Richmond Village Aston On Trent Care Home

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 changed to good. This meant people were safe and protected from avoidable harm.

At our last inspection the provider was in breach of the legal regulation in relation to safe care and treatment. At this inspection improvements had been made and the provider was no longer in breach of this regulation.

This service scored 75 (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 positive culture of safety, based on openness and honesty. Robust systems were in place to report, review and analyse key safety areas, including accidents, incidents and falls. Leaders were proactive in overseeing safety events, reviewing the severity, contributory factors, trends and steps to reduce risk. For example, additional staffing was put in place for busy times on the unit where an increase in falls had been identified. Evidence based initiatives were implemented to improve safety, such as promoting caffeine free drinks, as caffeine can be linked to increased risk of falls and education on falls prevention.

Lessons were now learnt to continually identify and embed good practice. Learning was then shared with staff to improve safety. One staff member told us, “When incidents occur, we discuss them. We experienced several falls and reviewed together why they may have happened and how we can work differently. There is no culture of blame, but poor performance is addressed.”

Staff were clear in their responsibility to report and record safety events. This included when people showed signs of distress or agitation, records were fully completed to show what action staff had taken, including appropriate de-escalation techniques and their effectiveness.

People and relatives, we spoke with all felt the service was a safe place to live and were satisfied with how safety events were handled.

We did not look at Safe systems, pathways and transitions during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Safeguarding during this assessment. The score for this quality statement is based on the previous rating for Safe.

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. Since our last inspection, the provider had worked to review and update care plans and risk assessments, so they were reflective of people’s current needs.

At this inspection we found risks to people’s health and well-being were clearly identified and assessed so staff could support them safely. For example, nationally recognised tools were used to assess skin integrity which informed people’s planned care. Where people needed regular support to reposition for pressure relief, records showed this was carried out. One relative confirmed, “Night staff do go in to see [person] as they encourage them to turn over several times in the night.” Care plans included guidance on signs and symptoms of health deterioration, such as hypoglycaemia, or hyperglycaemia for people with diabetes.

Where people showed signs of distress, or agitation, care plans had been updated to include guidance on how to support a person during these periods. This included potential triggers for the person.

Staff were observed to support people in line with their assessed needs. For example, kitchen staff were knowledgeable on those who needed a modified diet. A visiting healthcare professional confirmed choking risks were appropriately managed.

Care plans were reviewed regularly, and as people’s needs changed. People and relatives confirmed they were involved in planning their care and support. A person told us, “One relative told us, “I’ve seen [person’s] care plans and I’ve been involved in reviewing them, the staff will come to me and talk about how [person] is getting on and if anything needs changing in the plan.”

People were supported in a safe, secure and well-maintained environment. Potential risks in the environment were detected and controlled. Regular checks were completed on the environment, and systems were in place to monitor health and safety compliance at the service. Effective arrangements were in place to report issues within the environment to the maintenance team.

People had access to well-maintained equipment and facilities, such as pressure relief equipment, falls prevention aids and accessible bathrooms.

The provider considered the design of the environment, and how it could continually be improved to meet people’s needs. For example, opening access between the units to improve well-being. Plans were in place to create a sensory room. The maintenance team were well informed of research into dementia friendly and accessibility needs and took this into consideration within their refurbishment plans.

We received positive feedback from people and relatives on the environment and facilities. One relative told us, “Some places are built to look lovely but not maintained, but it’s not like that at Richmond Village, it is well-maintained.” And “It’s very clean and the maintenance team are helpful if you want another shelf put up.”

We did not look at Safe and effective staffing during this assessment. The score for this quality statement is based on the previous rating for Safe.

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.

At our last inspection, we found some instances of poor infection, prevention and control (IPC). At this inspection we found improvements had been made, all areas within the service, including pressure relieving cushions, were observed to be cleaned to a high standard. There was sufficient supply of personal, protective equipment (PPE) and hand sanitiser, and waste was disposed of safely. Appropriate policies and procedures were in place to monitor IPC risks.

Relative feedback included, “We were hugely impressed when [person] moved in on how clean everywhere was.” And “The rooms are very comfortable, clean and well maintained.”

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Medicines were safely stored, administered and managed. People received their medicines as prescribed from competent staff. Appropriate professionals, such as GP and pharmacy were consulted with as required regarding people’s medicine. Systems were in place to ensure effective oversight of medicines.

Protocols were in place for ‘as required’ medicines which were prescribed to manage agitation. These protocols detailed the signs and symptoms of distress and agitation for people who were not able to verbally communicate a need for this medicine. We did not see any evidence that these medicines were overused, and staff were able to explain less restrictive approaches which would be tried before administering medicine to manage behaviour.