CQC report explained · a nursing home
What the CQC found at Ribble View
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- The inspection found that choking risks were assessed and managed, and staff understood people's needs. Inspectors recommended more detailed records and better communication.
- Effective?
- Good
- This question was not reviewed in this targeted inspection.
- Caring?
- Good
- This question was not reviewed in this targeted inspection.
- Responsive?
- Good
- This question was not reviewed in this targeted inspection.
- Well-led?
- Good
- This question was not reviewed in this targeted inspection.
What inspectors found, June 2023
Inspected but not rated; inspectors found choking risks were managed, but communication records needed more detail.
This was an unannounced targeted inspection on 15 May 2023. Inspectors looked mainly at how the home assessed and managed choking risks, respected people's freedom and learned from accidents and incidents. They spoke with people and staff and reviewed care and management records.
Inspectors found clear risk management plans for choking. Staff understood people's individual risks and knew how to respond. Actions were taken after accidents and incidents, and learning was shared with staff.
Some handover and other communication records did not contain enough detail. The inspectors recommended clearer records and better communication with the home and external professionals. The home was marked 'Inspected but not rated' because this inspection did not review the whole Safe question or the other four questions.
The inspection followed notification of an incident in which a person died. CQC said the incident was still under further investigation and that this inspection did not examine what happened.
Choking risk management
The home had systems to identify and manage choking risks. Staff understood people's individual risks and responded in a person-centred way.
“The provider had system and processes in place to enable staff to identify and manage the risks of choking.” from the report
Staff knowledge
Staff showed good knowledge of people's clinical needs and how to manage their risks.
“Staff understood the individual risks and needs of people and responded to them in a person-centred way.” from the report
Learning from incidents
The home had systems for learning from accidents and incidents, including sharing learning with staff.
“Lessons were learned when thing went wrong. The provider had systems in place to learn from incidents to improve the safety of the service.” from the report
Respect for choice
Staff supported people's choices and balanced those choices with managing risks. The report said the home was working within the principles of the Mental Capacity Act.
“Staff respected people's choices and balanced them with the management of risk taking.” from the report
Record and communication detail
needs fixingSome records, including shift handovers, needed more detail. Inspectors recommended clearer communication within the home and with external professionals.
“We recommend the provider reviews the detailing in records to ensure absolute clarity and promote more dialogue in communications systems and processes used both in the home and with external professionals.” from the report
- 01What changes have you made to shift handovers and other records since the inspection?
- 02How do you make sure choking risk assessments stay up to date and are followed by every member of staff?
- 03How do you share important risk information with external health and social care professionals?
- 04What learning from recent accidents or incidents has been put into practice?
- 05What is the current position of CQC's further investigation into the incident mentioned in the report?
This was a targeted inspection of choking risk management, safety monitoring, freedom and choice, and learning from incidents; the other ratings were not reviewed and the previous Good rating came from the comprehensive inspection published on 2 September 2022. This explanation was written from the published report of 1 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, September 2022
Rated Good; inspectors found safe, caring support and strong management, with some concerns about medicine storage, staff turnover and communication.
Inspectors visited unannounced on 20 and 21 July 2022. They spoke with three people using the home, six relatives and eight staff. They also reviewed care plans, medicine records, recruitment files, audits and risk assessments.
The home was rated Good overall, with Safe and Well-led also rated Good. People were protected from abuse, there were enough staff to keep people safe, and infection control arrangements were suitable. Staff were described as kind and caring, and people were supported with their interests and hobbies.
Inspectors found one medicine storage concern. An unlocked cupboard contained drink thickener, which could cause harm if swallowed accidentally. The home locked it after inspectors raised the issue, and inspectors recommended reviewing current guidance. Some people also reported high staff turnover and some relatives found it difficult to make telephone contact.
The previous rating was Good, published on 8 August 2021. This inspection found that the Safe and Well-led ratings remained Good.
People felt safe
People were protected from abuse and relatives said people were well cared for. Staff understood safeguarding procedures and knew what to do if they had concerns.
“People were protected from the risk of abuse.” from the report
Kind and caring staff
Inspectors found a positive and caring atmosphere. Staff supported people with their needs, interests and hobbies while respecting their dignity and privacy.
“Staff were friendly and caring and worked with people to help them achieve good outcomes.” from the report
Strong management
The management team carried out regular audits, listened to feedback and used incidents to identify improvements. The home also worked with other agencies.
“The registered manager carried out regular audits and identified areas for improvement.” from the report
Family involvement
The home used newsletters, family liaison officers and meetings to provide updates and gather views from people and their families.
“The service provided newsletters to people and their families, and following feedback they set up two family liaison officers to provide regular updates to family and friends.” from the report
Drink thickener was not locked away
needs fixingAn unlocked cupboard contained drink thickener, which is used for people at risk of choking. Inspectors said accidental swallowing could cause harm. The home locked it after the issue was raised and was recommended to review current guidance.
“There was an unlocked cupboard which stored drink thickener.” from the report
Staff turnover
minorSome people reported a high turnover of staff and some reliance on agency staff. Inspectors still found there were enough staff to keep people safe.
“However, some people told us there was a high turnover of staff, with some reliance on agency staff.” from the report
Telephone contact
minorMost relatives said communication was good, but some found it difficult to contact the home by telephone.
“Some relatives said it was sometimes difficult to get in touch over the telephone.” from the report
Changes were not always shared with staff
minorSome staff were not always aware of changes made after incidents. The registered manager said they would look at improving how information was communicated.
“Some staff were not always aware of changes made.” from the report
- 01How do you make sure drink thickener is locked away at all times?
- 02How many permanent and agency staff are currently working at the home, and how are people affected by staff turnover?
- 03What is the best way for families to contact the home, and how quickly are calls returned?
- 04How do you make sure all staff know about changes following incidents such as falls?
- 05How will you continue to involve families through the family liaison officers, newsletters and meetings?
This inspection focused on Safe and Well-led, including infection prevention and control; the report does not give new ratings for Effective, Caring or Responsive. This explanation was written from the published report of 2 September 2022 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 Ribble View
3 rated inspections over 2 years: the service has improved, from Inadequate to Good.
- June 2023Inspected but not ratedcurrent ratingSafe: Inspected but not rated
- September 2022Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- August 2021Goodup from InadequateSafe: GoodWell-led: Good
- November 2020InadequateSafe: InadequateEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Inadequate
- November 2019
Registered with the Care Quality Commission on 14 November 2019.
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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