The Richmond

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people were safe and protected from avoidable harm.

This service scored 72 (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 proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice. Accidents and incidents were analysed and trends and patterns identified to mitigate future risks. The management team ensured lessons were learnt when things went wrong. Changes were made to improve practice where required. The provider was open and honest when things went wrong and acted in line with their duty of candour.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services. The provider had systems in place to ensure appropriate information was passed between services as required. For example, the electronic care planning system was able to generate a hospital information pack to support with transitions to hospital. A copy of the persons medication administration record also accompanied people. Care plans remained current and up to date to ensure information passed between services was up to date and current.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately. Systems were in place to ensure people were safeguarded from the risk of abuse. Staff received training and support and were able to identify any concerns. Staff were knowledgeable about the safeguarding process and told us they would report any concerns without delay. Staff were confident the management team would take appropriate action to keep people safe. The principles of the Mental Capacity Act 2005 (MCA) were understood by the registered manager and there were processes in place to review people’s capacity in line with the MCA.The MCA provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The MCA requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible. People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the Mental Capacity Act (MCA). In care homes, and some hospitals, this is usually through MCA application procedures called the Deprivation of Liberty Safeguards (DoLS). We found the service was working within the principles of the MCA. People had care plans in place to ensure DoLS were recorded and people supported in line with them.

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them. Risks associated with people’s care were identified and managed to keep people safe. Risk assessments in place were detailed, and staff knew how to manage risks safely. We observed staff ensuring people had assistance to relieve pressure after sitting for a while. We saw staff used equipment appropriately such as hoists, to support people to transfer safely. People felt safe living at the home and told us staff supported them to manage risks. One relative said. “[Family member] is safe and everything is on one level so there are no trip hazards. I have no concerns about any of the staff.” Another relative said, “[Family member] has a frame now and is more mobile that they have ever been.”

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. Environment checks were completed in line with expected standards and records were maintained. We carried out a tour of the home and found sensor equipment was in place where required to minimise the risk of falls. Care plans were in place regarding environmental safety. Personal Emergency Evacuation Plans (PEEP's) were in place to ensure people were supported appropriately in the event of an emergency evacuation.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs. The provider had a recruitment system which assisted them in the safe recruitment of staff. The provider completed pre-employment checks such as references and Disclosure and Barring Service (DBS) checks. DBS checks provide information including details about convictions and cautions held on the Police National Computer. This information helps employers make safer recruitment decisions. Staff were trained and supported to carry out their roles effectively. One relative said, “The staff are spot on. They are absolutely well trained, and I can’t speak highly enough about them.” We observed staff interacting with people and found there were enough staff to meet people’s needs. One staff member said. “I have recently had my appraisal with the home manager, I feel he was very supportive during this. I feel supported by the deputy manager and manager.”

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly. We carried out a tour of the home and found it to be clean and well maintained. Staff followed safe infection and prevention control (IPC) and used personal protective equipment (PPE) appropriately. People commented their rooms were kept clean and tidy. Regular IPC audits were carried out to ensure cleanliness was addressed in a timely way.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened. However, patch rotation could be improved. We saw 1 person’s patch had not been rotated in line with guidance. The registered manager took action to address this. Medication was stored correctly and temperatures taken of the medication rooms. Staff were knowledgeable about medicine administration and received training to ensure they had the skills and knowledge to administer medicines safely. Competency checks were carried out to ensure staff skills were maintained.