We carried out a review of the data available to us about Risedale Rest Home Limited 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 Risedale Rest Home Limited, you can give feedback on this service.
Risedale Rest Home provides personal care and accommodation to up to 17 older people across three floors in one converted residential terrace. At the time of inspection there were 15 people in receipt of care.
We found the following examples of good practice:
All visitors had to undergo a temperature check and answer a range of relevant questions before entry. There were ample PPE, handwashing facilities and signage, particularly regarding handwashing.
The registered manager and provider had continued to make improvement to the fabric of the building, which helped ensure cleanliness. For instance, improved laundry facilities.
The registered manager demonstrated a good understanding of changing national guidance and ensured staff and people who used the service were made aware of relevant changes. The registered manager worked well with external agencies during the pandemic.
The service had not used agency staff and ensured people received a continuity of care. Individualised risk assessments were in place to help staff and people adhere to social distancing and other government guidance.
People’s experience of using this service and what we found
The registered manager had made a range of improvements to care planning documentation, record keeping and to the fabric of the building. Rooms that were previously undecorated and in need of repair had been renovated and there were new bathroom facilities. The laundry was still in need of improvement; the registered manager agreed to pursue these as a priority with the owners.
Care plans had been completely rewritten where necessary and reviewed on a continual basis.
Risk assessments had also been reviewed and contained improved person-centred information. Daily recording information was accurate and up to date. The registered manager had implemented an electronic care records system, which was working well, although some staff were not yet fully proficient in it. People were kept safe through good staff knowledge and awareness.
The registered manager worked proactively in with external healthcare professionals.
The home felt welcoming and vibrant. Feedback was positive regarding the compassionate, affectionate and sensitive approach of staff.
The registered manager ensured people were involved in the planning of their care. They used a variety of meetings, one to one time and surveys to involve people in how the service was run.
People ate well and had a choice of meals and snacks. ‘Hydration stations’ had been set up in the dining areas so people could help themselves.
People’s rooms were clean and well decorated; refurbishment of communal spaces had continued.
Staff received training relevant to people’s needs. They had received end of life care training and the registered manager had ensured strong links were in place with external healthcare professionals in this regard.
Access to and involvement in activities had improved, with a dedicated member of staff in place.
The registered manager worked well with staff and there was a strong team ethic built on hard work and mutual respect. The registered manager was open and supportive with staff. They were appreciative of the support of a dedicated staff team.
Clear systems were in place for the review and audit of all aspects of the service. The registered manager was aware of a number of benefits the electronic care records system could offer them and staff in future and they planned to utilise it more.
Medicines were managed safely, in line with best practice. The administration of covert medicines and medicines to be given ‘when required’ had been improved, with clearer instructions in place. The premises were well maintained, and appropriate health and safety checks were in place. Emergency procedures and contingency plans were in place.
People’s capacity was assumed unless there were reasons to consider otherwise, and staff acted in line with the Mental Capacity Act 2005. 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.
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 requires improvement (published 28 September 2018). 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
This inspection was carried out to follow up on action we told the provider to take at the last inspection. The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our reinspection programme. If we receive any concerning information we may inspect sooner.
We previously inspected Risedale Rest Home Limited in May 2017, at which time the service was in breach of regulations 9 (person-centred care), 12 (safe care and treatment), 17 (well-led) and 18 (staffing) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. At the previous inspection we rated the service as requires improvement. At this inspection, whilst there had been some improvements, the service remained requires improvement.
We found risk assessments were not managed appropriately, care plans were not person-centred, staffing levels were too low, training had lapsed, premises were not adequately maintained or cleaned and that there was a lack of management oversight.
Risedale Rest 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.
Risedale Rest Home accommodates a maximum of 17 people across two floors. Nursing care is not provided. There were eight people using the service at the time of our inspection, some of whom were living with dementia.
The service did not have a registered manager in place at the time of inspection. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 manager had applied to be registered with CQC and was registered as the manager after the inspection.
At this inspection we found the manager had made a range of improvements and addressed the majority of the areas where the service was previously in breach of the regulations.
We found there were still improvements required with regard to the planning of staffing levels, which were not always adequate to meet people’s needs. Staffing levels were determined by a dependency tool which was not effective. We have made a recommendation about this.
People’s social needs, for example activities and hobbies, could not always be supported because of the lack of appropriate staffing levels. On at least one day a week, the manager was required to assist the one member of care staff on duty. Care staff also had to complete cleaning duties as the provider had not ensured adequate levels of staffing cover in this regard.
Activities provision was not effective. There was no activities co-ordinator and the manager did the bulk of activities planning. Staff helped people with individual activities or played games with people, but none of this was planned in line with people’s preferences. The provider had not ensured there was sufficient staffing in place to provide person-centred care. Subsequent to the inspection the provider confirmed they were seeking the help of a volunteer to help deliver activities.
There had been significant improvements in terms of cleanliness since our last inspection, with evidence of recent refurbishment and more planned. Infection control training had been delivered to staff and all visitors and people who used the service agreed the service was cleaner.
Medicines administration practices had improved and were now safe. Protocols for ‘when required’ were not yet in place.
Risk assessments were in place and described the factors which may put people at risk of harm, and what staff needed to do to minimise these risks. Documentation regarding risks, along with all aspects of care planning, were under review and would benefit from more detailed, person-centred information. Staff knowledge regarding how to keep people safe was good.
All staff were aware of their safeguarding responsibilities and the manager had done some work to ensure this was well understood.
Training and support for staff had improved since the last inspection. A range of mandatory and additional training had either been delivered or planned, whilst staff confirmed they now received supervision meetings. They told us they were now well supported.
Training was monitored via a training matrix, which did not always prove effective as it did not contain information regarding online courses staff had completed. The manager was aware of this and planned a new matrix.
People received a range of meal options and the mealtime experience we observed was a pleasant one. People’s individual tastes and preferences were well catered for.
People were supported to have maximum choice and control of their lives in the least restrictive way possible. Staff had received training in the Mental Capacity Act (2005).
There were adequate bathing and toileting facilities. Some refurbishment work had been undertaken, mostly downstairs in communal areas. Further work was required upstairs to renovate one bathroom and refurbish remaining bedrooms.
Staff knowledge of people’s needs was good and there were well documented interactions with external healthcare professionals.
People who used the service, their relatives and external professionals gave consistently strong feedback about how staff care for people who used the service.
There had been no complaints since our last inspection. The manager ensured the complaints process had been reviewed to ensure it was accessible and understood by people who used the service.
The manager demonstrated a keen desire to continue improving the service. Staff we spoke with and people who used the service confirmed they had taken a proactive, ‘hands-on’ approach to making improvements. All confirmed they had involved staff and people in planning and making improvements.
The culture was one focussed on caring for people in a dignified way, in a homely environment. The impact the manager had been able to make had been limited by the lack of resources at their disposal, most significantly staffing levels. The manager had done well to make a range of improvements but needed more supernumerary time to make further improvements, rather than having to provide cover for when there was only one care assistant on duty.
We have identified one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.
Risedale Rest Home provides residential care for up to 17 people. Most of the people who are cared for at the home are older people, and some people who use the service have mental health needs. At the time of our visit there were 11 people living at the home.
The home had a registered manager who had been unexpectedly absent from the home since April 2017. 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.
During this inspection we found the provider had breached the regulations relating to safe care and treatment; person-centred care; staffing and good governance. In particular, we found the provider had not been effective in assessing risks to people’s wellbeing and safety. The provider had also not ensured risks posed to people and others were managed appropriately.
Due to the registered manager's absence from their post there was a lack of leadership and management in the home. The interim management arrangements were unclear and many aspects of the home had lapsed. This included essential training, supervision, appraisals, meetings for people and staff and some quality assurance checks. Staff were also unable to locate important information we required to provide assurances the building was safe, such as electrical and gas safety checks and an up to date fire risk assessment.
The provider was unable to evidence there were sufficient staff on duty to meet people’s needs in a timely manner. Staff told us staffing levels were insufficient and people gave mixed views about there being enough staff.
Care plans were not personalised and lacked sufficient detail to accurately describe the care and support people required. Two people who moved to the home in March 2017 did not have care plans in place when we inspected.
People were not always supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible; the policies and systems in the service do not support this practice. We have made a recommendation about this.
People and relatives said the care provided at the home was good. People said staff were caring and treated them respectfully. They also said they felt safe living at the home.
Records confirmed medicines were administered by trained and competent staff. People and relatives told us they received their medicines in a timely manner.
Staff had a good understanding of safeguarding including how to report concerns. Previous safeguarding alerts had been referred to the local authority safeguarding team and investigated in line with expectations.
Incidents and accidents were logged, investigated and analysed to ensure appropriate action was taken to keep people safe.
People were supported to have enough to eat and drink in line with people’s needs. Relatives told us staff supported people to access health care when required and they were kept informed.
People had opportunities to take part in activities in the home, such as bingo, cards, dominoes, quizzes, exercise sessions, sing-alongs and a Sunday church service.
People did not raise any complaints with us but knew how to do so if needed. The provider had not received any complaints about the home.
The provider was in the process of looking to employ an interim manager for the home. Shortly after our visit they confirmed they had employed an experienced manager to oversee the home during the registered manager’s absence.
Relatives said the home had a welcoming and friendly atmosphere.
The provider received positive feedback from people, staff and health professionals during the most recent consultation in August 2016.
This inspection took place on 6 and 7 May 2015 and was unannounced We last inspected the service in April 2013, and at that visit found the service was meeting all of the regulations we inspected.
Risedale Rest Home is a care home in Whitley Bay. It accommodates up to 17 people. Most of the people who are cared for at the home are older people, and some people who use the service have mental health needs. At the time of our visit there were eight people living at the home.
At the time of our inspection there was not a registered manager in place. 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. A new manager had been employed at the service in December 2014. The new manager had applied with CQC to become registered. At the time of our inspection their application was being processed. In the weeks following our inspection this application to become registered manager was successful.
There were systems in place to guide staff on the appropriate action to take if they had any concerns over people’s safety or wellbeing. We saw staff had been trained in identifying and responding to potential abuse. The manager had assessed their knowledge of the safeguarding process to ensure staff were competent at following the correct processes.
There were enough staff to meet people’s needs. During our inspection we saw there was a good staff presence in the communal areas of the home. Staff did not appear to be rushed. We saw staff were able to support people with their needs and any requests, as well as spending time engaging with people in activities and conversation. Recruitment procedures had been followed to ensure staff were of good character and appropriately skilled for their role.
People’s medicines were managed safely and appropriately. There were systems in place to administer, store and dispose of medicines properly.
We reviewed the staff training matrix for all of the staff who worked in the home. Training had been planned for the next year so staff’s skills remained up to date. Staff had received refresher training in all health and safety related training within the last year. Training had been planned around the needs of people who used the service, with staff receiving training in mental health conditions. Staff received regular supervision and appraisals with the manager to discuss their role and performance.
The manager was aware of their responsibilities under the Mental Health Act 2005 (MCA) and was able to describe to us situations where they had put this into practice. Deprivation of Liberty Safeguards (DoLS) were lawfully applied. DoLS authorisation had been granted for one person who used the service, and the application was pending for another. Staff were aware of who had DoLS authorisation in place and could tell us about the safeguards in place to ensure these people were safe.
People were positive about the food on offer at the home. We saw people were given a choice of meals which were displayed using a pictorial menu. We spoke with the chef who was knowledgeable about people’s nutritional needs.
People and their relatives told us staff were very kind. We observed lots of good practice during our visit. Staff spent a lot of time speaking with people and sharing jokes. The atmosphere in the home seemed warm and light-hearted. Staff and people who used the service knew each other well and seemed to enjoy each other’s company.
Care records showed that people had been included in planning their care. Their preferences had been documented throughout their records. People were encouraged to maintain their independent skills. For example, some people visited the local shops by themselves and one person managed their own medicines.
People’s care plans were personal and specific. Their needs had been determined through a range of assessments. Care plans were in place to describe to staff how best to support people with their needs. People’s needs and care plans were reviewed on a regular basis. Staff were knowledgeable about people’s needs and how to support people.
A complaints procedure was in place. The manager told us no complaints had been received in the previous 12 months. Relatives we spoke with were aware of how to make a complaint, but told us they had never had any issues with the service. People and their relatives were invited to regular meetings to discuss the service and any improvements they would like to make.
People, their relatives and staff spoke highly of the manager of the service. They told us the manager was approachable and ran the service well. The provider of the service was also very involved in the home. She visited regularly and fed back her observations on the quality of the home both informally and through quality monitoring assessments.
A range of checks and audits were carried out regularly to monitor the quality of the service. These included reviewing accidents and incidents that occurred within the home and responding to any preventative measures that needed to be put into place. Action plans had been created to address any improvements which were required and these were monitored and updated when improvements had been made.
There were policies and procedures in place to ensure the home was clean and hygienic.
There were systems in place to help ensure appropriate staff were recruited to care for the people who used the service.
There was an effective procedure in place for dealing with complaints. People were given support to make a comment or complaint where they needed assistance. People said they knew how to make a complaint if they needed to. Comments included, "I have nothing to complain about", "I know I can make a complaint but I think everything is okay" and "I would complain if I needed to but there is no need".