Background to this inspection
Updated
20 February 2020
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 Care Act 2014.
Inspection team
The inspection was carried out by two inspectors and an inspection manager.
Service and service type
Riddlesden Rest and Convalescent Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
This inspection was unannounced.
What we did before inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.
During the inspection
We spoke with five people who used the service and two relatives about their experience of the care provided. We spoke with four members of staff including the registered manager and three care staff/ancillary staff. We reviewed a range of records. This included five people’s care records and multiple medication records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
After our visits to the home
We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. We spoke with a fire officer, and the local authority commissioning team about the service. We also liaised with the police, and the local authority commissioners in relation to the allegations raised.
Updated
20 February 2020
About the service
Riddlesden Rest and Convalescent Home is a residential care home providing personal and nursing care to up to 10 people aged 65 and over. The home is situated on the outskirts of Keighley providing care in a single storey building. There is car parking to the front of the building and wheelchair access into the home. The home does not have any gardens but there is a patio area for people to use. At the time of the inspection there were nine people using the service.
People’s experience of using this service and what we found
Some risks were managed well, but others had not been identified to ensure the necessary control measures were in place. Moving and handling risk assessments and care plans did not provide the necessary guidance for staff to follow. At times staffing levels were low. Some people required two staff members to support them and this was not always available.
Some of the systems and processes to monitor the quality of the service, which had been put in place by an external care consultant providing support to the home, had not been continued by the registered manager. The registered manager had been busy providing care at the home, which limited their time to complete managerial tasks such as audits.
Some people were quite happy watching television and some people liked to knit. However, there were times during the day when there was very little to occupy people. We have made a recommendation the provider considers current guidance on meaningful occupation and wellbeing.
Medicine management procedures were in place. Evidence to confirm all staff medication training was up to date and their competency levels checked, was not available. Evidence based guidance recommends an annual review of staff knowledge, skills and competency and this had not happened. Some staff training was also out of date in other topics essential to care provision.
People who had restrictions on their liberty had been referred to the relevant authorities. 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. Mental capacity assessments were not decision specific and best interest decisions processes didn't follow best practice. We have made a recommendation the provider considers current guidance on MCA and best interest decision making.
People liked living at the home and the relatives we spoke with who visited during the inspection, told us they were confident they were safe. Information we received following our first two days of inspection alleged some staff did not always treat people with dignity or respect.
Staff were recruited safely, and people received care from staff who knew them well. People and their relatives were happy with the staff at the home and reported there was a homely feel to the home.
People liked the food and were offered a choice of food options. People’s weight was regularly taken and action was taken when there was concern about weight loss.
Rating at last inspection
The last rating for this service was requires improvement (published 21 April 2017). Since this rating was awarded the legal entity of the provider has changed. We have used the previous rating to inform our planning and decisions about the rating at this inspection. This service has been rated requires improvement for the last two consecutive inspections.
Why we inspected
This was a planned inspection based on the previous rating. After the first two days of inspection, and before the inspection concluded we received information of concern. These concerns were in relation to serious allegations of abuse which are being investigated by the police. As a result of these concern we undertook a further two days of inspection. The investigation into the allegations has not been concluded.
Enforcement
At the inspection we identified breaches in relation to the management of risk, staffing levels, staff training and governance arrangements. Please see the action we have told the provider to take at the end of this report.
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 with the 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.