Background to this inspection
Updated
20 October 2018
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
This comprehensive inspection took place on 16 August and 12 September 2018 and was unannounced. The inspection was undertaken by two inspectors.
Before the inspection, we reviewed information we held about the service, which included notifications the provider had sent us. A notification is information about important events, which the provider is required to send us by law. We also contacted commissioners of the service and asked them for their views.
During the visits we spoke with six people who used the service and three relatives, we spoke with five people, who received care in their own homes, by telephone. We also spoke with three care workers, the cook, the registered manager and the nominated individual (the representative of the provider) and a visiting health professional. We also used the Short Observational Framework for inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us. We looked at all or parts of the care records of five people who used the service. We viewed medicines records, staff recruitment and training records, as well as a range of records relating to the running of the service including maintenance records and quality audits carried out by staff at the service.
Updated
20 October 2018
We inspected the service on 16 August and 12 September 2018. The inspection was unannounced. The service under the name Richmand House provides two regulated activities from this location. Richmand House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Richmand House is registered to provide care for 12 people, and on the day of our inspection 12 people were using the service. Richmand House is also a domiciliary care agency. It provides personal care to 10 people living in their own homes. It provides a service to older adults.
We previously inspected the service in May 2018 when we only inspected against the regulated activity Accommodation and nursing or personal care. At that inspection we found the provider to be in breach of two of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, and one of the Care Quality Commission (Registration) Regulations 2009 We asked the provider to send us an action plan to show how they would address our concerns. We received the actions plan and at this inspection we found the provider had addressed our concerns and was no longer in breach of these regulations.
On the day of our inspection there was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
People who used the services were protected from harm as the provider had processes in place to ensure their safety. Staff supporting people were aware of their responsibilities in relation to protecting people from abuse. They had received appropriate training to support their understanding of any safeguarding issues. The registered manager reported any issues of concern to both the CQC and the local safeguarding teams and worked in an open and transparent manner. There were clear processes in place to ensure lessons were learnt following any incidents or events.
The risks to people’s safety were clearly identified with measures in place to reduce these risks. The environment and essential equipment were well maintained.
People were supported by well-trained and competent staff in sufficient numbers to keep them safe. Their medicines were managed safely and people were protected from the risk of infection through good hygiene practices and staff knowledge of reducing the risks of cross infection.
People’s needs were assessed using effective evidenced based assessment tools. These were then used to provide clear guidance for staff to assist them gain a good understanding of an individual’s needs and offer the most effective support to people. Staff were supported with appropriate training for their roles.
People were supported to maintain a healthy diet, with staff showing good knowledge of people’s nutritional and health needs. They received support to manage their health needs through well-developed links with local health professionals. The environment people lived in was a safe environment which met their needs.
Staff sought consent from people before caring for them and they understood and followed the principles of the Mental Capacity Act, 2005 (MCA). People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.
People using the service, and relatives were treated with kindness and care by staff who supported people with respect and dignity, and developed positive relationships with people in their care.
People could maintain relationships with people who were important to them and relatives felt their views and opinions about their loved one’s care were listened to.
The care people received was person centred and met their individual needs, they were supported to take part in a range of social activities to prevent isolation. People’s wishes in relation to their end of life care were discussed with them so their wishes were known. There was a complaints procedure in place and people knew who to complain to should they have any issues.
The service was well led, the registered manager and nominated individual was visible and supportive towards people, their relatives and the staff who worked at the service. The quality assurance systems in place were used had been improved to monitor performance and quality of care. The registered manager responded positively to changes and used information to improve the service and care people received.