Richmond Court

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Involving people to manage risks
• Safe environments
• 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 changed to good. This meant people were safe and protected from avoidable harm. Improvements had been made since the last inspection, and the provider was no longer in breach of legal regulations in relation to safe care and treatment and the governance of the service.

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.

Safeguarding incidents, complaints, and accidents were reviewed to identify any trends or patterns, and the findings were used to drive improvements within the service. Lessons learned were communicated to staff and practice was amended where necessary. The registered manager was responsive to feedback and wherever possible took immediate action to mitigate risks and embed learning.

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.

Pre-admission assessments were completed before people moved into the service to make sure their needs and preferences could be met, whilst also considering the needs of people already living at the home.

Staff worked collaboratively with external partners such as district nurses, GP’s and other specialist teams to make sure people received timely and appropriate care. Feedback we received from health professionals involved in the service was positive.

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.

Individual and environmental risks had been identified and managed. Care plans outlined how best to mitigate each risk, to guide staff to support people to remain safe. These were regularly reviewed to ensure the information remained accurate and complete. Staff supported people to take positive risks where appropriate for the individual.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

Safety checks of the premises and equipment were completed regularly. Procedures were in place for emergency situations and these were reviewed and updated as needed.

Improvements had been made to the environment and refurbishments were ongoing when we visited. People living at the service had been consulted about the improvements to the environment and had been involved in choosing the décor.

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 followed safe infection prevention practices and used personal protective equipment (PPE) to help prevent the spread of infections. Staff had completed infection control training and PPE was readily available and used throughout the service.

Sufficient improvements had been made in medicine management that the service was no longer in breach of the legal regulation relating to medicines, however further improvements were needed in some medicine records.

Systems were in place to make sure people’s medicines were administered safely. Stock balanced with records, and a running balance was in place for assurance. Medicines that needed to be given at specific times were given correctly.

People’s medicines allergies were recorded accurately.

We observed medicine administration to two people; staff were respectful, and people were given the time they needed.

Guidance was available for creams applied by care staff as part of personal care; however, records were not fully completed, and clearer guidance was needed for some people.

Some people were prescribed medicines to be taken on a ‘when required’ basis or with a variable dose. Information for how these medicines should be administered had been updated to include person-centred information, but others needed further person-centred detail. Where monitoring was needed as part of a protocol this was not always clearly recorded. Information on why medicines were given and if they were effective should also be recorded in line with the provider’s policy.

Information on how people took their medicines if given covertly was not sufficiently clear. The registered manager said they would review this after our visit.

Medicines were stored securely including controlled drugs. Temperatures were recorded for the medicine rooms and fridges; however, only the current temperature was recorded, which was not in line with best practice to ensure medicines were safe to use.

Comprehensive policies and procedures were in place to support the administration of medicines. Audits had picked up some of the issues we found.

Staff understood and implemented the principles of STOMP (stopping over-medication of people with a learning disability, autism or both) and ensured that people's medicines were reviewed by prescribers in line with these principles.