they are in hospital or their property. We do a pre-admission assessment then build the initial care plan from what we have learnt, and then fully complete it within 72 hours of admission.” This helped to ensure peoples individual needs were identified to support staff in providing their care. Reviews of people’s care were then regularly undertaken to ensure their care and treatment remained appropriate and effective.

People and their relatives told us they were involved in the pre=assessment process where they discussed people’s needs, choices and preferences. Assessments included information about people’s healthcare, wellbeing and communication needs along with any risks associated with these. Health professionals were involved in assessing people’s medical needs when needed. A GP or advanced practice nurse visited the home weekly to support this process.

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

The provider used nationally recognised tools to assess, identify and monitor risks in relation to nutrition, skin damage, falls and weight loss. People told us they felt staff knew what they were doing when supporting them.

Information about people’s individual dietary requirements was available in the kitchen. The head chef understood people’s individual dietary needs and told us they were updated if there were any changes or if people were unwell. They described how they added extra calories to meals for people who were at risk of losing weight and offered healthier options to people who needed to reduce their calorie intake. Food allergies were recorded in people’s care plans and people were regularly weighed to ensure they were eating enough to remain well.

Staff received regular training to help them provide effective care which they described as good and interactive. One staff member told us, “The training is really quite good, they are on top of everything and the guys that do it are really nice and make it fun as well. There is a lot of interactive training, and I think you need that because you can’t just listen."

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

A relative spoke positively of the staff team. They told us, “I think that the staff work well together, and the nurses are knowledgeable and professional.”

Staff told us how they felt supported in their roles. Staff described communication and information sharing between themselves and management staff as good which helped ensure people received effective care and treatment. One staff member said, “Communication is very good, we work so well as a team because we work with each other."

Heads of departments came together on a daily basis to discuss issues related to the running of the service and any important information related to people. This included planned hospital appointments, changes in dietary needs, new people coming to live there etc. This meant staff were well informed of any change at the home.

Staff worked with other professionals including speech and language therapists, GP’s, and the advanced a nurse practitioner to ensure information about people was shared as appropriate to keep people safe and support their needs.

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

People were encouraged to engage in a variety of activities to maintain their physical, social and emotional wellbeing. Activities were provided both within the home and externally to support people’s interests. One person told us, “We have activities sheets; they are always doing something. “Visitors were welcomed to the home, 1 person told us, “My family visits and there are no restrictions.” Where relatives were not able to visit people regularly, people were supported to use social media to keep in touch with them.

Food was prepared to meet people’s specific dietary needs. Staff supported people to eat and drink well and attend routine health appointments, such as optician and chiropody services. The support people needed to maintain their oral health, was recorded in their care plans to ensure a consistent approach was provided by staff. People had access to weekly GP or Advanced Nurse Practitioner visits if needed.

The provider routinely monitored people’s care and treatment to continuously improve it. They did not ensure that outcomes were always clear. positive and consistent to show clinical expectations were met.

Staff monitored aspects of people’s health so they could identify any changes and escalate concerns to other healthcare professionals. For example, bowel health, weight, catheter care and when people were at risk of not eating and drinking enough to keep well. Staff told us the records on their handheld electronic devices would alert them if they had not completed a necessary monitoring check. They said, “They (the system) give warnings if they are not done.”

Whilst most records reflected risk management strategies were followed, we found nutritional records needed more detail. This was so it was clear exactly what and how much of the food provided had been eaten. Accurate records help inform decision making by other healthcare professionals, such as GPs and dieticians, to promote positive outcomes for people. The registered manager told us they had identified this as an area for improvement.

Repositioning charts were completed to identify any improvement or deterioration of the skin and if the repositioning was supporting skin healing. We saw how 1 person’s damaged skin had improved due to regular treatment and monitoring.

Care plan reviews took place to ensure people’s support needs remained appropriate. Changes were made where needed.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

Staff completed training in The Mental Capacity Act 2005 (MCA) and worked in the least restrictive way and acted in people’s best interests. They applied the principles of MCA, which provides a legal framework for decisions made on behalf of people who may lack capacity.

Staff had knowledge of the Mental Capacity Act (MCA) and understood the principles behind best interest decisions and capacity to consent.Staff knew it was important to gain people’s consent before providing care. One staff member explained whilst it was important to respect people’s right to refuse support, they sometimes had to work in people’s best interests to keep them safe. They told us, “It is communication and if you are kind and just give them time, they will change their mind in the end."

People were supported to make as many choices as possible to retain control over their daily lives. We saw staff gave people time to make decisions to ensure their choices were respected. For example, we observed 1 staff member ask a person if they were ready to be assisted out of bed. When the person declined, the staff member readily agreed to return later in the morning in accordance with the persons wishes.

Staff understood some people they cared for may have representatives who held the legal authority to make certain future decisions on their behalf. We saw Deprivation of Liberty Safeguard referrals had been applied for where restrictions on people’s care were necessary to keep people safe. The provider ensured DoLS were reviewed and applications made for renewal where necessary.