Archived: The Richmond

Updated 24 March 2015

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked 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.

The inspection was unannounced, which meant that the home’s management, staff and people using the service did not know the inspection was going to take place. The inspection visit was carried out on 4 November 2014.

The inspection team was made up of two CQC adult social care inspectors and an expert by experience, who had experience of older people’s care services. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of service.

Before our inspection, we reviewed information we held about this service and the provider, including notifications that the provider had submitted to us, as required by law, to tell us about certain incidents within the service. We contacted Doncaster Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We contacted Doncaster Council who commission services from the provider. They had no contracts information to share with us.

During the inspection we spoke with 14 people who used the service and 10 people’s relatives. We spoke with 10 staff including nurses, senior carers, activity coordinators and ancillary staff, and the regional and deputy managers. We also checked the personal records of six people who used the service. We checked records relating to the management of the home, team meeting minutes, training records, medication records and records of quality and monitoring audits carried out by the management team.

We observed care taking place in the home, and saw staff undertaking various activities, including handling medication and using specific pieces of equipment to support people. In addition to this, we undertook a Short Observation Framework for Inspection (SOFI) SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us. We spoke with two external, healthcare professionals who visited the service, a community matron and a specialist community nurse. Both had positive experiences of the service and considered the people who used the service to be well supported.

Updated 24 March 2015

The Richmond is situated in Sprotborough on the outskirts of Doncaster. The service provides nursing and personal care for up to 50 older people and people living with dementia. At the time of the inspection there were 47 who used the service.

This inspection took place on 4 November 2014 and was unannounced. This meant that the provider did not know when we were inspecting the service. The home was previously inspected in December 2013, when no breaches of legal requirements were found.

There should be a registered manager for the service. 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 and associated Regulations about how the service is run. The service did not have a registered manager. The provider had appointed a manager, who had been running the service. Before the inspection the manager told us they intended to apply to be registered.

People who used the service and their visiting relatives said positive things about the service, particularly the staff, the management team and the food. One person who used the service said, “Quite happy. Staff are lovely. I have a great relationship with them.” People told us that they enjoyed the range of activities available in the home, and staff we spoke with and observed understood people’s needs and preferences.

There were effective systems in place to make sure people were kept safe. Staff had a good knowledge about safeguarding people from abuse and neglect, and up to date risk assessments were in place. The way staff were recruited was safe and thorough pre-employment checks were done before they started work. One person’s relative told us they felt their family member was, “Safe, warm and well cared for.”

We saw evidence of people’s healthcare and nutritional needs being met and people’s medicines were stored and handled safely.

People and those who mattered to them were involved in the assessment about their care, support and health needs and involved in producing their care plans, but there was not always evidence that people were involved in the monthly reviews, so that their views about care and support could continue to be incorporated into the care plans.

Throughout the inspection most staff showed people respect and took steps to maintain their privacy and dignity. People told us that staff always knocked on their bedroom door. One visitor said, in regard to their family member, “They talk to him like a grown up. Treat him with respect.”

Overall, we found that staff received a good level of training and support, but not all staff had undertaken formal training in the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS).

The management team asked people to give feedback about their care and support to see if there were any improvements they needed to make and we saw several instances where their feedback had been used to improve the service. There was a system for the managers to review the quality of care being provided, and the staff team learned from incidents and accidents.

There was information available about how to make a complaint and people were confident they would be listened to. One visitor said, “The deputy manager is brilliant. If I have a problem she will deal with it without a moan or grumble.”