CQC report explained · a nursing home
What the CQC found at Richmond Court
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, August 2023
Richmond Court was rated Requires Improvement; inspectors found ongoing problems with medicines, risk management, dignity and quality checks.
This was an unannounced focused inspection. Inspectors visited on 12 June and 27 June 2023, and gathered further information until 3 July 2023. They spoke with people, relatives and staff, observed care, and checked care, medicine, staffing and management records.
The home was not always safe. Medicines were not always stored or managed safely, some risks had not been properly assessed, and some areas containing hazardous items were left unlocked. There were also problems with infection control arrangements and records about consent and capacity.
The home had enough staff, and people and relatives generally said they felt safe. Staff knew people well, reported concerns and incidents, and worked with other agencies. However, quality checks had not found or fixed important problems, and people's dignity was not always protected.
The overall rating remains Requires Improvement, as does Safe and Well-led. The other areas were not inspected during this visit, and their previous ratings were used in calculating the overall rating. The home had been rated Requires Improvement at the previous inspection and remained in breach of regulations.
Enough staff
Inspectors found enough staff to meet people's needs. The previous staffing recommendation had been met.
“There were enough staff in the home to meet people's needs.” from the report
Safeguarding
Staff knew people well, understood how to protect them from abuse, and acted on incidents and concerns.
“People and relatives told us they felt staff kept people safe.” from the report
More activities
The home had increased support for activities and was offering people more social engagement. People were also accessing the community and taking part in more skill-building activities.
“There had been a recent increase in staff supporting activities to offer people more engagement.” from the report
Open management
Inspectors found the management team open during the inspection. Staff felt supported and relatives and staff said the manager was approachable and responsive.
“Management staff were honest and open with us during the inspection.” from the report
Medicine safety
seriousStaff did not always have clear instructions about when or how to give medicines. Medicines were not always stored or checked properly, and out-of-date medicines had been given to one person.
“Medicines were not always managed safely. Staff were not always given clear guidance about how and when to administer people's medicines.” from the report
Unmanaged risks
seriousSome doors, cupboards and rooms containing hazardous items were left unlocked. Individual risk assessments did not always reflect current risks or explain how those risks would be reduced.
“Several areas of the home which should have been secured were open.” from the report
Weak quality checks
seriousAudits failed to identify problems with medicines, risk management and care records. Records were not always accurate or updated when people's needs changed.
“The systems for checking on the quality and safety of the service were not always effective.” from the report
Dignity and suitability
seriousSome towels were worn, ripped, stained or threadbare. Some activities were not suitable for adults, and planning did not always reflect people's longer-term goals and skills.
“People's dignity was not always promoted. This was a breach of regulation 10 (Dignity and respect) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.” from the report
Infection control
needs fixingPersonal items, toiletries and a duvet were stored in communal bathrooms. Inspectors said this increased the risk of infection spreading.
“Various personal items, toiletries and a duvet were stored in communal bathrooms.” from the report
- 01What exact changes have been made to medicine guidance, storage and checks since this inspection?
- 02How are locked doors, cupboards, bathrooms and the sluice room checked each day to prevent access to hazardous items?
- 03How are individual risk assessments updated when a person's risks change, including fire risks?
- 04What is being done to make sure care records, consent decisions and capacity records are accurate and kept up to date?
- 05How will you make sure activities, towels and other daily care arrangements consistently promote people's dignity and suit their age and abilities?
This was a focused inspection of Safe and Well-led only; the other key question ratings were carried over from the previous inspection. This explanation was written from the published report of 23 August 2023 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, June 2022
Richmond Court is rated Requires Improvement; inspectors found risks in medicines, care planning, staffing and people's independence.
The inspection was unannounced and took place over four visits in February and March 2022. It began as a targeted check after a COVID-19 outbreak, but was widened to cover all five key questions when concerns were found. Inspectors observed daily care, spoke with relatives and staff, and reviewed care, medicines, recruitment and management records.
All five areas were rated Requires Improvement. Inspectors found medicines, risk assessments, the environment and infection control were not always managed safely. Some people waited for help because staffing did not always match their needs. Care plans did not always reflect people's needs, communication support was limited, and people were not consistently supported to make choices or build independence.
There were also some positive findings. Staff understood safeguarding, recruitment checks were robust, people had access to healthcare professionals, and most relatives spoken with were happy with the care. The provider made changes or started action plans after inspectors raised concerns, but the report said improvements needed to become embedded.
Safeguarding
Staff had safeguarding training, understood their responsibilities and knew how to recognise and report abuse.
“People were protected from abuse because staff knew them well and understood their safeguarding responsibilities.” from the report
Safe recruitment
The recruitment records reviewed contained the required checks, including DBS checks. Nursing staff records also showed professional registration.
“Staff were recruited safely. Staff underwent a robust recruitment process.” from the report
Health support
The home worked with health and social care professionals so people could receive timely support for their health needs.
“The service worked well with other professionals to ensure people's health needs were met effectively and in a timely manner.” from the report
Complaints
There was a complaints system, relatives knew how to raise concerns, and complaints were investigated with follow-up checks.
“When people had raised concerns they were investigated and the registered manager checked people were satisfied with the outcome.” from the report
COVID-19 arrangements
People and staff had regular testing, PPE supplies were ample, and PPE was disposed of appropriately.
“People and staff were accessing regular testing and appropriate action was taken if someone were to test positive for COVID-19.” from the report
Medicines safety
seriousMedicines were not always given or recorded safely. Inspectors saw medicines left in a person's hand, found a loose tablet on the floor and found unclear guidance and records for some medicines.
“Medicines administration processes were not always safe and did not assure us that medicines were being administered as required.” from the report
Risk management
seriousRisk assessments were missing or did not reflect people's current needs. Some were not followed, and staff had not had the opportunity to take part in a practice evacuation in the previous 12 months.
“People were exposed to risk of harm due to a lack of person-centred risk assessments.” from the report
Staffing and training
needs fixingStaff numbers and skills did not always match people's needs, causing some people to wait for help at mealtimes. Staff training and competency checks were also incomplete in important areas.
“The numbers and skills of staff did not match the needs of people using the service.” from the report
Care planning and independence
needs fixingCare plans did not always accurately describe people's needs, choices, communication or long-term goals. People were not consistently helped to use their abilities or take part in everyday tasks.
“People were not always supported in a way that met their individual needs or encouraged independence.” from the report
Activities and communication
needs fixingPeople were often sitting in communal areas with television or music on and no meaningful activity. Staff were not always trained or using available tools to communicate with people.
“People could not always take part in activities and pursue interests that were tailored to them.” from the report
Cleanliness and repairs
needs fixingSome bathrooms were dirty and some equipment and fittings needed repair or replacement. Inspectors also found problems with water temperatures and a damaged garden fence.
“Some areas of the home, specifically bathrooms, were dirty and needed cleaning.” from the report
- 01What checks now make sure medicines, including thickening agents, creams and patches, are given and recorded correctly?
- 02What staffing levels and skills will be available for my relative, especially at mealtimes?
- 03How have my relative's risk assessments and care plans been reviewed, and how will you keep them up to date?
- 04What training do staff have in Makaton, communication tools, learning disabilities, dementia and promoting independence?
- 05What meaningful activities, outings and opportunities for choice and everyday tasks are now available?
This inspection began as a targeted infection prevention and control inspection after a COVID-19 outbreak, but concerns led CQC to widen it to all five key questions; the previous ratings were from 2018. This explanation was written from the published report of 18 June 2022 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Richmond Court
4 rated inspections over 7 years: the service has slipped, from Good to Requires improvement.
- August 2023Requires improvementcurrent ratingstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- June 2022Requires improvementdown from GoodSafe: Requires improvementWell-led: Requires improvement
- May 2018Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2014
Report published without a new overall rating.
- January 2014
Report published without a new overall rating.
- October 2013
Report published without a new overall rating.
- December 2012
Report published without a new overall rating.
- November 2011
Registered with the Care Quality Commission on 1 November 2011.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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47 live-in carers within about an hour of County Durham
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £960 to £1,210 a week. 42 can care for a couple. 10 years' experience on average.
“Petty introduced herself to Mum every time she was caring for her and responded very quickly to Mum if she was distressed in the night.”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.