Archived: Richmond Heights

Richmond Heights is a care home that provides accommodation for people who require personal or nursing care. The home can accommodate up to 51 people. At the time of this inspection there were 47 people using the service.

People’s experience of using this service:

• People told us they felt safe at Richmond Heights. They knew who to report any concerns to and were happy with the support they received from staff. People’s care records contained guidance for staff about how to support people safely and minimise risks to people. Staff were trained in their responsibilities for safeguarding adults and knew what action to take if they witnessed or suspected any abuse;

• The service had systems in place to ensure people received their medicines as prescribed. Staff supported people to maintain their health by making appropriate referrals to community health professionals and acting on any advice they were given;

• There were enough staff on shift to keep people safe and we observed staff usually responded to people in a timely manner throughout the day. Staff told us they thought there were enough staff to meet people’s needs. We have made a recommendation about the deployment of staff during mealtimes as we observed some people had to wait for support during lunchtime;

• People told us staff were kind and caring. We observed staff knew people well. People’s likes, dislikes and social histories were recorded in their care records. This helped staff get to know people well and care for them in a personalised way;

• Staff were competent, knowledgeable and skilled. They received regular training, supervisions and appraisals which supported them to conduct their roles effectively;

• 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 were happy with the food provided at Richmond Heights. The service catered for people's special dietary requirements and staff monitored food and fluid intake levels of people who were assessed to be at risk;

• A range of activities were provided for people living at Richmond Heights, such as ‘chairobics’, quizzes, games and external entertainers such as singers. We received mixed feedback about the activity schedule. Some people said there was plenty to do. Other people and some relatives said there was not much to do so they watched a lot of TV. We have made a recommendation about the involvement of care staff with the activity provision in the service;

• The provider had recently purchased a mini-bus so people could be supported to access the local community. People had recently been supported to visit a local country park and the pub for lunch. They had provided staff with positive feedback about these experiences;

• The provider had an effective complaints procedure in place. Information about how to complain was displayed in the entrance to the home. People and their relatives knew how to complain if they needed to;

• The provider and registered manager understood the regulatory requirements and monitored the quality and safety of the service on a regular basis;

• Staff provided positive feedback about how the home was run by the registered manager. Staff told us they enjoyed their jobs, their morale was positive and they told us the staff team worked very well together;

• More information is in the full report.

Rating at last inspection:

At the last inspection the service was rated good (published 17 August 2016).

Why we inspected:

This was a planned inspection based on the rating awarded at the last inspection.

Follow up:

We will continue to monitor this service. We plan to complete a further inspection in line with our re-inspection schedule for those services rated good.

Richmond Heights is in a residential area of Sheffield and provides accommodation for 55 people who require nursing and/or personal care. Accommodation is provided over two floors, accessed by a lift. All bedrooms are single with en-suite toilets. There are lounge and dining areas on each floor of the home. The service has a garden and a car park. At the time of the inspection there were 49 people living at the service.

There was a registered manager. 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.

There was a calm and friendly atmosphere in the service. The service was clean and had a pleasant aroma. Our observations during the inspection told us people’s needs were being met in a timely manner by staff. We observed staff giving care and assistance to people throughout the inspection. They were respectful and treated people in a caring and supportive way.

People told us they felt safe and were treated with dignity and respect. Staff had undertaken safeguarding training which was regularly refreshed so they understood their role and responsibility to keep people safe from harm.

The service had appropriate arrangements in place to manage medicines so people were protected from the risks associated with medicines.

Robust recruitment procedures were in place and appropriate checks were undertaken before staff started work. This meant people were cared for by suitably qualified staff who had been assessed as safe to work with people.

People had personalised their rooms and they reflected their personalities and interests. We saw the signage in the service to help people navigate around the building could be improved. People living with dementia may need such signs every time they move around a building.

People spoken with told us they were satisfied with the quality of care they had received and made positive comments about the staff. Relatives spoken with also made positive comments about the care their family members had received and about the staff working at the service.

People had a person centred care plan in place. People’s records were updated on a daily basis. Individual risk assessments were completed for people so that identifiable risks were managed effectively. People and/or their representatives were included in the completion of these and they were reviewed regularly and in response to changes. There was evidence of involvement from other professionals such as doctors, opticians, tissue viability nurses and speech and language practitioners.

People’s nutritional needs were monitored and actions taken where required. People made positive comments about the food and said their preferences and dietary needs were being met.

Staff told us that there was a good team working at the service and that they enjoyed caring for people living at the service. Staff were able to describe people’s individual needs, likes and dislikes.

Staff received training and ongoing support to enable them to support people appropriately.

We saw the service promoted people’s wellbeing by taking account of their needs including daytime activities. There was a range of activities available which included: boules, quizzes, card games, basketball and do remember cards. We looked at the service’s newsletter dated July 2016. It gave details of the events the service was holding in July. For example, a barbecue, an outing to the armed forces day in Chesterfield and an outing to Norfolk Park. It also gave details of upcoming birthdays for people and staff.

The provider had a complaint’s process in place. We found the service had a robust process in place to enable them to respond to people and/or their representative’s concerns, investigate them and take action to address their concerns.

Regular residents and relatives meeting were held at the service. The service completed surveys on a regular basis with relatives.

Accidents and untoward occurrences were monitored by the registered manager to ensure any trends were identified. There were effective systems in place to monitor and improve the quality of the service provided.

People spoken with were satisfied with the quality of care they had received and made positive comments about the staff. Their comments included: “they [the staff} always ask me how I am feeling”, “the staff are lovely” and “I can talk to any of them but the most important thing is they listen”.

Relatives spoken with were satisfied with the quality of care their family member had received. Their comments included: “we think it is pretty good and the staff are very good” and “they [the staff] treat her very well, they maintain her dignity and her personal care is good”

We reviewed five people’s care plans. We found action had been taken by the service to ensure that a risk assessment and care plan for all areas of identified need in the person’s pre-assessment and reviews were in place. This showed that people had been protected against the risks of receiving inappropriate or unsafe care as care had been planned to meet people's needs.

People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines.

People we spoke were satisfied with the quality of care that they had received and that staff responded in a reasonable time when they used their buzzer to call for assistance. One person commented: “when I ring the buzzer you may have to wait a little bit but they always come”.

We spoke with one relative and two advocates who were very satisfied with the quality of care their family member or person they represented had received. Their comments included: “all the staff are wonderful”; “I am very satisfied with the quality of care” and “very good care”.

We found that although the service had carried out an assessment of the needs of people using the service, we saw that the service had not planned or delivered the care to meet some people’s individual needs. The service was non compliant in this outcome area.

People were not protected against the risks associated with medicines because the provider did not have appropriate arrangements in place to manage medicines. The service was non compliant in this outcome area.

We saw the service had a procedure in place to deal with complaints. All the people we spoke with told us that they felt “safe” and that if they had any concerns that they would speak to a relative or staff.

We found that the standard of the care plans had improved and that people’s care and treatment was planned and that staff had accessed training from the Sheffield care home support team.

We saw that improvements had been made on how people were assisted to eat at meal times. We found the environment in one of the dining rooms to be more calm and conducive to people eating.

We found that staff monitored people’s wellbeing and recorded it in their charts. We saw that some people had access to their call buzzers but we found examples where this was not the case.

We found that there were clear procedures in place for the administration of medication. We found that people had received medicines at the times they needed them and in a safe way.