CQC report explained · a residential care home
What the CQC found at Remyck House
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Inadequate
- Inspectors found improvements in medicines, fire safety, infection control, risk management and safeguarding. They identified gaps in records of some safety checks and were not assured that medicine alerts were acted on promptly.
- Effective?
- Requires improvement
- This question was not assessed during the targeted inspection.
- Caring?
- Good
- This question was not assessed during the targeted inspection.
- Responsive?
- Good
- This question was not assessed during the targeted inspection.
- Well-led?
- Requires improvement
- This question was not assessed during the targeted inspection.
What inspectors found, August 2023
Not rated; a targeted inspection found important improvements, but medicines alerts and safety records still needed attention.
This was an unannounced targeted inspection on 3 and 6 July 2023. Inspectors checked whether earlier warning notices about safety, risk management, infection control and medicines had been met. They spoke with people, relatives, staff and a visiting professional, and reviewed care, medicines and safety records.
Inspectors found that medicines were stored and given safely, infection control had improved, and safeguarding arrangements were stronger. Fire safety work was under way, the home was clean, and people generally appeared relaxed and safe. People and relatives said they felt safe, although some people wanted better meals.
The home was not given a new rating. Its previous overall rating was Requires Improvement, and the previous Safe rating was Inadequate. This targeted inspection did not look at every part of Safe or the other key questions, so the earlier ratings remain in place until a fuller inspection.
Safer medicines
Medicines were securely stored and staff observed giving them correctly. Staff had training and competency checks.
“Enough improvement had been made at this inspection and the provider was no longer in breach of Regulation 12.” from the report
Infection control
The home and equipment were visibly clean. Staff used protective equipment appropriately and supported people to reduce infection risks.
“We were assured that the provider was using personal protective equipment (PPE) effectively and safely.” from the report
Safeguarding improvements
Staff had refreshed their safeguarding knowledge and worked with relevant agencies when concerns arose. People were generally relaxed and said they felt safe.
“People told us they felt safe and knew they could speak to staff if they had any concerns.” from the report
Fire and environmental safety
Fire training, drills and safety checks had been updated. Hazards had been removed or secured, and improvements had been made to lighting, carpets and the garden.
“We observed the home was clutter free and electrical items were not charged in the corridors.” from the report
Medicine safety alerts
needs fixingInspectors were not assured that the home had a reliable process for receiving and acting on medicine alerts quickly. They made a recommendation for the provider to review its policy and processes.
“We were not assured there was a process in place for staff to receive and act on medicine alerts in a timely manner, for people's safety.” from the report
Incomplete safety records
needs fixingThere were gaps in records showing that checks on air mattresses and bedrails had been completed. The home was asked to make sure staff recorded all checks consistently.
“We saw there were some gaps in the records. Further work is required to ensure all staff consistently record all of the checks they have completed.” from the report
Fire work still ongoing
needs fixingSome fire safety work had been completed or planned, but not all work was finished. Inspectors said they would check the remaining work at a later inspection.
“We will follow-up at the next focused inspection to ensure the rest of the planned works have been completed.” from the report
Unlocked laundry room
minorInspectors found the laundry room doors unlocked, even though the room could contain hazards. This was raised with the manager to address.
“Although doors were locked, we saw the laundry room doors were unlocked.” from the report
- 01How do you now make sure medicine safety alerts are received and acted on promptly?
- 02How do you check that air mattress and bedrail safety checks are completed and recorded every day?
- 03Which fire safety works identified in the action plan are still outstanding, and when will they be finished?
- 04What has been done to make sure the laundry room remains locked when people could access it?
- 05What improvements have been made to the quality of meals since inspectors recorded concerns about them?
This was a targeted inspection of specific parts of Safe, following earlier warning notices; it did not assess the whole Safe question or the other four key questions, so previous ratings remain in place. This explanation was written from the published report of 3 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 2023
Rated Requires Improvement; inspectors found people were not always safe, and the safe rating was Inadequate.
This was an unannounced inspection on 6 and 7 March 2023. Inspectors spoke with people, visitors, staff and health professionals. They reviewed care records, medicines records and management records.
Inspectors found serious safety problems. People had experienced physical and verbal abuse from others, staffing was not always sufficient or skilled enough, and medicines, infection control, fire safety and the building were not always managed safely.
Care was effective and management were rated Requires Improvement. Staff worked with health professionals and people received enough food and drink, but staff training, supervision, dietary records, dementia-friendly design and activities needed improvement.
The overall rating fell from Good at the previous inspection, published in March 2019, to Requires Improvement. The provider was told to make changes, and CQC said it would monitor progress with the local authority.
Healthcare support
Staff worked with health professionals to understand and meet people's healthcare needs. People were referred to a range of professionals, including dental and mental health services.
“Staff worked both together and with health care professionals to understand and meet people's healthcare needs.” from the report
Food and drink
People received enough food and drink for their needs. They could choose between two main meals and eat where they wished.
“People received sufficient food and drink for their needs.” from the report
Incident reporting
Staff recorded incidents and reviewed them to identify actions for people's safety. Staff said learning from incidents was shared.
“Staff reported any incidents which were then recorded and reviewed, to identify if further actions were required for the individual.” from the report
Staff relationships
Most staff tried to engage with people and were patient and kind. Staff also said they enjoyed working at the service.
“Although most staff tried to engage with people and were patient and kind.” from the report
Risk of harm from others
seriousPeople had experienced physical and verbal abuse from other people. One person remained at the home while alternative accommodation was arranged, so inspectors found an ongoing risk.
“People had not been kept safe from the risk of harm from other people.” from the report
Unsafe care and surroundings
seriousInspectors found trip hazards, fire safety gaps and risks linked to pressure care. Some equipment and care records were not managed in a way that protected people from avoidable harm.
“The failure to ensure people were provided with safe care and treatment was a breach of Regulation 12(1) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.” from the report
Medicines
seriousMedicines instructions and records were incomplete or inconsistent. Some medicines and thickener were not stored securely, and evidence of staff competence was missing or out of date.
“People did not all have protocols in place for medicines they took 'as required,' to guide and inform staff about their use.” from the report
Staffing and training
seriousThere were not always enough suitably skilled staff. Staff had gaps in training and supervision, and some pre-employment checks had not been completed.
“There were insufficient staff deployed to meet people's needs.” from the report
Infection control
seriousInspectors saw dirty areas, uncovered bathroom bins and an unsafe discarded pad. The home was not consistently clean enough to protect people from infection.
“The failure to protect people from the risk of acquiring an infection was a breach of Regulation 12(1) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.” from the report
Weak management checks
seriousAudits were not reliable or thorough enough to identify and fix risks. Some known problems remained unresolved, and some audits recorded standards as met when the inspection found otherwise.
“The failure to assess, monitor and mitigate potential risks to people or to improve the quality and safety of the service or to operate effective audit systems was a breach of Regulation 17(1) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.” from the report
- 01What has been done to protect residents from the person whose behaviour was assessed as very likely to become angry and intimidating?
- 02How many care staff are now on duty in the afternoons, and how do you ensure there are enough staff to supervise both lounge areas?
- 03How are medicines now checked, including as-required medicines, covert medicines, thickener and insulin administration?
- 04Have the legionella, fire safety, damaged carpet, cleaning and unsafe storage problems all been fixed, and can we see the latest checks?
- 05How are you using falls, safeguarding and medicines audits to identify trends and prevent repeat problems?
This was a focused inspection of Safe, Effective and Well-led, following targeted concerns; Caring and Responsive were not inspected and their previous ratings were used. This explanation was written from the published report of 14 April 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.
Every inspection of Remyck House
3 rated inspections over 6 years: the service has slipped, from Good to Requires improvement.
- August 2023Inspected but not ratedcurrent ratingSafe: Inspected but not rated
- April 2023Requires improvementSafe: InadequateEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- February 2021Inspected but not ratedSafe: Inspected but not rated
- March 2019Goodstayed GoodSafe: GoodEffective: GoodWell-led: Good
- November 2016GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2014
Report published without a new overall rating.
- March 2014
Report published without a new overall rating.
- November 2013
Report published without a new overall rating.
- July 2013
Report published without a new overall rating.
- April 2013
Report published without a new overall rating.
- March 2013
Report published without a new overall rating.
- May 2012
Report published without a new overall rating.
- December 2011
Report published without a new overall rating.
- October 2011
Report published without a new overall rating.
- September 2011
Report published without a new overall rating.
- March 2011
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 15 December 2010.
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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