We carried out a review of the data available to us about Richford Gate on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Richford Gate, you can give feedback on this service.
We found the following examples of good practice.
The service had implemented regular COVID-19 testing for staff and people who used the service. The service was planning for the implementation of rapid testing.
There were clear risk assessments for each person who used the service to help reduce the risk of contracting or spreading the virus. These included personalised contingency plans for how to promote self-isolation if the person became unwell.
People were supported to maintain contact with family, friends and structured activities. People were able to access meaningful activities through the use of video calls and by using the adjoining premises.
Further information is in the detailed findings below.
Richford gate is a care home for adults with learning disabilities. At the time of our inspection there were eight people using the service living in two adjoining flats.
The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.
People’s experience of using this service:
At the last inspection we found a breach of regulations regarding good governance. This was because records relating to health and safety were incomplete and not checked by managers to make sure they were correct. At this inspection we found this service was meeting this regulation. There were new systems in place to audit and check records and these were effective.
People told us that they found staff kind and caring and approachable. Relatives we spoke with were also positive about the approach of the staff team and they knew who to speak to if they had concerns about the service.
People were supported to maintain and develop their independence and to access the community to carry out activities of their choice. Support plans were developed with people during regular reviews. People were encouraged to set and meet goals for their lives.
People using the service had regular opportunities to speak up and had access to advocacy services to help protect their rights.
There was a new management team which had recently started following the resignation of the registered manager. The management team had ensured people and their relatives knew them and could speak with a manager when needed. Managers were implementing new systems, auditing files and simplifying documents and care workers told us these actions were helping them.
Aspects of the building required maintenance, including to meet fire safety recommendations. The provider had worked with the landlord to implement these. The staff team had worked with people to reduce clutter and improve the overall appearance of the service.
Care workers received enough training and supervision to carry out their roles and were recruited in line with safer processes.
The provider worked with other agencies to help people stay healthy. People were supported to eat and drink and make choices about these daily activities. The provider sought advice from dietitians when people were at risk of malnutrition. Sometimes people chose to continue to have unhealthy food, and there were not detailed plans on how best to encourage healthier choices. We have made a recommendation about this.
Rating at last inspection:
At our last inspection in February 2018 we rated this service ‘requires improvement’.
Why we inspected:
This was a routine inspection.
Follow up:
The service was rated 'good'. We will continue to monitor information and intelligence we receive about the
service until we return to visit as per our re-inspection guidelines. We may inspect sooner if any concerning
information is received.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Richford Gate is a ‘care home’. People living in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.
The service comprises two adjoining first floor flats, each with four single occupancy bedrooms. Each flat has its own lounge, kitchen, bathroom and separate toilet. At the time of the inspection the premises were at full occupancy. The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.
There was a registered manager in post, who has managed the service for several years. A registered manager is a person who has registered with the CQC 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. The registered manager was on annual leave on the first two days of the inspection and was present on the third day.
At the previous inspection we had been informed by the registered manager that there had been seven separate medicine errors since October 2016. We had noted that measures had been taken by the registered manager and provider to fully investigate why these errors had occurred, and staff had received additional medicines training and other appropriate support and guidance from the registered manager, the area manager and the provider’s medicines trainer. During the previous inspection we had discovered two concerns that needed to be addressed in regards to how staff completed medicine administration record (MAR) charts and how they checked expiry dates for prescribed medicines. We had issued a breach of regulations in relation to the management of medicines. Following the inspection, the provider had sent us an action plan which outlined how they proposed to address this breach of regulations. At this inspection we found that the provider had achieved improvements with the management of medicines, however we found further issues that the service had not identified and addressed.
At the previous inspection we had found that the provider had failed to notify us about a safeguarding concern which had resulted in the police attending the service. This had meant the CQC could not effectively monitor events at the service in order to ensure people’s safety. We had issued a breach of regulations in regards to the provider not informing us about significant incidences at the service, in accordance with the Health and Social Care Act 2008. Following the inspection, the provider sent us an action plan which outlined how they proposed to address this breach of regulations. At this inspection we found that the provider had appropriately notified us of any notifiable events, in accordance with legislation.
People who used the service were supported to lead active, interesting and fulfilling lives. They were encouraged by staff to be as independent as possible, take positive risks where applicable, and meet their health care needs with appropriate guidance and support.
People’s care and support plans showed that they were consulted about their needs and wishes. Their views and ideas were clearly reflected during the care planning process and at regular review meetings held at the service. The relatives we spoke with confirmed that they were invited to attend these meetings, and felt that the registered manager and the staff team also took into account their opinions. People and their supporters where applicable, were provided with information about their rights and entitlements, including clear guidance about how to make a complaint.
People were supported to contribute to the daily running of the service and the provider actively sought their involvement to continuously develop the service. For example, people received training and remuneration to participate in staff recruitment at the provider’s head office if they wished to. Staff supported people to feel part of their local community by joining nearby leisure centres and libraries, and through attending groups and/or place of worship in line with their individual needs and wishes.
Systems were in place to ensure that people were supported by staff who were safely recruited, and sufficient staff were deployed to enable people to receive the support they needed at home and within the wider community. People received their care and support from staff who received suitable opportunities for training and development to undertake their roles and responsibilities. Staff reported that they felt supported by the registered manager.
The registered manager demonstrated a committed approach to supporting people who used the service and we observed that he had developed positive relationships with them. Relatives stated that they were pleased with how the service was managed and described the registered manager as being “approachable” and “helpful.” There were processes in place to monitor the quality of the service and the safety of the care home. However the issues we found during the inspection showed that the provider’s own quality monitoring process was not sufficiently rigorous. This had resulted in specific practices having not been detected and addressed, for example the absence of a risk assessment in relation to the safety of a bedroom window and the gaps found for the recording of the medicine fridge temperatures.
We have made one recommendation for the provider to seek guidance from a reputable source in order to demonstrate best practice with the safe management of medicines and have issued one breach of regulation in relation to the need for the provider to undertake more robust monitoring. You can see what action we asked the provider to take at the back of the full version of the report.
Richford Gate is an eight bedded care home for adults with a learning disability. The service comprises two adjoining first floor flats, each with four single occupancy bedrooms. Each flat has its own lounge, kitchen, bathroom and separate toilet.
There was a registered manager in post, who has managed the service for several years. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.
At the previous inspection we had found that medicines were stored, administered and disposed of safely. We had noted that staff had completed mandatory and refresher medicines training and understood their duties in regards to the safe management of medicines. At this inspection we were informed by the registered manager that there had been seven separate medicine errors since April 2016. Measures had been taken by the registered manager and provider to fully investigate why these errors had occurred, and staff had received additional medicines training and other appropriate support and guidance from the registered manager, the area manager and the provider’s medicines trainer. During the inspection we discovered two issues that needed to be addressed when we looked at how staff completed medicine administration record (MAR) charts and how they checked expiry dates for prescribed medicines. These findings demonstrated that further actions by the provider were required to ensure people using the service were suitably protected from the risks associated with unsafe medicines management.
At the previous inspection we had noted that the provider had promptly reported safeguarding concerns to the CQC and produced clear information about the actions they had taken to protect people. At this inspection we found that staff had received safeguarding training and understood how to identify and protect people from different types of abuse, however the provider had failed to notify us about a safeguarding concern which had resulted in the police attending the service, which meant the CQC could not effectively monitor events at the service in order to ensure people’s safety.
The risk assessments within the three care plans we looked at demonstrated people were supported to be as independent as possible whilst taking into account their safety and wellbeing. The staffing rotas showed there were sufficient staff rostered each day to enable people to access community resources with staff support, if required. We observed on the first day of the inspection that seven people were out in the wider community at their chosen social and educational activities. The provider adhered to robust recruitment practices to ensure that people were supported by staff with suitable knowledge and experience.
The provider had implemented a programme of training, supervision and annual appraisals in order to support staff to carry out their roles and responsibilities. The staff we spoke with demonstrated an appropriate understanding of systems to protect people who could not make decisions, as they had received guidance and training in relation to the legal requirements of the Mental Capacity Act (MCA) 2005 and the Deprivation of Liberty Safeguards (DoLS).
People were supported to maintain a healthy and balanced diet, and to participate with food preparation tasks where possible. We observed people making cups of tea and sandwiches, either independently or with varying levels of staff encouragement and support in line with people’s individual needs. The service evidenced positive relationships with external health professionals and actively involved medical and nursing staff at the nearby GP practice with the development and evaluation of people’s individual health action plans.
We saw warm and friendly interactions between people who use the service and staff. People regularly popped into the office to speak with the registered manager and the deputy. For example, one person spoke with staff about their arrangements to have lunch before they went to college and another person let staff know they were going over to a resource centre operated by the provider, which is located next door to the service. Staff promoted people’s entitlement to dignity and privacy. People were spoken with and treated by staff in a kind and respectful way. For example, people were asked by staff if they were happy to speak privately with us, and consulted about a convenient time and location for a chat.
People’s care plans were up to date and had been produced in a clearly person centred manner. We noted that people and relatives were involved in the planning and reviewing of their care plans, and people using the service told us they were happy with their care. One person told us they liked the service but felt it was time to move on, and their view was respected and supported by staff. Most of the comments from relatives about the quality of the service were positive.
There were effective processes in place to advise people and their relatives about how to make a complaint, which included pictorial guidance. The provider had not received any formal complaints since the previous inspection, however we saw how the registered manager had supported people to make complaints to external organisations if they felt they had received a sub-standard level of service.
People told us the registered manager and the deputy manager were both helpful and responsive to their needs. Staff informed us they felt supported by the management team and were given opportunities to seek guidance and express their opinions during one to one supervision meetings, staff meetings and whenever necessary through the registered manager’s ‘open door’ leadership approach. The comments from external professionals were complimentary, in regards to how they observed staff support people and the well-organised management style. There were systems in place to seek the views of people and their relatives and quality assurance systems were used to gather feedback, monitor practices in the service and mitigate risks. However, our findings in relation to the safe management of medicines and the provider’s failure to consistently send us statutory notifications demonstrated that the managerial monitoring systems needed to be strengthened.
We have made a recommendation in relation to the regular checking of window restrictors to ensure they are safely maintained. We found two breaches of Regulations. One breach was in relation to the safe management of medicines and the second breach was in regards to the provider informing us about significant incidences at the service, in accordance with the Health and Social Care Act 2008.
You can see what actions we asked the provider to take at the back of the main report.
This inspection took place on 29 December 2014 and 2 January 2015. The first day of the inspection was unannounced and we told the registered manager we were returning on the second day. At our previous inspection on 12 December 2013 we found the provider was meeting regulations in relation to the outcomes we inspected.
Richford Gate is an eight bedded care home for adults with a learning disability. The service comprises two adjoining first floor flats, each with four single occupancy bedrooms. Each flat has its own lounge, kitchen, bathroom and separate toilet.
There was a registered manager in post, who has managed the service for three years. 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.
There were policies and procedures in place to protect people from harm or abuse. Records showed that staff had attended relevant safeguarding training and they were able to tell us the actions they would take to protect people. The four care plans we looked at contained risk assessments, which provided guidance about how to support people with varying wishes and needs, including how to support people to safely use a cooker and to travel with confidence on public transport. We found that there was enough staff available to support people with their personal care and social interests at home, and to go out for activities. Medicines were stored, administered and disposed of safely. Staff undertook appropriate medicines training and could describe their duties in regard to the safe management of medicines.
Staff had regular supervision and training, including training about how to meet the needs of people with a learning disability. This meant that people were supported by staff with suitable knowledge and skills to meet their needs. People were offered choices about their food and drinks, and encouraged and supported to make their own snacks, light meals and beverages in accordance with their individual wishes and abilities. The Care Quality Commission (CQC) is required by law to monitor the operation of the Mental Capacity Act (MCA) 2005, Deprivation of Liberty Safeguards (DoLS) and to report upon our findings. DoLS are in place to protect people where they do not have capacity to make decisions and where it is regarded as necessary to restrict their freedom in some way, to protect themselves or others. We found that staff had received applicable training and could explain how they protected people’s rights.
We saw that people had positive and friendly relationships with staff, who demonstrated their understanding and knowledge of people’s needs and wishes. Staff knew about people’s hobbies, college courses, relationships with family and friends, and favourite local cafes, markets and leisure facilities. People were spoken with and treated by staff in a caring and respectful manner, and their privacy was maintained. For example, people were asked by staff if they were happy to have a chat with us and show us their bedrooms.
People using the service told us they were happy with their care and we received complimentary remarks from their families. Care plans reflected people’s needs and interests and were up to date. People were involved in planning and reviewing their goals, and relatives told us they were consulted about their family member’s care and support. People accessed community medical and healthcare facilities and the local practice nurse was involved in the care planning to meet healthcare needs.
People’s relatives told us they were pleased with how the service was managed and they described the registered manager as being "caring", "friendly but professional" and "always approachable". We observed the registered manager interacting well with people who used the service and staff. There were systems in place for the ongoing monitoring of the quality and effectiveness of the service, in order to use this information to make improvements.
There was a good system for people to raise their concerns, especially at the residents' meetings. People were encouraged and supported in raising their concerns and they felt that their concerns were listened to and acted upon. The complaints procedure was in an easy-read format.
There were arrangements for the ordering, dispensing, storage and administration of medicines; staff had been trained and were competent in administering medicines.
The provider supported the staff in their professional development and provided them with ongoing supervision, support and training. One member of staff told us: "It's a good team here. We are passionate about what we do here".
We were told that if for any reason people were not happy about anything in their home, they would report it to staff.