CQC report explained · a residential care home
What the CQC found at Riccall House Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found safe systems for managing risks, medicines, safeguarding, staffing and infection control. They said the home was no longer in breach of regulations relating to these areas.
- Effective?
- Good
- This question was not inspected during this focused visit. Its previous rating was carried forward into the overall rating.
- Caring?
- Good
- This question was not inspected during this focused visit. People and relatives nevertheless told inspectors they were happy with the care and described staff as caring.
- Responsive?
- Good
- This question was not inspected during this focused visit. Inspectors did note that feedback from people and relatives was sought and acted on.
- Well-led?
- Good
- Inspectors found positive and open leadership, effective audits and prompt action on feedback. The home was no longer in breach of the governance regulation.
What inspectors found, November 2022
Rated Good; inspectors found safe, caring support and clear improvements since the previous inspection, with some further environmental work still planned.
Inspectors visited on 4 and 7 October 2022. The first visit was unannounced and the second was announced. One inspector spoke with people, relatives and staff, and reviewed care, medicines, recruitment, training and management records.
The home was rated Good overall. Safe and Well-led were both rated Good. Inspectors found that medicines, staffing, safeguarding, infection control and risk management had improved. People and relatives said they felt safe and were happy with the care.
This was a focused inspection of Safe and Well-led. The other three question ratings were not inspected during this visit and carried over from the previous inspection. The previous overall rating was Requires Improvement, but inspectors found the home was no longer in breach of regulations.
Safe, homely environment
Inspectors found the environment clean, homely and safe, with systems to monitor health and safety.
“People's environment was homely, clean and safe because systems were in place to monitor and manage all aspects of health and safety.” from the report
Medicines managed safely
Medicines were given as prescribed by trained staff. Staff understood people's preferences and had guidance for medicines prescribed when needed.
“People received their medicines as prescribed in line with their preferences by trained and competent staff.” from the report
Open management
The manager had introduced audits and acted on feedback. Staff, people and relatives were encouraged to suggest improvements.
“The culture of the service was positive, open and person-centred.” from the report
People's views used
The home used meetings and written feedback to make changes, including developing a new menu after people asked for more adventurous food.
“Feedback was sought from people, relatives and staff to improve the service.” from the report
Further environmental work
minorThe provider and manager had identified limitations in the environment and were working on further improvements. The report does not describe these limitations in detail.
“The provider and registered manager were working together to make further improvements to the environment of the service as they identified the current limitations they faced.” from the report
- 01What environmental limitations did inspectors identify, and what improvements have been completed since the inspection?
- 02What were the previous ratings for Effective, Caring and Responsive, which were carried forward rather than inspected this time?
- 03How do you check that medicines prescribed to be given when needed are offered at the right time and recorded correctly?
- 04How do people and relatives give feedback, and can you show examples of changes made from that feedback?
- 05How do you assess staffing levels against each person's changing needs?
This was a focused inspection of Safe and Well-led only; the other ratings were carried over from the previous inspection. This explanation was written from the published report of 5 November 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.
What inspectors found, February 2021
Rated Requires Improvement; inspectors found serious shortfalls in medicines, infection control, staffing and checks on safety.
This was a focused inspection on 25 November and 15 December 2020. It followed concerns about infection prevention and control. Inspectors widened the visit to include Safe and Well-led. They spoke with people, relatives and staff, and checked care records, medicines records, staff files and management documents.
The home was not always safe. Medicines were not managed properly, some staff lacked medicines training, risks and accidents were not consistently reviewed, and infection control arrangements did not reflect current guidance. There were also gaps in staffing competence and environmental safety checks.
The home was not well-led because its systems for checking quality and safety were not effective. Staff and relatives described kind care and positive relationships, but staff did not always feel listened to and relatives wanted more proactive updates. The provider took some immediate action and was asked to submit an action plan.
Kind staff
People and relatives gave positive feedback about the care. People said staff were caring and looked after them well.
“The staff are caring. You get well looked after in every way.” from the report
Positive relationships
People said they felt safe and could approach staff. Inspectors found staff were familiar with people's care and support needs.
“I feel safe, the comfort and the care you get makes you feel safe” from the report
Working with health professionals
The home made referrals when people became unwell and worked with other services to provide specialist support.
“The service worked well with other partnership agencies such as district nurses, GP services and the mental health team to ensure people receive specialist care when needed.” from the report
Action after feedback
The provider took action on some immediate risks and continued to send evidence of further improvements after the visits.
“Throughout the inspection the provider and registered manager demonstrated a positive approach to improving the service and acted quickly to feedback provided.” from the report
Medicines were not managed safely
seriousSome staff giving medicines had not received suitable training or competency checks. Guidance for some medicines was missing, and storage and records needed improvement.
“Some staff administering medication had not been provided with appropriate medicines training” from the report
Risks were not properly controlled
seriousEnvironmental and personal risks were not always identified, reviewed or acted on quickly. Window restrictors were missing until inspectors raised the issue, and fire risks had remained outstanding.
“There were no window restrictors in place. This put people at risk of falling from a height likely to cause harm.” from the report
Infection control needed urgent improvement
seriousPolicies were out of date, cleaning schedules and infection control audits were missing, and some staff did not fully understand their responsibilities.
“People were not protected from the risk of infection. We could not be assured that the provider had taken steps to mitigate the risks to people's safety and welfare as a result of an infectious outbreak.” from the report
Training and staffing gaps
seriousSome staff had not completed essential or refreshed training. The home did not always use dependency information to make sure the right number and mix of skilled staff were available.
“The service did not always provide enough staff that have the right mix of skills and competence to support people safely.” from the report
Weak monitoring and communication
seriousSystems did not reliably monitor accidents, incidents, quality or safety. Staff did not always feel listened to, and relatives wanted more proactive updates.
“Systems were not in place to record and monitor accidents and incidents. Trends and themes could not be identified to learn lessons when things went wrong.” from the report
- 01What action has been completed to make medicines storage, records and as-needed medicines guidance safe?
- 02Which staff are now trained and competency-checked to administer medicines, including night staff?
- 03How are risks, accidents, incidents and fire safety actions now recorded, reviewed and followed up?
- 04What up-to-date infection control guidance, cleaning schedules, waste arrangements and audits are now in place?
- 05How will the home make sure staff feedback and relatives' requests for more regular updates are acted on?
This was a focused inspection of Safe and Well-led, prompted by infection prevention and control concerns; the other key question ratings were carried over from the previous comprehensive inspection. This explanation was written from the published report of 27 February 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 Riccall House Care Home
5 rated inspections over 8 years: the service has held its Good rating throughout.
- November 2022Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- February 2021Requires improvementdown from GoodSafe: Requires improvementWell-led: Requires improvement
- November 2019Goodstayed GoodSafe: GoodWell-led: Good
- April 2017Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2013
Report published without a new overall rating.
- December 2012
Report published without a new overall rating.
- November 2011
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 6 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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