Richmond Village Witney

Updated 1 February 2023

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 team consisted 3 inspectors 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.

Service and service type

Richmond Village Witney 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 Village Witney 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 not a registered manager in post. A new manager had been in post for 5 months and had submitted an application to register. We are currently assessing this application.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service. We sought feedback from the local authority and professionals who worked 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. This information helps support our inspections. We looked at notifications received from the provider. A notification is information about important events which the provider is required to tell us about by law. This ensured we were addressing any areas of concern. We reviewed the provider’s last inspection report. We used all of this information to plan our inspection.

During the inspection

We spoke with 9 people who used the service and 8 relatives. Some people living in the home could not verbally give us feedback. As such we looked around the home and observed the way staff interacted with people. We received feedback from 3 healthcare professionals. We looked at 6 people's care records and 4 medicine administration records (MAR). We spoke with 13 members of staff including a regional support manager, village manager, the manager, clinical lead, nurses, carers, the administrator and domestic staff. We reviewed a range of records relating to people's care and the way the service was managed. These included staff training records, 6 staff recruitment files, quality assurance audits, incidents and accidents reports, complaints records, and records relating to the management of the service.

Updated 1 February 2023

About the service

Richmond Village Witney is a purpose-built residential care home providing personal and nursing care to up to 63 people within a village. The service accommodates people across 2 separate wings each of which has separate adapted facilities. One of the wings specialises in providing care to people living with dementia. At the time of the inspection there were 46 people living at the home.

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

Prior to the inspection, we had received concerns in relation of staffing, environment, nutritional support, records and management of the home. We found, inconsistency in leadership had impacted on staff support, morale and management of the home. The service had gone through several managers since our last inspection in 2018. There was a manager who had been in post for 5 months who knew the service as they had managed the other part of the village.

People’s care plans were not always complete or up to date. Staff records of supervisions and support had not been completed in line with the provider’s policy. However, staff told us they felt supported by the new manager and said they were approachable and available. The provider’s quality assurance systems had identified these shortfalls and the team was working through an improvement plan.

On the day of the inspection we saw there were enough staff on the dementia unit. However, staff deployment could be improved on the nursing unit. The village manager told us they were one staff member short due to an unplanned absence. However, staff told us they often struggled to meet people’s needs especially during busy periods.

People living at Richmond Village told us they felt safe living in the home. Staff knew how to identify and report any concerns. The provider had safe recruitment and selection processes in place.

Medicines were managed safely, and people received their medicines as prescribed. Staff had the necessary skills to carry out their roles. The environment was clean, and staff followed strict cleaning schedules.

People had a positive dining experience which offered a variety of food choices available at times that suited people’s preferences. We saw people were supported with nutrition and staff had oversight of people on special diets.

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. Staff had a particularly good understanding of when the principles of the Mental Capacity Act should be applied. People were supported to meet their nutritional needs and complimented the food at the home.

Rating at last inspection and update

The last rating for this service was good (Published 8 January 2019)

Why we inspected

We received concerns in relation to staffing, environment, records and management of the home. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only.

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 changed from good to requires improvement based on the findings of this inspection.

We have found evidence that the provider needs to make improvements. Please see the safe, effective and well-led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

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

Enforcement and Recommendations

We have identified a breach in relation to record keeping and inconsistency in leadership at this inspection. Please see the action we have told the provider to take at the end of this report.

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.