Richmond Heights

Updated 16 December 2022

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by one inspector and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Richmond Heights is a ‘care home.’ People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Richmond Heights is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spent time observing staff interacting with people. We spoke with 3 people who used the service and 8 relatives about their experience of the care provided. We spoke with 5 members of staff including the regional manager, deputy manager, nurses and care staff. We reviewed a range of documentation. This included 4 people’s care records and multiple medication records. We looked at 3 staff files in relation to recruitment. We looked at a variety of records relating to the management of the service.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records.

Updated 16 December 2022

About the service

Richmond Heights is a residential care home providing personal and nursing care to up to 51 people. Some people using the service were living with dementia. At the time of our inspection there were 44 people using the service.

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

The provider had systems in place to monitor the quality of the service. These systems had not identified all the issues we found on inspection. Where issues had been noted as a result of internal audits, actions to rectify them had not been completed in a timely way. There was little evidence to show people had been involved in the development of the service or had been asked their views and opinions.

Whilst staff were kind, they were task orientated and interactions sometimes lacked a person-centred approach. Care plans also lacked detail about people's preferences and how they liked to be supported. We were informed care plans had been changed from a paper format to an electronic system and some information had not been transferred.

There was a lack of social activities and stimulation to meet people's needs. Most people were cared for from bed with very little to stimulate them throughout the day.

Risks associated with people's care were not always managed to ensure people's needs were met safely. People received their medicines as prescribed. However, a tally of medicines in stock was not available and some temperatures of the medicine room and fridge had not been documented.

There were enough staff available to meet people's needs. People were safeguarded from the risk of abuse. Staff were recruited safely. Accidents and incidents were analysed, and action was taken to mitigate future incidents.

People's needs were assessed and staff knew people well. People received a healthy balanced diet which met their needs and considered their preferences. There was no menu on display, only a picture menu which did not display the meal options available on the day of inspection.

The provider had identified some areas of the home that required decoration and/or refurbishment and they were in the process of carrying out this work.

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.

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 26 August 2021 and this was the first inspection.

The last rating for the service under the previous provider was good, published on 3 June 2019.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

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.

Enforcement and Recommendations

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection.

We will continue to monitor the service and will take further action if needed. Please see the action we have told the provider to take at the end of this report.

We have identified breaches in relation to risk management and good governance at this inspection.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.