Richmond Village Aston On Trent Care Home

We found the following examples of good practice

• Safe staffing levels were maintained at the service. All staff had completed training in relation to infection prevention and control (IPC) and correct use of personal protective equipment (PPE), including donning and doffing. Regular refresher training sessions were held with the in-house trainer who also completed regular competency checks.

• Robust systems were in place to ensure safe visiting, including checking vaccination status of professionals attending the service and a comprehensive orientation for all visitors to ensure they were familiar with the service's IPC procedures.

• Cleaning schedules were in place and frequently audited to ensure the equipment and premises were clean, and on each floor dedicated cleaning staff were deployed. High touch areas were cleaned at least 4 times every 24 hours with appropriate cleaning products.

• Policies, procedures and risk assessments in relation to COVID-19 were up to date and reviewed regularly. People had individualised care plans and risk assessments detailing their choices about receiving visitors and going out during the pandemic.

Richmond Village Aston On Trent Care Home is a residential care home providing personal and nursing care to 61 people. At the time of our inspection there were 26 people living at the home. The home is part of a retirement village which included access to spa and leisure facilities, a restaurant, and gardens. Within the home care is provided across two floors and there were communal rooms on each floor.

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

People did not always receive safe care because risk was not always managed effectively, and lessons were not always learnt when things went wrong. There were not always enough experienced staff deployed in all areas of the home to meet people’s needs promptly and to ensure their dignity. People were not always supported to have maximum choice and control of their lives and staff weren’t always able to support them in the least restrictive way possible and in their best interests. The policies and systems in the service supported this practice and we made a recommendation to fully implement them.

There was a new management team in place who were reviewing the systems and implementing change. However, we found improvements were required to fully embed management systems to achieve good outcomes for people.

Regular staff knew people well and understood their preferences. There were lots of opportunities for people to engage them in meaningful activities, including through working with other organisations. Care plans were informative and regularly reviewed to support them. People were supported to maintain good health and nutrition.

The new manager was approachable and there were meetings in place which encouraged people and staff to give their feedback. People and relatives knew how to raise a concern or make a complaint. The environment was adapted to meet people’s needs.

More information is in the full report.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update: The last rating for this service was requires improvement (published 9 October 2018). The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection enough improvement had not been sustained and the provider was still in breach of regulations. The service remains rated requires improvement and has now been rated requires improvement for two consecutive inspections.

Why we inspected

This was a planned inspection based on the previous rating.

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

Enforcement

We have identified breaches in relation to safe care and treatment, staffing and good governance at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Richmond Village Aston On Trent Care Home is a care home for 61 older people which was registered with CQC in September 2017. There was a planned approach to people coming to live at the home and at the time of our inspection 19 people were living there. This was their first 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.

The audits and systems implemented to monitor the service and improve it were not always effective in doing so. Medicines were not always well managed to reduce the risks associated with them and to ensure people received them as prescribed. The checks that were in place to manage them were not always completed or actioned. Tools for monitoring staffing levels were not always effectively analysed and we found that there were not always enough staff deployed to meet people’s needs promptly. When safeguarding concerns were raised or things went wrong there was not always sufficient learning from them to reduce the risk of them happening again.

When staff were rushed or task focussed they did not always take the time to speak with people or reassure them. They did not always promote and respect people’s privacy. At other times we observed kind and respectful relationships with staff.

People’s capacity to consent to restrictions which were put in place to keep them safe was not always assessed. Legal safeguards to authorise these were not always applied for. Therefore, people were not always supported to have maximum choice and control of their lives in the least restrictive way possible.

People were encouraged to pursue interests and hobbies and regular activities were planned. Visitors were welcomed at any time. There were regular meetings with people and their relatives and the feedback was used to improve the home.

People were supported to maintain good health and this was done through partnership with other professionals and organisations. There were also facilities on the village site for people to use such as gym and chiropody. Mealtimes were not rushed and people were given a choice of meal. We saw that food and drink was regularly provided and records were maintained for people who were nutritionally at risk. Care plans were regularly reviewed to correspond with changing support needs and they were personalised and accessible.

Staff received regular supervision and training to enable them to do their job well. Safe recruitment procedures were followed to ensure they were suitable to support people. There were systems in the home to keep it clean and free from infection.

We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Full information about CQC's regulatory response to any concerns found during inspections is added to reports after any representations and appeals have been concluded.