CQC report explained · a nursing home
What the CQC found at The Julie Richardson Nursing Home
Rated Outstanding: inspectors found the home performing exceptionally well.
- Safe?
- Good
- There were enough staff, risks were assessed and medicines were managed safely. Inspectors also found suitable safeguarding, emergency, infection control and accident-reporting systems.
- Effective?
- Outstanding
- People received highly skilled, personalised support based on guidance and research. Staff worked well with health professionals, supported nutrition and hydration, and understood mental capacity and best-interest decisions.
- Caring?
- Outstanding
- Inspectors saw a warm and respectful culture. Staff involved people in decisions, respected privacy and dignity, and made considerable efforts to support individual wishes and relationships.
- Responsive?
- Outstanding
- Care and activities were tailored to people's interests, communication needs and changing behaviour. People had access to outings, sensory therapies, community links and compassionate end of life support.
- Well-led?
- Outstanding
- Inspectors found committed leadership, a stable and motivated staff team, and a strong culture of improvement. Staff were encouraged to develop their skills and take responsibility for quality.
What inspectors found, April 2020
Rated Outstanding overall; inspectors found exceptionally caring, personalised support, with safety rated Good.
This was an unannounced inspection on 18 February 2020. Inspectors spoke with people, relatives, staff and outside professionals. They observed care and reviewed care plans, medicines records, staff records, complaints, accidents and audits.
The home supported 37 people, most living with dementia, and could accommodate up to 40. Inspectors found enough staff, safe medicines management and clear plans for managing risks. The environment was clean, welcoming and adapted for people with dementia.
Care was highly personalised. Staff knew people well, supported people who could become distressed, and offered activities linked to their interests and life histories. Inspectors also found strong support with food, healthcare, communication, dignity and end of life care.
The overall rating was Outstanding. Effective, Caring, Responsive and Well-led were rated Outstanding. Safe was rated Good. The previous overall rating was Good, with Caring, Responsive and Well-led improving from Good to Outstanding, while Effective remained Outstanding and Safe remained Good.
Personalised dementia care
Staff used people's life histories and knowledge of their behaviour to reduce anxiety and support people in a calm, individual way.
“The staff excelled in using personalised, responsive techniques when caring for people who could display behaviour that may challenge.” from the report
Kind and respectful staff
Inspectors saw people being treated with warmth, patience, dignity and respect. Staff involved people in care decisions, including when communication was non-verbal.
“Throughout the day we experienced an exceptionally warm, caring, relaxed and happy atmosphere.” from the report
Activities and community links
People were offered activities based on their interests, as well as outings and links with local groups. Inspectors found these had a positive effect on engagement and wellbeing.
“The provision of activities was a real strength of the service.” from the report
Strong staff team
The home had a stable team with enough staff to meet people's needs, including people needing one-to-one support. Staff received extensive training and support to develop their skills.
“People benefitted from a long standing and stable team which contributed to continuity of care.” from the report
Good partnership working
The home made prompt referrals and worked closely with health professionals. Inspectors received very positive feedback from the professionals they contacted.
“The number of professionals the registered manager provided us with to obtain feedback and the exceptional feedback received from all who responded before the report was finalised demonstrated exceptionally good partnership working.” from the report
Inspectors raised no specific concerns in this report.
- 01How many staff are on duty now, and how do you maintain one-to-one support when someone needs it?
- 02How do you use a new resident's life history to understand and respond to distress or behaviour that may challenge?
- 03Which activities and outings would be suitable for my relative, and how often could they take part?
- 04How would you support my relative's communication if they could not speak clearly or did not understand English?
- 05How are falls, nutrition, skin integrity and medicines reviewed when a person's needs change?
This was an unannounced, planned inspection that looked at all five key questions and the overall quality and safety of the home. This explanation was written from the published report of 18 April 2020 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. The report was longer than we could read in one go; the later sections may not be reflected.
What inspectors found, August 2017
The Julie Richardson Nursing Home was rated Good overall, with Outstanding effectiveness and kind, personalised care.
Inspectors visited on 18 July 2017 without warning. They spoke with 16 people, 10 relatives and staff, and reviewed care records, medicine records, staff files, complaints and other management records.
People were found to be safe. Staff understood safeguarding, risks were assessed, medicines were managed safely and there were enough staff to meet people's needs. Care was kind, respectful and based on people's preferences.
The home was rated Outstanding for being effective. Inspectors found highly skilled staff, strong links with health professionals, excellent dementia care, a supportive environment and sociable mealtimes. The home had also helped reduce the use of antipsychotic medicines for some people.
The home remained Good overall, as well as Good for Safe, Caring, Responsive and Well-led. It was Good at the previous inspection too.
Skilled dementia care
Staff understood complex dementia needs and used personalised approaches to reduce distress and support wellbeing.
“People received exceptional care from well trained staff.” from the report
Dementia-friendly environment
The home used signs, colours and themed areas to help people find their way, stay independent and have reasons to move around.
“The home had been involved with the University of Oxford in a research project aimed at improving environments for those living with dementia.” from the report
Strong health support
The home worked closely with health professionals and reduced or stopped antipsychotic medicines for many people, while using other approaches to support them.
“The home worked effectively with the GP and CHSS mental health team to reduce the use of anti-psychotic medicines in people with challenging behaviours.” from the report
Positive mealtimes
People had choices, their dietary needs were met and meals were described as sociable and pleasant.
“Mealtimes were truly sociable events and staff and people greeted each other with smiles.” from the report
Best-interest records
minorWhen best-interest decisions had been made, the involvement of other people was not always recorded in line with the relevant guidance. The provider took immediate action to improve this.
“However, we found where the best interest process had been completed, the involvement of other people had not always been recorded in line with the MCA Code of Practice.” from the report
- 01How do you now record who was involved in best-interest decisions?
- 02What dementia training do staff receive, and how is their practice checked?
- 03How do you review the use of antipsychotic medicines and consider other ways to support people?
- 04How do you make sure care plans and risk assessments are updated when a person's needs change?
- 05What personalised activities are available for someone with my relative's interests and abilities?
This was an unannounced inspection covering the overall service and all five key questions, with ratings for Safe, Effective, Caring, Responsive and Well-led. This explanation was written from the published report of 26 August 2017 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 The Julie Richardson Nursing Home
3 rated inspections over 5 years: the service has improved, from Good to Outstanding.
- April 2020Outstandingcurrent ratingup from GoodSafe: GoodEffective: OutstandingCaring: OutstandingResponsive: OutstandingWell-led: Outstanding
Read what inspectors found at The Julie Richardson Nursing Home →
- August 2017Goodstayed GoodSafe: GoodEffective: OutstandingCaring: GoodResponsive: GoodWell-led: Good
Read what inspectors found at The Julie Richardson Nursing Home →
- July 2015GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2014
Report published without a new overall rating.
- November 2013
Report published without a new overall rating.
- May 2013
Report published without a new overall rating.
- April 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 26 January 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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