Riseley House Care Home

Updated 4 April 2024

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

Inspection team

This inspection was carried out by 2 inspectors, a specialist professional advisor who was a nurse and a regulatory coordinator who made calls to staff and relatives.

Service and service type

Riseley House Care Home is a 'care home'. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Riseley House Care Home is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was not a registered manager in post. A new manager had been in post for 2 months but had not yet submitted an application to register.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service. We sought feedback from the local authority and professionals who worked with the service. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 5 people who used the service and 6 relatives about their experience of the care provided. We also spoke with 3 visiting health professionals and observed interactions between staff and people living at Riseley House Care Home. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We spoke with 11 members of staff in various roles and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We reviewed 7 people's care records and other records relating to people's care and support. We looked at 5 staff files in relation to recruitment. A variety of records relating to the management of the service were reviewed, including policies and procedures.

Updated 4 April 2024

About the service

Riseley House Care Home is a care home providing personal care for older people, including people living with dementia. The service also provides care and a period of rehabilitation to people being discharged from the local hospital prior to going back home. Riseley House Care Home can support to up to 67 people over 3 floors and 8 units. At the time of the inspection 22 people were using the service.

People’s experience of using this service and what we found

People were exposed to the risk of harm as care plans and risk assessments were not reflective of people’s care needs and not updated following accidents and falls. We found incident analysis was not always completed by the provider to review lessons learned, mitigate risk and improve care for people.

Equipment to keep people safe was not regularly checked, or always in working order to ensure staff were alerted when people required urgent care or support.

Regular checks relating to health and safety and the environment were not always completed and there was a lack of awareness of senior staff’s responsibilities in this area.

We observed a lack of engagement and activities for people, which was reflective in feedback we received from people, relatives, and staff.

Medicines were not always managed safely and documentation was not always completed, nor provided staff with clear guidance on how to support people in his area.

Records staff completed relating to people’s health, emotional and care needs were inconsistently recorded. Systems to update care records following changes in people’s care to ensure that staff had guidance on how to support and meet people’s needs were ineffective.

People spoke positively regarding the care they received from staff and this view was shared by relatives.

Improvements were required on how people were involved in care planning and how the provider obtained feedback from people and their loved ones.

The home was not well-led. Audits and checks the provider made were ineffective. This meant people were receiving inconsistent care and there was a failure to ensure consistent effective monitoring of risk and the quality of the home.

Actions the provider informed CQC they would make following the last inspection had not been completed.

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests, the policies and systems in the service did not support this practice. Processes were in place to assess people under the principles of the Mental Capacity Act (MCA) however, we found the provider was not always working in line with this.

Rating at last inspection and update

The last rating for this service was Requires Improvement (published 18 September 2023).

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 the provider remained in breach of regulations.

Why we inspected

The inspection was prompted in part due to concerns received safe care and treatment of people. A decision was made for us to inspect and examine those risks.

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 the service can respond to COVID-19 and other infection outbreaks effectively.

Enforcement and Recommendations

We have identified repeated breaches in relation to safety of people and premises and management of documentation, checks and audits. We have also identified a breach in relation to consent and adherence to the Mental Capacity Act 2005.

We have made recommendation relating to activities and the completeness of staff recruitment documentation.

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 meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Special Measures

The overall rating for this service is 'Inadequate' and the service is therefore in 'special measures'. This means we will keep the service under review and, if we do not propose to cancel the provider's registration, we will re-inspect within 6 months to check for significant improvements. If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures.

This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.