Richmond Court Nursing Home

Updated 2 August 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.

Inspection team

This inspection was carried out by 1 inspector and a nurse specialist advisor.

Service and service type

Richmond Court Nursing Home 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 Court Nursing Home 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 2 months at the time of the inspection and intended to register with CQC. Since the inspection, the manager has now been registered with us.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work 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. We used all this information to plan our inspection.

During the inspection

We spoke to 8 people and 6 relatives about their experience of the care provided. We spoke with 5 professionals who have contact with the service. We spoke with 11 members of staff including the nominated individual, area manager, manager, and 8 members of staff. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

We reviewed a range of records. This included 6 people's care plans, medicine administration records (MAR) and 3 staff recruitment files. We viewed a variety of records relating to the management of the service including audit systems.

Updated 2 August 2023

About the service

Richmond Court Nursing Home is a care home which provides personal care and nursing for up to 39 people, including people with dementia. At the time of our inspection there were 30 people using the service.

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

People were not always protected from the risk of harm. We found systems were not effective in assessing and monitoring risks to people through their dietary needs, the spread of infection or the safe storage of medicines. Systems were in place to safeguard people from abuse, although people didn’t always feel safe. Processes for learning lessons were effective and improvements were noted as a result.

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.

People were not always treated in a compassionate, respectful way. Some people experienced inconsistencies in the caring nature of staff members. The service considered people's cultural needs and wishes. People were supported to express their views and be involved in their care, although people didn't always feel this was effective.

People’s care plans did not always contain accurate information about their person-centred needs. However, staff had good knowledge of people’s likes and dislikes and people were given day to day choices. People who were cared for in bed did not always have access to meaningful activities, although a full program of group activities took place in communal areas.

Quality assurance systems were not always effective for people. This meant the action taken by the provider had not always ensured people received consistent, good quality and safe care. However, people and relatives spoke positively about the management of the service. Systems were in place to seek feedback and resolve people's complaints.

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

Rating at last inspection

The last rating for this service was requires improvement (published 20 November 2019).

Why we inspected

The inspection was prompted in part due to concerns received about how people’s health and personal care needs were managed. We also received information from health professionals about shortfalls that had been identified in relation to nutrition and hydration, the monitoring of people’s health needs and the management of the service. A decision was made for us to inspect and examine those risks.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Enforcement

We have identified breaches in relation to how people’s safety was managed, how people’s rights were promoted, people being treated with dignity and respect and how the service was run at this inspection.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

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 continue to monitor information we receive about the service, which will help inform when we next inspect.