CQC report explained · a residential care home
What the CQC found at Raby Hall
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, July 2019
Requires Improvement; inspectors found kind, personalised care but risks, decision-making and leadership needed improvement.
This was an unannounced inspection on 15 and 26 April 2019. Inspectors spoke with people living at the home, relatives and staff. They reviewed care records, medicines records, recruitment files and management documents.
The home was rated Requires Improvement overall. Safe, Effective and Well-led were also Requires Improvement. Caring and Responsive were rated Good.
People appeared relaxed and comfortable. Staff were kind and knew people's needs well. Care plans were personalised, medicines were administered safely, and people received timely healthcare when concerns were noticed.
However, risk assessments did not always protect people from preventable harm. The Mental Capacity Act was not always followed when decisions were made for people. Records sometimes used undignified or institutional language, and leadership had not consistently ensured good-quality care.
Kind relationships
People appeared comfortable and staff treated them with kindness and dignity. Staff adapted how they communicated with people who were anxious or could not use words to speak.
“People were supported and treated with dignity and respect; and involved as partners in their care.” from the report
Personalised support
Care plans recorded what mattered to each person, including their preferences, likes and dislikes. Staff showed that they knew people's individual support needs well.
“Each person had an individualised care plan that asked people the question, "What's important to me.” from the report
Timely healthcare
Staff monitored people's health and acted promptly when they noticed concerns, including when people did not express pain or discomfort.
“We saw examples of when staff being observant and vigilant to people's health needs had led to people receiving healthcare in a timely way.” from the report
Safe medicines
Inspectors found that medicines were administered safely, with suitable records, guidance and staff training.
“People's medication was administered safely. There were appropriate records kept and guidance available for staff in each person's medication support plan.” from the report
Risk management
seriousA known pattern of incidents had not led to all reasonable steps being taken to reduce the risk. The person's risk assessment did not reflect the significant risks, and CQC found a breach of Regulation 12.
“the person was not safe from preventable harm.” from the report
Decisions made for people
seriousSome decisions made by staff affected people's ability to live an ordinary lifestyle. Records did not always show that the least restrictive option, other choices and the person's own views had been considered.
“Not following the principles of the MCA when making significant decisions on a person's behalf was a breach of Regulation 11” from the report
Respectful records
needs fixingSome support plans and incident reports used institutional or undignified language. They did not always explore what a person might be feeling, needing or trying to communicate.
“Some people's support plans and incident reports were not consistently written in an everyday, dignified and respectful manner.” from the report
Institutional setting
minorCQC said the home had not been developed in line with best-practice guidance that promotes greater independence, choice and control. Some support and accommodation remained institutionalised.
“Some aspects of people's support and accommodation was institutionalised.” from the report
- 01What specific changes have been made to assess and reduce the risks identified in the report?
- 02How do you now make sure decisions made on someone's behalf follow the Mental Capacity Act and consider less restrictive options?
- 03How are care plans and incident reports checked to ensure they use everyday, dignified and respectful language?
- 04How will people have more choice and control over food shopping and other everyday decisions?
- 05What progress has been made with the action plan requested by CQC, and how is this progress checked?
This was a planned inspection covering all five CQC questions, with CQC reviewing records, the premises and the care provided; end-of-life care was not assessed because nobody was receiving it. This explanation was written from the published report of 9 July 2019 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, October 2016
Rated Good; inspectors found safe, kind and personalised care, while the older building's décor was tired and due for refurbishment.
This was a comprehensive, announced inspection on 6 and 7 July 2016. One inspector toured both the main building and The Courtyard, observed care, spoke with staff and managers, and checked care files, training, recruitment and management records.
The inspectors found good care in all five areas. They found enough staff, safe recruitment, safe medicines systems, suitable care planning, trained staff and appropriate safeguarding arrangements. People appeared safe, comfortable and supported, and relatives were involved in care planning.
The care was described as person-centred. People could choose activities, food and some aspects of their rooms. Information was often provided in easy-read formats, and complaints procedures were available in an easy-read form.
The overall rating of Good means the inspectors found the home was meeting the relevant standards at the time of this inspection. The report also says the older building was due for major refurbishment, and many people had moved to other accommodation or another provider.
Safe medicines
Inspectors found that medicines were locked away, in date and given correctly. Stock matched the medicine records, including as-required medicines.
“The medicines stocks stored in the cabinet and the MAR sheets, tallied.” from the report
Personalised care
Care plans included people's backgrounds, health, emotional needs and interests. Staff knew people's preferences and supported them to make choices.
“The care files that we saw were easily readable, understandable and person centred.” from the report
Kind relationships
Staff were patient, friendly and respectful. People were supported to maintain contact with friends and family.
“We saw that the relationships which people had with friends and family were well maintained.” from the report
Activities and communication
People could take part in activities suited to their interests. Easy-read information and communication tools were used to help people understand and express themselves.
“People were able to take part in activities of their choice.” from the report
Strong records and oversight
The home kept care, staffing, safety and management records up to date. Regular audits identified actions and included completion dates.
“The home had systems in place to assess the quality of the service provided to the people who lived there.” from the report
Older building needed refurbishment
minorThe décor in the older building was described as tired and shabby. A major refurbishment was planned, so families should check what work was completed and what the building is like now.
“Most of the old building's décor was tired and shabby and it was due to be re-decorated during the refurbishment.” from the report
Paper towel bins were missing
minorThere were no bins for used paper towels when inspectors first looked. The manager bought nine bins during the inspection, so this issue was addressed before the visit ended.
“However, there were no bins for the disposal of used paper towels.” from the report
- 01What refurbishment has been completed in the older building, and are any further works planned?
- 02How many people currently live in each part of the home, and is each part still operated as one service?
- 03What staffing levels are provided during the day and overnight for the person we are considering?
- 04How will our relative be involved in creating and reviewing their care plan, including communication in an easy-read format if needed?
- 05What activities are currently available that match our relative's interests and choices?
This was a comprehensive inspection of the whole service, including the main Raby Hall building and The Courtyard, and it assessed all five key questions. This explanation was written from the published report of 18 October 2016 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Raby Hall
2 rated inspections over 3 years: the service has slipped, from Good to Requires improvement.
- July 2019Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- October 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2014
Report published without a new overall rating.
- February 2014
Report published without a new overall rating.
- February 2013
Report published without a new overall rating.
- January 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 24 January 2011.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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40 live-in carers within about an hour of Wirral
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £980 to £1,230 a week. 37 can care for a couple. 8 years' experience on average.
“It was clear that she genuinely cared and her warm approach really helped put our minds at ease.”
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Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.