CQC report explained · a residential care home
What the CQC found at Rathmore Care Home
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- Staffing was not based systematically on people's needs. Inspectors also found weaknesses in fire safety, practical training, risk management and some medicines checks.
- Effective?
- Good
- This key question was not assessed during this focused inspection. Its previous rating was carried forward when calculating the overall rating.
- Caring?
- Good
- This key question was not assessed during this focused inspection. Its previous rating was carried forward when calculating the overall rating.
- Responsive?
- Good
- This key question was not assessed during this focused inspection. Its previous rating was carried forward when calculating the overall rating.
- Well-led?
- Requires improvement
- The home's monitoring systems had not identified or addressed important shortfalls. There were no formal systems for feedback, and staff had not received supervision, appraisals or staff meetings.
What inspectors found, August 2023
Rathmore Care Home is rated Requires Improvement; inspectors found staffing, risk management and oversight problems, with four regulations breached.
This was an unannounced focused inspection on 19 and 25 May 2023. Inspectors spoke with people living at the home, a relative, a visitor and staff. They observed care, checked medicines, examined care records and reviewed training, safety and management records.
The home was not always safe. Staffing was not planned around people's needs, there was only one staff member overnight, and staff lacked practical training in areas such as moving and handling, basic life support and fire evacuation. Fire risks and an unsecured door were also not properly managed.
The home was not well-led. Its checks had not identified or fixed problems with staffing, training and risk management. People were not formally asked for their views, and some care was not person-centred, including limited bathing choices and one person spending the evening and night in bed.
The overall rating changed from Good at the previous inspection to Requires Improvement. The provider must send an action plan, and the CQC will work with the provider and local authority to monitor progress.
Safe recruitment
Inspectors found that staff continued to be recruited safely.
“Staff continued to be recruited safely.” from the report
Clean and maintained
The home was clean and maintained. Inspectors were also assured about infection prevention and control arrangements.
“The provider did not take a systematic approach to assessing staffing levels. Governance systems had not been operated effectively. Staff had not received practical training and the management of risk was not always safe. Staff were recruited safely and the home was clean and maintained.” from the report
Kind approach
Inspectors observed staff being caring and kind. People and relatives also gave positive comments about feeling safe and looked after.
“We observed staff were caring and kind in their approach with people.” from the report
Partnership working
The home worked with healthcare professionals and other agencies when concerns were raised.
“The service worked in partnership with a range of healthcare professionals.” from the report
Insufficient staffing
seriousStaffing was not adjusted when people's needs increased. Staff were also cooking and cleaning, and one person had to remain in bed from the evening until morning because two staff were needed to support them.
“There was only one staff member overnight, which left people at risk and impacted the care people received.” from the report
Fire and practical training
seriousStaff had not taken part in fire drills or practical training for evacuation, moving and handling or basic life support. Fire safety arrangements had not been thoroughly assessed and tested.
“Staff told us they had never been involved any fire drills or practical training on evacuation.” from the report
Unmanaged safety risk
seriousA door to the adjoining property was not secured and could have allowed someone into or out of the home. The alarm could also be deactivated.
“However, as it is not secured this could provide an access point for anyone from the building next door, or an exit for someone living at the home.” from the report
Limited personal choice
seriousSome care did not reflect people's preferences. One person remained in bed during the evening and night, bathing was limited to once a week, and people were not asked about menus or meaningful activities.
“There were aspects of the service that were not person-centred.” from the report
Weak oversight and feedback
seriousThe home's audits did not identify important problems. There were no formal meetings or feedback systems for people, relatives or staff.
“The provider's systems had not identified and addressed the shortfalls highlighted during our inspection in relation to staffing, staff training and management of risk.” from the report
Medicines checks
needs fixingOnly one medicines administrator had had their competence checked. Some medicines were recorded as given at the wrong time, although the manager said this was a recording error.
“However, the registered manager had only checked the competence of one member of staff, to make sure they administered medicines safely.” from the report
- 01How many staff are on duty during the day and overnight, and how do you change staffing when a resident's needs increase?
- 02What practical training have staff now completed in moving and handling, basic life support, fire safety and evacuation?
- 03What has been done to secure the door to the adjoining property and test the home's evacuation arrangements?
- 04How do you make sure residents can choose when to bathe, spend time out of bed, take part in activities and influence the menu?
- 05What formal meetings, supervision and feedback systems are now in place for residents, relatives and staff?
This was a focused inspection of Safe and Well-led only; the other key question ratings were carried forward from the previous inspection when calculating the overall rating. This explanation was written from the published report of 25 August 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, April 2021
Inspected but not rated; inspectors found strong infection prevention and control arrangements during a targeted COVID-19 inspection.
The inspection took place on 16 March 2021 and was announced. It was a targeted inspection of infection prevention and control measures during the coronavirus pandemic.
Inspectors found plentiful personal protective equipment, trained staff and suitable cleaning, ventilation and social distancing arrangements. They were assured that admissions, visitor arrangements, testing and infection outbreak plans were in place.
The home was inspected but not rated. This means the inspection did not give an overall quality rating or a rated judgement on the five main areas of care.
Infection control supplies
The home had enough PPE and monitored its supplies carefully. Staff had been trained in infection control.
“There were plentiful supplies of PPE and stocks were carefully monitored.” from the report
Safe admissions and testing
New admissions followed COVID-19 guidance, including a negative test and up to 14 days of self-isolation. Regular testing was in place for people living in the home and staff.
“People were only admitted following a negative COVID-19 test result and supported to self-isolate for up to 14 days following admission” from the report
Clean and suitable environment
Inspectors found the premises clean and hygienic, with enhanced cleaning, good ventilation and communal areas suitable for social distancing.
“The premises had a good level of cleanliness and was hygienic throughout.” from the report
Support for contact with relatives
The home had arrangements for people who wanted a designated visitor, while the layout supported social distancing.
“People were supported to stay in contact with their relatives and friends.” from the report
Inspectors raised no specific concerns in this report.
- 01How are visitors currently supported, including designated visitors?
- 02How often are people living in the home and staff tested now?
- 03How would you manage a suspected infection outbreak?
- 04How do you check that PPE supplies remain sufficient and that staff use PPE correctly?
- 05What arrangements are in place if there is a staff shortage?
This was a targeted inspection of infection prevention and control during the coronavirus pandemic, and the service was inspected but not rated overall. This explanation was written from the published report of 10 April 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 Rathmore Care Home
4 rated inspections over 8 years: the service has slipped, from Good to Requires improvement.
- August 2023Requires improvementcurrent ratingSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- April 2021Inspected but not ratedSafe: Inspected but not rated
- March 2020Goodstayed GoodSafe: GoodWell-led: Good
- May 2017Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- November 2013
Report published without a new overall rating.
- February 2013
Report published without a new overall rating.
- October 2011
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 17 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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