Richmond Village Cheltenham

Richmond Care Village is a care home providing accommodation, nursing and residential care to up to 60 people, some of whom live with dementia. At the time of our inspection there were 21 people using the service, one of whom was receiving respite care.

Richmond Care Village provided purpose-built accommodation over 3 floors. The residential, nursing and dementia care units were each self-contained and offered single en-suite bedrooms, lounge(s), dining room and adapted bathrooms. People using the service could access the care village facilities which included an activities room, restaurant, gym and wellness facilities, wheelchair accessible garden and roof top terrace.

People’s experience of using this service and what we found

People and their relatives were positive about Richmond Care Village Cheltenham. They praised the way staff supported them and said the service was well-run. Comments included, “I find it a very impressive place. It is beautifully kept up. It is immaculate” and “The reception team have been very kind and kept my spirits up.” We saw staff were kind and respectful when supporting people and there were enough suitable staff employed. People and their relatives could raise complaints and their views were listened to.

People’s risks had been assessed and their support plans described the actions staff should take to keep them safe and maintain their independence. Risk assessments and support plans were reviewed regularly, and timely action was taken when people’s needs changed or incidents occurred. Staff followed advice from professionals when managing risks in relation to choking, pressure area care, diabetes and medicines. The registered manager and provider ensured provider policies were followed to manage risks, for example, relating to fire, infection control and equipment, and to ensure regulatory requirements were met.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. When people were unable to consent to any restrictions needed to keep them safe, capacity assessments had been completed and applications to deprive them of their liberty had been submitted.

There had been significant changes to the management team at the service since January 2023. Governance systems had been operated effectively to identify areas where improvement was needed, including record-keeping and medicines management. The registered manager was working through the service’s action plan to ensure all necessary improvements were completed in a timely way. Although early days, leadership changes were having a positive impact on staff morale and well-being.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 15 July 2021).

Why we inspected

We received concerns in relation to medicines errors, response to incidents, staffing levels and staff support. As a result, we undertook a focused inspection to review the key questions of safe and well-led only. We found no evidence during this inspection that people were at risk of harm from these concerns. Please see the safe and well-led sections of this full report.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has remained good, based on the findings of this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Richmond Care Village on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Richmond Village Cheltenham is part of a care village. The care home contained a range of lounges, with a dining room on each floor. The home also had access to facilities shared with the village including an activities room, a restaurant, gym and wellness facilities. There is also a roof top garden as well as large garden that people living in the home can enjoy.

People’s experience of using this service and what we found

People felt safe and at home at Richmond Village Cheltenham and spoke positively about the care and support they received. Relatives had peace of mind regarding their loved one’s care.

Nursing and care staff understood people’s needs and how to assist them to protect them from avoidable harm. Detailed person-centred care plans and risk assessments were in place, which provided staff with clear guidance on how to meet people’s needs.

People’s medicines were managed safely and appropriately. Staff were responsive to people’s changing medical needs.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People were supported by staff who had been trained and supported to meet their needs. People and their relatives spoke positively about the caring nature of staff.

Staff spoke positively about people and meeting their care needs.

People were supported with activities and engagement from dedicated activity and lifestyle staff. Staff had time to spend with people, including supporting them accessing the village grounds. Staff and management understood people’s needs and interests and used the environment creatively to meet these needs.

Alongside Richmond Village Cheltenham DCA, which is located on the same site of the care home, the services worked collaboratively to provide a pathway of care which supported people to stay within the village if and when their needs changed. The service worked alongside healthcare professionals to reduce unnecessary hospital admissions.

People’s individual dietary needs were met. People were supported to make choices regarding diets. Where people were at risk of malnutrition, staff took appropriate action to ensure their needs were met.

Richmond Village Cheltenham was a new purpose-built care home. The home was clean and well decorated. There were clear plans in place to maintain the building and equipment.

The service had infection control processes and systems in place to reduce the risk of people contracting COVID-19.

People, their relatives and staff spoke positively about the management of the home. The management team and provider had systems in place to assess and monitor people’s health and wellbeing. The manager reviewed all incident and accident records to ensure appropriate action had been taken and to identify trends to reduce the risk of recurrences.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

This service was registered with us on 13 March 2020 due to a change in ownership. This is the first inspection.

Why we inspected

This was a planned inspection based on the service being newly registered.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Follow up

We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Richmond Village Cheltenham can accommodate up to 60 older people and people living with dementia. There is also a supported living complex as part of the wider village, however this was not inspected as part of this inspection. At the time of our inspection 7 people were living or receiving respite care at the home. The home had only opened in March 2020 and while there were two units, only one of these was open at this time. Each room was en-suite and there was a range of communal areas people could use on the unit, including a large living room. The village also had a spa area, a large restaurant and grounds which people could enjoy.

We found the following examples of good practice at Richmond Village Cheltenham.

¿ The provider supplied personal protective equipment (PPE) to visitors and ensured there was clear guidance and support in relation to the application and removal of PPE for visitors. The provider had ensured there was enough PPE available for staff and visitors.

¿ The provider had ensured that temperature checks were completed for all visitors, staff and people living at the service to minimise the risk of infection. The provider ensured there were Covid-19 routine testing protocols in place for staff and people.

¿ People were supported to isolate when they were admitted to the home or when returning from hospital. There was clear guidance for staff to follow and PPE equipment was made available by people's rooms to promote effective infection control practices and reduce the risk of cross infection.

¿ People were supported to socially distance. The home was clean, new and purpose built, this meant people and staff had plenty of space in which to promote social distancing.

¿ Staff and managers worked with people's relatives to ensure social distanced visits could work whilst protecting people who were vulnerable. Activities and events were in place to promote people's individual wellbeing.

¿ The provider implemented clear protocols when there was an outbreak of Covid-19. This included actions staff were required to take when starting their shift on arrival, and when leaving the home. Staff understood the reason for these protocols and followed them.

¿ The provider had robust systems to ensure there was clear oversight of staff training in relation to infection prevention and control. The provider and service managers ensured staff adhered to national guidance on PPE. The provider operated comprehensive infection control audits used to help protect people and staff from the spread of infection.

¿ The provider and registered manager had ensured that all information and guidance, in relation to COVID19, had been effectively communicated to and understood by staff.