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Inspection Summary


Overall summary & rating

Good

Updated 5 January 2019

We inspected Richmond Village on 4 December 2018. This inspection was unannounced.

Richmond Village 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.

The care home accommodates up to 63 people in an adapted building. At the time of the inspection there were 43 people living at the service.

There was no registered manager in place. 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. A clinical lead had been recruited and was managing the service. A new manager had been appointed and scheduled to in January 2019.

People told us they were safe living at Richmond Village. There were enough staff to meet people’s needs. Staff demonstrated they understood how to keep people safe and we saw that risks to people's safety and well-being were managed through a risk management process. There were systems in place to manage safe administration and storage of medicines. People received their medicines as prescribed.

People had their needs assessed prior to living at Richmond Village to ensure staff were able to meet people’s needs. Staff worked with various local social and health care professionals. Referrals for specialist advice were submitted in a timely manner.

People were supported by staff that had the right skills and knowledge to fulfil their roles effectively. Staff told us they were well supported by the management team.

People living at Richmond Village were supported to meet their nutritional needs and maintain an enjoyable and varied diet. Meal times were considered social events. We observed a pleasant dining experience during our inspection.

People told us they were treated with respect and their dignity was maintained. People were supported to maintain their independency. The provider had an equality and diversity policy which stated their commitment to equal opportunities and diversity. Staff knew how to support people without breaching their rights. The provider had processes in place to maintain confidentiality.

The Care Quality Commission (CQC) is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) and report on what we find. Staff had a good understanding of the MCA and applied its principles in their work. We saw people were supported without breaching their rights.

People knew how to complain and complaints were dealt with in line with the provider’s complaints policy. People’s input was valued and they were encouraged to feedback on the quality of the service and make suggestions for improvements. Where people had received end of life care, staff had taken actions to ensure people would have as dignified and comfortable death as possible. People had access to a wide range of meaningful activities.

People, their relatives and staff told us they felt inconsistences in leadership had affected how Richmond was run. However, they also commented on recent positive changes. We also found staff supervision records were not always up to date. The village manager and clinical lead promoted a positive, transparent and open culture. Staff told us they worked well as a team. The provider had effective quality assurance systems in place which were used to drive improvement. The management team had a plan to further develop and improve the home. The home had established links with the local communities which allowed people to maintain their relationships.

Inspection areas

Safe

Good

Updated 5 January 2019

The service was safe.

Staff understood safeguarding procedures.

Risks to people were assessed and risk management plans were in place to keep people safe.

There were enough staff to keep people safe.

Medicines were managed safely.

Effective

Good

Updated 5 January 2019

The service was effective.

Staff had the knowledge and skills to meet people’s needs.

The MCA principles were followed and people were cared for in the least restrictive way.

People were supported to access healthcare support when needed.

Caring

Good

Updated 5 January 2019

The service was caring.

People were treated as individuals and were involved in their care.

People were treated with dignity and respect and supported to maintain their independence.

Staff knew how to maintain confidentiality.

Responsive

Good

Updated 5 January 2019

The service was responsive.

Staff understood people's needs and preferences. Staff were knowledgeable about the support people needed.

People's records were not always up to date. However, the provider had already identified this and were working through them.

People had access to activities.

People and their relatives knew how to raise concerns.

Well-led

Requires improvement

Updated 5 January 2019

The service was not always well-led.

Inconsistences in leadership affected improvement of the home.

Staff supervision and appraisals records were not up to date.

The leadership created a culture of openness that made people and staff feel included and well supported.

There were systems in place to monitor the quality and safety of the service and drive improvement.