We carried out a review of the data available to us about Riccall House Care Home on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Riccall House Care Home, you can give feedback on this service.
Riccall House Care Home is a residential care home providing personal and nursing care to up to 18 people. The service provides support to older adults, some of who may be living with dementia. At the time of our inspection there were 16 people using the service.
Riccall House Care Home is a detached property that has been adapted. Bedroom are across two floors with a stair lift serving one part of the first floor.
People’s experience of using this service and what we found
People’s environment was homely, clean and safe because systems were in place to monitor and manage all aspects of health and safety.
People and their relatives told us they were happy with the care they received. They were confident in the registered manager and staff’s abilities to provide a safe and caring environment with engaging and enjoyable activities.
People received their medicines as prescribed in line with their preferences by trained and competent staff.
People were safe from the risk of abuse and neglect because staff were trained and confident to speak up. Staff were safely recruited and had the relevant training for their roles.
Managers in the service led by example and created a positive and open atmosphere where everybody was confident to provide feedback to improve the service. The registered manager was quick to act on feedback to improve the experience of care for people living at the service.
One relative told us, “There seems to be an ethos of real care shown for the residents from all the staff and the registered manager and they have a knack of making them feel special.” Another relative told us, “The residents and family meetings that the registered manager has introduced are very positive and constructive and have led to some enjoyable shared experiences, suggested by family and residents. They encourage and welcomes suggestions, for example having a banjo player visit the home for my relative’s birthday celebration, when everyone in the home enthusiastically joined in. For me, the meetings have also been a good opportunity to meet some of the relatives of other residents.”
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was requires improvement (published 27 February 2021) and there were breaches of regulations. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
We carried out an unannounced focused inspection of this service on 25 November 2020. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment, staffing and governance.
We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the key questions safe and well-led which contain those requirements.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Riccall House Care Home on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
Riccall House Care Home is a residential care home providing personal care and support to people aged 65 and over, some of whom were living with Dementia. Riccall House Care Home is an adapted building across two floors. At the time of the inspection there were 15 people using the service. The service can support up to 18 people.
People’s experience of using this service and what we found
There was a clear lack of systems and processes in place to monitor the quality and safety of the service. Some policies and procedures were not in place or were not in line with current guidance.
Some staff had not received essential training and other training had not been refreshed in line with the providers own timeframes. Checks were not in place to ensure they were competent in carrying out their duties.
Records relating to risks to people had not always been regularly reviewed and care plans were not always updated to reflect the current level of need and support for the person. Risks in relation to the environment has not always been considered. Systems were not in place to effectively monitor accidents and incidents within the service.
Medicines were not managed safely and staff administering medications were not always trained to do so. We also identify some issues around medicines records and storage of medication that required improvement.
Infection prevention and control policies and procedures were not up to date and did not reflect current government guidance. Additional cleaning and checks in response to the COVID 19 pandemic were not in place and risk assessments were not completed for individuals at risk as a result of infectious outbreak.
Staff were familiar with people and their care and support needs. Staff worked well as a team but they did not always feel listened to by the registered manager.
Feedback from people who used the service and their relatives was positive and they found staff to be caring and kind. People told us "I'm so lucky to be here" and "The staff are caring. You get well looked after in every way."
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
We discussed several issues with the registered manager during the inspection and asked them to take action to address immediate risks. We also asked that they update some records relating to risk and take steps to reduce risk around infection prevention and control (IPC). Other areas requiring improvement are ongoing and we will ask the provider to inform us when these have been completed.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Why we inspected
The last rating for this service was good (published 21 November 2019).
Why we inspected
We undertook this targeted inspection to follow up on specific concerns which we had received about the service. The inspection was prompted in part due to concerns received about infection prevention and control (IPC). A decision was made for us to inspect and examine those risks.
We inspected and found concerns with the management of IPC so we widened the scope of the inspection to become a focused inspection which included the key questions of safe and well-led.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to coronavirus and other infection outbreaks effectively.
We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.
We have found evidence that the provider needs to make improvements. Please see the Safe and Well-led sections of this full report. The provider had taken some action during the inspection to mitigate risks and continued to liaise with the inspector after the inspection to advise of further improvements scheduled and/or carried out.
You can see what action we have asked the provider to take at the end of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Riccall House Care home on our website at www.cqc.org.uk.
Enforcement
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.
We have identified breaches in relation to medicines management, risk assessments, staffing and monitoring of the service at this inspection.
Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.
Follow up
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
People’s experience of using this service and what we found
Since the last inspection the provider and registered manager continued to improve people’s quality of life and maintain high standards of care. A plan was in place to keep improving the service in areas such as fire safety, care plans and staff recruitment, supervisions and appraisals. The provider was committed to using feedback from people to develop the service further.
We have made a recommendation in this report, in relation to quality assessment and monitoring.
The staff team were inducted, supported and trained; they understood their roles clearly and knew what was expected of them. People were treated with respect and dignity, they were also supported to maintain their independence.
People’s needs and preferences were known by the staff and people received person centred, responsive care. Feedback from people and their relatives was positive. Staff had developed good relationships with people which led to people feeling safe and happy.
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 enjoyed access to a garden and were offered a wide variety of activities to take part in if they chose this.
For more details, please see the full report which is on the Care Quality Commission (CQC) website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published 14 April 2017).
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
At the last inspection in January 2015, the service was rated Good. We made recommendations regarding the recruitment procedure and staff supervision arrangements. At this inspection we found the service remained Good.
People were supported by staff who had been checked and vetted as suitable to work in a care service. We found there were enough staff to assist people in a timely way. We asked the registered manager to keep the hours individual staff worked under review.
Environmental and individual risk assessments were completed. These were used to identify and minimise the risks to people who used the service. We have made a recommendation about using best practice guidance to assess and reduce the potential risk of falls on stairs for people living with dementia.
People’s medicines were managed in a safe way.
Staff received updated training including safeguarding training to ensure they could meet people’s needs safely.
People were supported to have 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’s nutritional needs were effectively met. People spoke positively about the quality of the food, which they enjoyed.
People were supported to access health care professionals when needed. Feedback we received from visiting healthcare professionals was positive. A healthcare professional told us that the staff acted on any advice given and this resulted in improved outcomes for people.
People and relatives said the registered manager and staff were helpful and friendly. Staff understood the importance of respecting people's dignity and treating people with respect.
People felt there was a good range of activities of their choosing. They knew who to speak with if they had any worries or concerns and were confident that action would be taken if they raised any issues.
There was a registered manager in post. The registered manager made sure regular audits were carried out to ensure the service was well managed and organised.
Further information is in the detailed findings below.
This inspection took place over two days, 29 and 30 January 2015 and was unannounced. At our last inspection on 18 November 2013 we had not found any breaches of legal requirements.
This service is registered to provide accommodation for 18 older people some of whom have dementia. Accommodation is provided over two floors; the home is set in private secure gardens. There is a small car park for visitors. The home is situated on Main Street in Riccall village close to local amenities. Staff are available twenty four hours a day to support people.
The home has 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 the legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
People who used the service were cared for by staff who understood they had a duty to protect people from harm. Staff knew how to report abuse and said they felt able to raise any issues, which helped to keep people safe.
We observed that there were enough staff available to support people during our visits. Staff knew people’s care needs and risks to their health and wellbeing which enabled them to support people appropriately. Training was provided to all staff to help them to develop and maintain their skill.
People lived in a well maintained, clean environment, bedrooms were personalised with memory boxes placed outside people’s bedroom doors to help them find their bedroom. Pictorial signage was provided to help guide people to bathrooms, toilets and lounge areas.
People were offered home cooked food with appropriate fluids to maintain their nutrition. Those who required prompting or support to eat were assisted by patient and attentive staff. Staff monitored people’s dietary intake and gained help and advice if people were losing weight. This ensured that people’s nutritional needs were met.
Visiting health care professionals that we spoke with informed us that they had no concerns about the service people received and they were positive about the help and support provided to people by staff. They confirmed staff acted upon their advice to promote people’s health and wellbeing.
People were involved in making decisions about their care. Staff supported people to make decisions for themselves. People’s privacy and dignity was respected.
A complaints procedure was in place, anyone wishing to make a complaint could do so. There were systems in place to deal with complaints in a timely manner.
People living at the home and their relatives were asked for their opinions about the service provided. The registered manager undertook regular audits which helped them to monitor and maintain the quality of the service. However, we have made some recommendations throughout the report for the registered provider to consider.
We found people looked well cared for and relatives told us they thought people were treated well and their experiences in the home were positive. We observed the care staff being kind and respectful to people.
We looked at people's care records and saw arrangements were in place to identify those people at a greater risk of poor nutrition and dehydration. This was continually monitored. Comments from people who lived in the home included: 'The food is very good.'
Medicines were prescribed and given to people appropriately; we saw people were given the right medicine, in the right way and at the right time on the day of our inspection.
Staff we spoke with told us they received training which helped them to deliver care and support safely to people.
The provider had systems in place to identify, assess and manage risks to the health, safety and welfare of people using the service. This meant people who lived and staff who worked there were protected from potential risks to their well-being.
Whilst we saw the care plans were person centred we did however find, not all of them had been formally agreed to and we asked the provider to review the process of obtaining consent.
People said they thought everybody was very kind to them. One person told us, 'They couldn't be kinder.' One of the relatives we spoke with said, 'It's the little things they do that make people happy.' We observed the care staff treating everyone with respect. They were unhurried and gentle when supporting people. They sat down and encouraged people to communicate with them.
We spoke with two relatives and one health care professional who were visiting on the day of our inspection. They told us they felt there were always 'enough staff caring for the people who lived here.' The care staff we spoke with also confirmed the staffing levels were satisfactory.
We saw the provider had systems in place to assess and monitor the quality of the service provided. This included residents and relatives meetings where people discussed the running of the home and could make suggestions for changes if necessary.