We carried out a review of the data available to us about Risby Park Nursing 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 Risby Park Nursing Home, you can give feedback on this service.
Risby Park Nursing Home was providing accommodation, nursing and personal care to 47 people the time of the inspection. The service can support up to 54 people.
People’s experience of using this service and what we found
Risby Park Nursing home continued to provide an outstanding service, delivered by a highly skilled, motivated and very caring workforce, led by an exceptional registered manager. People and their relatives shared the highest praise in describing how they were supported, for example, “They have everything covered, it’s the best place ever.”
The service had worked hard in the continued upskilling and training of nursing staff so that people could receive additional services within the home, which improved their quality of life. Local healthcare professionals had high levels of trust and respect for the staff and their skills. The provider and registered manager had continued to invest in improving the homes environment in line with the very latest best practice and published research in care for people living with dementia. Managers worked creatively and in partnership with people to enhance visitor experience. Visitors, and pets, were made very welcome and comfortable, so all could get the best from their time together, reducing social isolation and improving wellbeing.
Risby Park Nursing Home continued to provide outstanding caring practice to people, and their loved ones. People felt they were partners in their care and encouraged to make decisions about this. Managers had been instrumental in setting up a network of carer events, both in the service and social events in the community. Relatives told us of the positive impact this had on them, as they came to terms with the impact of their loved ones decline in health. This support network extended to relatives whose loved ones had passed away, so that they could continue to receive support from the networks they made over the past months and years. There was a very high level of promoting the dignity of people. The understanding of people’s life history was seen as a key in the planning of peoples care delivery, and we saw this being used in staff’s daily practice. People were supported to celebrate their previous experiences and achievements, including using these to help younger people understand the impact of dementia and the breaking down of barriers and associated stigmas.
The provision of care and support at Risby park Nursing Home was exceptionally person centred. Very detailed assessments of people’s needs were completed before they moved in, even at short notice, with action taken to meets these needs without delay. One person who had very recently moved in told us, “We keep thinking its [Risby Park] too good be true.” End of life care at the service was incredibly well planned by staff who had received additional training to make this as dignified and peaceful of possible.
The provider and registered manager were proud of their place in the local community and saw actively arranging community events and hosting intergenerational projects as a way of reducing social isolation and creating enjoyment for all. People’s wellbeing was enhanced by person-centred activity planning by a dedicated engagement team. Social opportunities were widespread and took place within the community as well as the home. Relatives told us the high levels of activity people were able to engage in kept their family members active which was beneficial for their health.
The service was led by a registered manager and management team that were committed to delivering a service which improved the lives of the people in fulfilling and creative ways. Their drive and passion had created a service that provided the very best dementia care that was based on best practice and research. The registered manager encouraged and facilitated staff to go the extra mile in delivering care that made people feel special. Staff understood how to make people and their relatives feel valued and told us this improved their lives and made them happy. In the words of one relative, Risby Park Nursing Home gave them, “Five years I never thought I'd have with [relative]. Here (Risby Park) made it all easier to accept.”
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
The last rating for this service was Outstanding (Published 13 September 2017)
Why we inspected
This was a planned inspection based on the previous rating.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Risby Park Nursing Home on our website at www.cqc.org.uk.
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.
There was a registered manager in post at the time of our inspection. 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.
At our last inspection on 17 March 2015 we rated the service good overall and requires improvement in safe because we had concerns about the staffing levels. At this inspection we found significant improvements. The service had continued to develop and had further strengthened the very caring approach, responsiveness and how well the service was led. People received exceptional care that was personalised to them, taking account of their individual needs and wishes.
Extremely caring relationships had been built between people and staff. Staff working in the home were especially caring and compassionate. Staff knew the needs and preferences of the people they cared for and people were given reassurance and encouragement when they needed it. Where people needed support in order to make their own day to day decisions this was provided by staff. People's rights to privacy, dignity and independence were taken into account by staff in the way they cared for them. People receiving end of life care were treated with exceptional care and compassion.
Risby Park Nursing Home was exceptionally well-led. The registered manager was a highly skilled leader who had clear oversight of the home and a passion for delivering the very best care to people. The registered manager ensured staff were meeting people’s needs holistically. There were processes in place to seek feedback from people, relatives and supporting health and social care professionals to drive improvements in the quality of the service. Complaints were managed in accordance with the provider's policy. Where concerns were raised these were dealt with speedily and in depth. Relatives said they felt welcomed and supported at the home and would highly recommend it to other people.
People received exceptionally personalised care and support which they were in control of. People were encouraged and supported to express their views and opinions about how they wanted to be looked after and cared for. People were at the forefront of their care and staff went the extra mile to ensure people had their care needs met in the way they wanted them. People and their relatives were listened to if they were unhappy or had comments to make. Actions were taken where appropriate in order to improve the quality of care provided. Improvements were made as a result of feedback received.
The registered manager and provider strived for excellence and improving the lives of people who lived at the home through involvement with external organisations and the local community.
There were extremely effective quality monitoring processes in place which covered all areas of the home and care delivered to people. Staff morale in the home was extremely high. Staff were proud to work at Risby Park and were remarkably enthusiastic and passionate about delivering high quality care.
Staff were proud to work at the home. They were particularly positive about the way the home was managed and were very happy in their work. There was a clear management structure in place; staff understood their roles and responsibilities. The home was highly organised and well run and the culture was open and transparent.
Care practice at the home was based on best practice and the registered manager ensured that they kept themselves up to date with their knowledge for the delivery of high quality care. Working collaboratively with other agencies and professionals to drive continual improvement was a fundamental part of the management of the home.
The home had sufficient staff to meet the needs and preferences of the people living there. Staff were recruited only after completing the necessary checks to make sure they were suitable to work at the home.
Appropriate plans were in place to guide staff in how to minimise risks to keep people safe. Staff knew what action to take to ensure people were protected if they suspected they were at risk of harm. They were encouraged to raise and report any concerns they had about people through safeguarding and whistleblowing procedures.
Care records contained individual risk assessments and risk management plans to protect people from identified risks and help to keep them safe. They provided information to staff about action to be taken to minimise any risks whilst allowing people to be as independent as possible.
Staff were very well trained and knowledgeable regarding people's needs. Staff felt well supported by management and felt able to speak with senior staff at any time.
People were supported by staff who understood and effectively applied the principles of the Mental Capacity Act, 2005 and the Deprivation of Liberty Safeguards. Staff confidently applied the MCA to make sure that people were involved in decisions about their care so that their human and legal rights were protected. People were supported to have maximum choice and control of their lives and staff assisted them in the least restrictive way possible.
We inspected this service on the 17 March 2105 and it was unannounced. The last inspection to the service was on the 29 October 2014. It was carried out because of concerns raised about staffing levels and how some people’s needs were being met. We made compliance actions. The home has made significant improvements in terms of meeting people’s needs but there were still some concerns about staffing levels.
The service is registered for: accommodation for persons who require nursing or personal care and treatment of disease, disorder or injury. They are registered for up to 54 people both over and under 65 years old, with or without dementia.
There is 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 service was well managed and run in the interest of people using it. During our inspection we saw that there were enough staff to meet people’s needs. However we received feedback to suggest this was not always the case and a minority of people told us that at times there were insufficient staffing. This meant we were not confident staffing levels were always appropriate to people’s needs.
There were systems in place to ensure people had the medicine they needed and staff received training to ensure they were competent and able to administer medicines safely.
Staff received training on how to recognise abuse and actions they should take if they believed a person was at risk of harm or abuse. Staff demonstrated enough understanding of safeguarding and had policies they could refer to which told them how to report concerns.
Risks to people’s safety had been assessed and as far as possible reduced which meant people were as safe as they could be and their health and welfare was promoted.
Staff have the necessary skills, training and support to meet people’s needs and demonstrated that they knew what the requirements of the job were.
People were supported to eat and drink in sufficient quantities and people’s weights were monitored to ensure they were not unintentionally losing weight.
People’s rights were upheld and staff acted lawfully when supporting people to make decisions about their care and welfare. They were asked about how they would like their care to be provided and gave their consent before it was.
People’s emotional and health care needs were met and a plan was in place informing staff how people wished to have their needs met.
The home had a complaints procedure and the service acted upon suggestions and complaints to improve the service.
The service was well led with a strong ethos and person centred values. Investment in the staff and good quality assurances processes meant the service provided was good and took into account people’s views and acted upon them.
The health and safety of people was promoted through good risk assessment processes and audits which identified risk so it could be reduced as far as possible.
As part of this inspection we looked at five people's care plans, spoke with six members of staff, five people living in the service and four relatives.
We considered our inspection findings to answer questions we always ask; Is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well-led?
This is a summary of what we found;
Is the service safe:
We found that the service was not safe. Care plans were not up to date and guidance given by care professionals had not always been followed. There were not always sufficient staff to meet people's needs.
Is the service effective:
The service was not effective. People were not always supported to have their meals by staff that had time to spend with them.
Is the service caring:
The service was caring. People told us, "The care is good" and "The girls are lovely."
Is the service responsive:
The service was not responsive. People's assessed needs were not always met. Risk assessments and care plans were not reviewed regularly.
Is the service well-led?
The service was well-led. Relatives and staff told us they found the registered manager approachable and if they made a complaint it was dealt with. However, one relative did qualify this by saying that they had had to make the same complaint a number of times as things improved initially but then slipped back.
There was a registered manager in place.
We found that people were well supported to access adequate hydration and nutrition. People were offered choices around what and when and where they ate. Staff were on hand to assist people at mealtimes to ensure that people received an adequate diet.
Medications were stored and administered appropriately and staff were trained and competent in managing people's prescribed drugs.
We saw that there was an adequate complaints policy in place and that people were aware of how to complain if they needed to.
People were provided with a balanced diet and weights were monitored. People's health care needs were met but care records did not show how people had been consulted. Daily notes gave limited information so it would be difficult to evaluate the effectiveness of the care being provided.
The environment was well maintained and fit for purpose. It was both stimulating and comfortable. We saw evidence of activities being provided to promote people's emotional well being.
Staff were appropriately supported but improvements to the recruitment process were necessary. Staffing levels were not always maintained to an appropriate level for people's safety. Staff told us that staffing levels were short at times which compromised people's care.
The service had effective systems in place to measure and assess the care provided so knew what improvements were necessary.