Richmond Court is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during the inspection.

Richmond Court accommodates up to 47 people in one building. Some people were younger adults and had a learning disability and lived on the ground floor of the service whilst older adults living with dementia and mental health needs lived on the first floor. People were accommodated over two floors and in five distinct areas, two areas on the top floor and three areas on the ground floor. The service provides residential and nursing care on the first floor and residential care on the ground floor. On the day of our inspection there were 47 people using the service.

The inspection took place on 30 April 2018 and was unannounced. This meant staff did not know we were visiting.

We last inspected Richmond Court in April 2016 and rated the service as ‘Good’. At this inspection we found the service remained ‘Good’.

The service had a registered manager who was on duty during the course of our visit. They had worked at the service for many years. 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.

Staff and the management team understood their responsibilities with regards to safeguarding and staff had been trained in safeguarding adults. We saw the registered manager had shared learning within the staff team from safeguarding occurrences that occurred at the service.

People’s needs were assessed before they came to live at the service. Where potential risks had been identified an assessment had been completed to keep people as safe as possible. Health and safety checks were completed and procedures were in place to deal with emergency situations.

The home was clean, and we saw staff followed good practice in relation to wearing personal protective equipment when providing people with care and support.

Medicines were managed safely. We saw medicines being administered to people in a safe and caring way.

We found there were sufficient care staff deployed to provide people’s support in a timely manner. We saw that recruitment checks were carried out to ensure that staff were suitable to work with vulnerable people. People told us their needs were attended to promptly.

Staff received the support and training they required. Records confirmed training, supervisions and appraisals were up to date.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People gave positive feedback about the meals they were served at the home. People received the support they needed with eating and drinking by the kitchen team who were trained in the support of people with nutritional needs.

The premises were homely and suitable for people's needs. People were involved in decisions about the decoration and the provider had taken steps to make the environment more accessible and personalised in response to changes in people's needs.

People had access to healthcare services in order to promote their physical and mental health. We saw that people were supported to have annual health checks and to attend health screening appointments.

People were supported by care staff who were aware of how to protect their privacy and dignity and show them respect at all times.

There were detailed, person-centred care plans in place, so that staff had information on how to support people. ‘Person-centred’ is about ensuring the person is at the centre of everything and their i

This inspection took place on 6 and 7 April 2016 was unannounced.

The service was last inspected in April 2014 when the provider was compliant with the regulations.

Richmond Court is part of the Willington Care Village, a group of homes owned by Bondcare Willington Limited. Richmond Court is registered to provide care for up to 49 people and includes three separate units. One unit is for individuals with dementia care and nursing needs and the other two units for people with learning disabilities which also included respite facilities. These latter two units whilst registered with CQC under the overarching service Richmond Court are also known as Binchester and Raby Court.

:

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 registered provider carried out checks on staff before they started work in the service to see if they were suitable to work with vulnerable people.

We found the home to be clean and the registered manager had in place cleaning schedules to reduce the risks of cross infection.

Staff demonstrating to us they had a good understanding of safeguarding and what to look out for if a person was being abused.

We found people’s medicines were given to them in a safe manner and staff had been assessed to ensure they were competent to apply people’s topical medicines.

There were regular checks in place to ensure the building was safe, these included health and safety checks, fire alarm checks and fire drills. Checks were also in place for water temperatures and to ensure window restrictors were working.

The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The Act requires that as far as possible people make their own decisions and are helped to do so when needed. We found the service worked within the principles of the act and when required had made applications to the appropriate authority to restrict people’s liberty and keep them safe. The Deprivation of Liberty Safeguards (DoLS) provides guidance to enable care providers to do this. We found the service had followed the guidance.

Kitchen staff were aware of people’s dietary needs and their preferences. We found people were supported to eat when needed by staff and staff encouraged people during their mealtimes to eat. People’s weights had been stable with only minor fluctuations.

Staff had received training pertinent to the role. We found staff completed e-learning training and then were tested by the registered manager using a workbook. This meant the registered manager endure they were competent to carry out their roles.

Staff were viewed by relatives as very caring and supportive to the people living in the home. Relatives expressed confidence in the service.

We observed staff approaching people and treating them with dignity, respect and kindness.

Activities coordinators were employed by the service and we found people were engaged either in group or individual activities according to their preferences. People appeared to enjoy the activities.

We found there was a strong management presence in the unit. Staff and visitors to the unit made favourable comments about the manager.

The home had a range of quality audits in place to monitor the service. We found if any deficits were noted these were addressed and reported as having been carried out.

The manager had in place staff meetings where they resolved issues and gave direction and /or permission to staff to improve the service.

Surveys of the home had been conducted to monitor the service provision. The responses to the surveys were positive.

During our inspection we asked the provider, staff and people who used the service specific questions; our findings are below.

Is the service caring?

We observed people were treated with dignity and respect by the staff. People told us they liked living there. One person said, “I was made to feel very welcome .” People’s preferences and needs were recorded and their care was provided in line with their wishes.

Is the service responsive?

People participated in a range of activities to meet their needs. We found the manager had responded to suggestions for improvements by external auditors.

Is the service safe?

The registered manager set the staff rotas. People's needs were considered when making decisions about staffing numbers, qualifications, skills. The registered manager was aware of the requirements under the Deprivation of Liberty Safeguards and had appropriately used them

Is the service effective?

People’s health and care needs were assessed with them, their family members and with health and social care professionals. Dietary, social, mobility, equipment and dementia care needs had been identified in care plans where required.

Is the service well-led?

The registered manager undertook regular audits to continually improve the service. The records we looked at showed any shortfalls were addressed promptly. We found equipment was regularly serviced therefore not putting people at unnecessary risk.

Due to the nature of this responsive inspection we did not seek the views of people using the service.

We found people who used the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.

We also found the provider had taken steps to make sure only suitable people were employed to work in the care home. This was because thorough background checks had been carried out.

Richmond Court is subdivided into three units.

Richmond Court was one unit and this provided care for up to 29 people with dementia type needs. Raby Cottage was the second unit which provided care for eight people with learning disabilities. Binchester Court was the third unit providing respite care for up to eight people with learning disabilities.

Most of the people in the three units found it difficult to express their experiences of living at the home. We spoke to eight people and two visitors and those able to tell us themselves or through a visitor said: “I feel very safe here and staff always have time to listen to me”. A visitor to the service said: “My relative has good company and has made new friends”. A visitor also told us that their relative has put weight on since living at the home. One person said: “The food is good, I like everything”.

We observed that people were treated with dignity and respect and that they appeared comfortable and relaxed in the presence of all the staff, including the manager. There was also a smoke room for people to use whenever they wanted to.

Many of the staff had been with the provider for many years and commented that they were well supported and had training opportunities for both personal development and to help the people living in the home.

Richmond Court historically provided care for up to 49 people with dementia type conditions who required nursing. The manager told us in early 2012 the provider modified the premises by subdividing the building into three separate units. From May 2012 Richmond Court provided care for up to 29 people with dementia care needs. A new unit called Raby Cottage provided residential care for up to 8 people with learning disabilities and another new unit, Binchester Court, provided respite care for up to 8 people with learning disabilities.

We saw the premises were on two floors. The ground floor of Richmond Court accommodated a mix of male and female residents whilst the first floor had been established as a male only facility. The new Raby Cottage was located on the ground floor and Binchester Court was on the first floor.

On the day we visited, most of the people who lived in Raby Cottage and Binchester Court were out at day care centres. Most people who lived in Richmond Court had dementia needs, so were not always able to tell us about their experiences of living at the home. We therefore spent time watching how people were supported. People appeared generally content, at ease in the home and with the staff on duty.

We spoke with three people. Those able to express an opinion told us they were happy and were well cared for. Comments included, “It couldn’t be better here” and “It’s champion. I like a smoke in the smoke room” and “The staff are lovely; we have a laugh.”