CQC report explained · a residential care home
What the CQC found at Richmond Residential Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Requires improvement
- People were supported by enough safely recruited staff, and medicines and infection control were managed safely. However, some COVID-19 risk assessments and records of accidents, medical advice and staff testing were incomplete.
- Effective?
- Good
- This question was not covered by this focused inspection. The previous rating was used in calculating the overall rating.
- Caring?
- Good
- This question was not covered by this focused inspection. The previous rating was used in calculating the overall rating.
- Responsive?
- Good
- This question was not covered by this focused inspection. The previous rating was used in calculating the overall rating.
- Well-led?
- Good
- The home had improved its checks and quality monitoring. The registered manager understood their responsibilities, responded to issues and worked with professionals to support people's health and wellbeing.
What inspectors found, October 2021
Rated Good overall, but inspectors found the home was not always safe because some risk, accident and COVID-19 records were incomplete.
Inspectors made an unannounced focused visit on 20 September 2021. They spoke with two people living in the home, one relative and four staff. They reviewed care, medicine, recruitment, training, safety and quality records.
The home had improved since the previous inspection. Staff were safely recruited, people said they felt safe, medicines were managed safely and there were enough staff. The home was clean, had suitable infection control measures and staff had enough protective equipment.
There were still weaknesses in safety records. COVID-19 risk assessments were not in place for everyone, temperature checks had stopped but were restarted during the inspection, and accident and testing records were not always complete. The overall rating was Good, but Safe remained Requires Improvement.
The home was no longer in breach of regulations found at the previous inspection. Well-led improved from Requires Improvement to Good. However, this was a focused inspection, so the ratings for Caring, Effective and Responsive were carried over from the earlier comprehensive inspection.
Enough staff
People said there were enough staff to meet their needs. Recruitment checks were completed to make sure staff were suitable for their roles.
“There are enough staff, there is always someone there; they are very helpful.” from the report
Medicines managed safely
Medicines were stored securely, temperatures were checked and stock balances were accurate. Staff administering medicines had training and competency checks.
“Systems in place helped to ensure medicines were managed safely.” from the report
Infection control
The home was clean and had cleaning schedules, visiting procedures and an infection control policy. Staff had enough protective equipment and inspectors saw it being used appropriately.
“Staff had access to good supplies of PPE, and we observed this being used appropriately.” from the report
Improved leadership
Quality and safety checks had improved since the previous inspection. The provider and registered manager acted on earlier concerns and made changes during this inspection.
“The registered manager took responsive action to issues raised during this inspection to make improvements and maintain safety.” from the report
COVID-19 risk assessments
needs fixingCOVID-19 risk assessments were not in place for everyone. Temperature checks had also stopped after vaccinations, although they were restarted during the inspection.
“Although COVID-19 risk assessments were in place for people in specific circumstances, such as those people accessing the community, or people who chose not to take part in the regular testing regime, they were not in place for all people.” from the report
Accident records
needs fixingAccidents and incidents were not always recorded fully, and records did not always show whether medical advice had been sought. The provider was asked to review its procedures.
“Staff supported people following accidents to ensure they were safe, however it was not always clearly recorded if medical advice was sought appropriately.” from the report
- 01How do you now make sure every person has an up-to-date COVID-19 risk assessment?
- 02How are accidents and incidents recorded, including whether medical advice was sought?
- 03How do you check and record that all staff complete COVID-19 testing as required?
- 04What changes were made after the previous inspection, and how do you check that they remain effective?
- 05What were the previous ratings for Effective, Caring and Responsive, which were not reassessed at this visit?
This was a focused inspection of Safe and Well-led, with infection control also reviewed; the other ratings carried over from the previous comprehensive inspection. This explanation was written from the published report of 5 October 2021 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, May 2019
Rated Requires Improvement; inspectors found kind, effective care but safety and quality checks were not reliable.
This was an unannounced comprehensive inspection on 24 April 2019. Inspectors reviewed information held by the CQC, spoke with seven people, the registered manager and three staff, and checked care files, medicine records, recruitment files and quality records.
People said they felt safe, received their medicines when needed and were treated kindly. Inspectors found enough staff, good support with health and nutrition, personalised care, activities and respect for privacy and independence.
However, some equipment and parts of the environment were not safely maintained. The lift was out of use, checks on the bath hoist and water safety had not been completed, some call bells did not work, and fire safety actions had not been finished.
The overall rating was Requires Improvement, down from Good at the previous inspection in September 2016. Effective, Caring and Responsive remained Good, while Safe and Well-led dropped to Requires Improvement.
Kind and respectful care
People said staff were caring and compassionate. Inspectors saw positive interactions and found that staff protected privacy, dignity and independence.
“People told us staff were kind and caring and always treated them with compassion.” from the report
Enough suitable staff
Recruitment checks had been completed and rotas showed enough staff were available during the day and night.
“There were enough staff available to support people both in the home and in the community.” from the report
Personalised support
Care plans included people's preferences, life histories, medical needs and interests. Staff used this information to support people in individual ways.
“People's preferences in relation to their care and treatment were incorporated throughout the plans.” from the report
Activities and community life
People were supported to take part in activities they enjoyed, go out into the community and maintain important relationships.
“A range of activities was available based on people's interests and hobbies.” from the report
Weak quality monitoring
seriousThe home's own checks did not find all the problems identified during the inspection. Actions from internal and external checks were not always completed promptly.
“The systems in place to assess and monitor the quality and safety of the service were not always effective.” from the report
Missed CQC notifications
seriousNot all incidents and events that should have been reported to the CQC had been notified.
“Notifications regarding events and incidents within the service had not all been submitted to CQC as required.” from the report
- 01Has the passenger lift been repaired, and what arrangements are in place if it stops working again?
- 02Have the bath hoist, call bells, fire doors and water safety systems now been checked and repaired?
- 03How do you make sure actions from fire, legionella and internal quality checks are completed promptly?
- 04Are all personal emergency evacuation plans now accurate and up to date?
- 05What system is now used to ensure all incidents and events are notified to the CQC when required?
This was an unannounced comprehensive inspection covering all five CQC questions; Safe and Well-led were rated Requires Improvement, while the other three remained Good. This explanation was written from the published report of 21 May 2019 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 Residential Home
4 rated inspections over 6 years: the service has improved, from Requires improvement to Good.
- October 2021Goodcurrent ratingup from Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2019Requires improvementdown from GoodSafe: Requires improvementWell-led: Requires improvement
- September 2016Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- August 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- June 2014
Report published without a new overall rating.
- June 2013
Report published without a new overall rating.
- April 2013
Report published without a new overall rating.
- July 2012
Report published without a new overall rating.
- April 2011
Registered with the Care Quality Commission on 11 April 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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