Richmond Village Witney

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 Requires Improvement. At this assessment the rating has remained Requires improvement: This meant some aspects of the service were not always safe and there was limited assurance about safety. There was an increased risk that people could be harmed.

We found one continued breach of the regulation in relation to good governance. People did not always have care plans to guide safe practice, we were not assured there were enough staff to support people safely.

However, staff had received appropriate training, recruitment documentation was in place, the home was clean and staff knew people and their needs well.

This service scored 59 (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 did not always ensure there was a proactive and positive learning culture. When incidents or accidents had occurred, these were logged, immediate action had been taken to make people safe. However, lessons learnt did not always evidence the action to minimise the risk from recurring. Staff understood their responsibilities to report and record accidents and incidents.

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 raised and shared safeguarding concerns appropriately. The provider was working on improving people’s lives, protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. However, this had not yet been embedded into the service. Deprivation of Libery Safeguards (DoLS) and mental capacity assessments were not always in place for people. Staff knew how to raise safeguarding concerns and how to support people with limited capacity.

We received mixed feedback from relatives around communication and safety of their loved ones. We observed good standards of care on the day of inspection. People who used the service felt safe. People told us, ‘Yes, I’ve had a couple of falls. They have always checked me out physically’ and ‘I definitely feel safe, can’t fault that because staff are always watching you.” However, we also heard about long response times which people felt impacted their care.

The service did not work always work well with people to understand and manage risks. Care plans were not always consistent or clear, and risk assessments relating to the health, safety and welfare of people using the service were not always accurate or in place. For example, catheter risk assessments, fluids, flammable creams, and mental capacity assessment were not always in place. This meant plans were not always in place to support people to manage risks. No one had come to harm because of these concerns. The service documented people’s nutritional needs, and staff knew people and their needs well. However, staff were not always involved within care planning to ensure plans contained correct up to date information about people’s care. Some staff we spoke to felt they did not always get enough time to read peoples care plans, and not all care plans contained the most up to date information. People told us they felt safe but were not always involved with their care planning. Some people’s gender preferences for staff were not always followed.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. Staff felt the current systems in place to monitor people’s needs was not always effective, this was something the provider had identified and were working on. People told us the environment was always clean. We heard, “I am quite impressed with the way they do it and they do it very efficiently.”

The provider did not always make sure there were enough staff to support people. On the day of the inspection, there were enough staff to meet people’s needs, however we could not be assured people always received support when they needed it. People told us although staff were kind and caring they often had to wait long times for staff to answer call bells. Staff felt there wasn’t always enough staff to meet people’s needs. The staffing dependency tool was not always reflective of support times required, or reflective of what staff told us about people’s needs. One person told us they had to wait 45 minutes and were concerned they would have to wait a long time in life threatening situations. People told us, “Most of the time [there is enough staff] but sometimes I do have a bit of a wait if they are really busy”, “Sometimes the staff will come in, turn off the buzzer and say they’ll be back in five minutes and sometimes you never see them again or you can wait up to an hour if they are very busy.” Staff did not feel they had enough time, or staff to meet people’s needs safely. Staff felt they had enough training and were positive about their training experiences, however, did not always feel teams worked well together. This was something the home manager had already identified and was working on addressing. We reviewed the training matrix, which confirmed staffs training was mostly up to date. Staff had received the relevant pre-employment checks before they could start working in the home to ensure they were safe to do so.

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. Staff told us they had enough PPE. People told us staff always supported them by ensuring they were seen by the GP if they were unwell and, “Staff will notice if you are not feeling too good and will get the nurse to call in” and always wore appropriate PPE.

The service made sure medicines and treatments were safe, however guidance and assessments were not always in place to inform staff when medicines should be given to people. The provider took action to ensure this had been implemented following the inspection. People told us they received their medicines timely and complimented the standard of care with medicines and had no concerns. There was documentation in place around covert medicines and medicine management.