CQC report explained · a residential care home
What the CQC found at Rastrick Hall and Grange
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
What inspectors found, June 2023
Rated Good overall; inspectors found caring leadership but medicines and some care records were not always safe.
This was an unannounced inspection, with visits on 10 and 15 May 2023. Inspectors spoke with people living at the home, relatives and staff. They observed care and checked care plans, risk assessments, medicines records, recruitment files and management records.
The overall rating was Good. Safe was rated Requires Improvement because some medicines were not managed safely and care records did not always give staff clear or consistent instructions. The manager acted during the inspection, including changing record-keeping systems and addressing medicine problems.
Well-led was rated Good. Inspectors found positive views about the new manager, systems for checking quality, safer recruitment and efforts to involve people and families. Infection prevention arrangements were also found to be suitable.
The previous overall rating was Requires Improvement, with a breach of regulation. The report says improvements had been made and the home was no longer in breach. Only Safe and Well-led were inspected at this visit, so the other question ratings carried over from the previous inspection.
Positive leadership
People, relatives and staff spoke positively about the new manager. Inspectors found the manager approachable, willing to listen and focused on improving quality.
“Feedback from staff was overwhelmingly positive for the registered manager.” from the report
Resident involvement
A resident was given an ambassador role involving ideas about menus, activities and décor, as well as recruitment and community links.
“This meant they were involved in several aspects of the service including interviewing new staff, liaising with people living at the service to put forward ideas for menu planning, activity planning and décor.” from the report
Safe recruitment
The staff files checked showed that references and DBS checks were obtained before staff started work.
“Staff were recruited safely with references and Disclosure and Barring Service (DBS) checks obtained prior to staff starting work.” from the report
Infection prevention
Inspectors were assured that the home had suitable arrangements for preventing and managing infections, including the use of protective equipment.
“We were assured that the provider was responding effectively to risks and signs of infection.” from the report
Learning from problems
The manager used inspection feedback and events in the home as learning opportunities, and shared the learning with staff.
“The registered manager used feedback during the inspection to learn lessons.” from the report
Medicine safety
seriousMedicines were not always managed safely. An emergency medicine care plan did not meet one person's needs, and some creams were missed or applied incorrectly.
“One person's medicine care plan (containing information about an emergency medicine) did not meet their needs and put the person at risk of harm.” from the report
Care records and risk management
needs fixingSome care plans contained inconsistent information, and staff did not always provide the care recorded in them. This included missing repositioning guidance and a lack of evidence that food intake was monitored.
“Risk assessments and care plans were in place, but we found inconsistencies in the information and staff did not always deliver the care detailed in the care plan.” from the report
Staff availability
minorStaffing levels were considered sufficient, but staff were sometimes busy making notes instead of spending time with people. Some people also said staff could be slow to answer buzzers.
“Although staffing levels were sufficient to meet people's needs, the registered manager introduced some changes, as a result of our feedback, to improve staff availability and increase social time with people.” from the report
- 01What checks now show that emergency medicine care plans are complete and meet each person's needs?
- 02How do you confirm that creams and other medicines are received, recorded and applied correctly every time?
- 03How are repositioning instructions and nutrition monitoring recorded and checked after the changes to the care-record system?
- 04How quickly are call bells answered, and how is staff time spent with residents monitored?
- 05Which ratings were carried forward from the previous inspection, and when will the other key questions be inspected?
This was a focused inspection of Safe and Well-led, including infection prevention; the other question ratings were carried forward from the previous inspection. This explanation was written from the published report of 13 June 2023 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, June 2021
Rated Requires Improvement; inspectors found kind and responsive care, but medicines were not managed safely and leadership still needed to improve.
Inspectors reviewed care, medicines, staff files and management records. They spoke with people, relatives and staff, observed care and checked infection control arrangements. The inspection activity ran from 27 April to 11 May 2021, with a visit to the home on 27 April and other work carried out remotely.
The main safety problem was medicines. Some doses were missed, records had gaps and staff did not always have enough information about medicines. Care records did not always show how risks were being managed. Recruitment checks and the way staff were deployed also needed improvement.
People and relatives described staff as kind and said they felt safe. Inspectors rated the home Good for effective, caring and responsive care. It was rated Requires Improvement overall, with Safe and Well-led also rated Requires Improvement.
Kind and respectful staff
People and relatives spoke highly of the staff. Inspectors saw staff treating people with kindness, respect and care.
“People and relatives praised the staff for their kindness and compassion.” from the report
Good support and training
Staff received induction, training and supervision. People and relatives had confidence in staff's skills.
“Staff received the training and support they required to meet people's needs.” from the report
Family contact and activities
The home helped people stay in touch with family and friends during the pandemic. Activities had increased and included group events and hobbies.
“People were supported to keep in touch with family and friends through video, phone calls and indoor visits.” from the report
Healthcare support
Staff helped people access healthcare and records showed involvement from a range of health and social care professionals.
“Staff supported people to access the healthcare support they needed.” from the report
Clean and maintained environment
The premises were clean, well ventilated and maintained. There was also a planned refurbishment programme.
“The premises were clean, hygienic and well ventilated.” from the report
Medicines were not safe
seriousSome medicines were unavailable, doses were missed and records were incomplete. Staff also lacked some information about medicines and when to give them.
“Medicines were not managed safely which meant people were at risk of not receiving their medicines as prescribed.” from the report
Care records did not always show risk controls
needs fixingSome care plans did not explain how identified risks were being managed. Inspectors found an example involving falls and another involving a soft diet for choking risk.
“Risks were assessed, however the action taken to manage risk was not always fully reflected in people's care records.” from the report
Staff deployment needed review
needs fixingStaffing levels were viewed differently by people and staff. On one floor, there were long periods when no staff were present in communal areas because staff were helping people in their rooms.
“There were long periods of time where there were no staff present in communal areas as they were busy assisting people in their rooms.” from the report
Recruitment checks were late
needs fixingReferences for two staff arrived after they had started work. The provider had identified this and was auditing staff files.
“References for two staff were received after they had started employment.” from the report
Leadership systems were not consistent
needs fixingThe home had experienced a period of inconsistent leadership. The current manager was making improvements, but medicines audits had not found the problems identified by inspectors.
“However, medicines audits needed to improve as issues we identified at the inspection had not been picked up or addressed.” from the report
- 01What changes have been made to ensure every prescribed medicine is available when people need it?
- 02How are medicine administration records now checked for gaps, missing times and missed doses?
- 03How are staff allocated across each floor, including areas supporting people living with dementia?
- 04Have all staff recruitment files now been checked, and are references received before staff start work?
- 05How are care plans checked to ensure they clearly explain how each person's risks are managed?
This was a planned inspection covering all five key questions, including infection prevention and control; the previous targeted inspection on 23 January 2021 was not rated. This explanation was written from the published report of 25 June 2021 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 Rastrick Hall and Grange
6 rated inspections over 7 years: the service has improved, from Requires improvement to Good.
- June 2023Goodcurrent ratingup from Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- June 2021Requires improvementSafe: Requires improvementWell-led: Requires improvement
- April 2021Inspected but not ratedSafe: Inspected but not rated
- August 2019Requires improvementup from InadequateSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- January 2019Inadequatedown from GoodSafe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- June 2017Goodup from Requires improvementSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- March 2016Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: GoodWell-led: Requires improvement
- February 2020
Registered with the Care Quality Commission on 6 February 2020.
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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At least 100 live-in carers within about an hour of Calderdale
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 £1,260 a week. 87 can care for a couple. 12 years' experience on average.
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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.