CQC report explained · a nursing home
What the CQC found at Rider House Care Centre
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from abuse and avoidable harm. Risks, fire safety, recruitment, medicines, infection control and accidents were monitored.
- Effective?
- Good
- People's needs were assessed and reviewed, staff received relevant training, and people were supported with food, drinks and healthcare. Some care plans did not contain enough detailed, person-centred information.
- Caring?
- Good
- People were treated with kindness, dignity and respect. They were involved in decisions about their care and supported to maintain their independence.
- Responsive?
- Requires improvement
- Basic care needs were met, but staff had limited time to talk with people and there was no continuous plan offering a meaningful range of activities. The call bell sometimes sounded for extended periods before being answered.
- Well-led?
- Good
- The new manager had a clear vision, had strengthened audits and had created action plans. Engagement with people, relatives and staff had increased.
What inspectors found, April 2019
Rated Good overall; inspectors found safe, kind care, but the home was not always responsive to people's activities and personal engagement.
Inspectors carried out an unannounced inspection on 6 March 2019. They spoke with people living in the home, relatives, staff and a visiting health professional. They also reviewed care plans, medicines, staff files, complaints, staffing records and other checks.
The home was rated Good for being safe, effective, caring and well-led. People were protected from harm, received medicines from trained nurses, had access to healthcare and food, and were treated with kindness and dignity.
The home was rated Requires Improvement for being responsive. Inspectors found that staff were often focused on tasks and had limited time for conversation and activities. The manager had identified these issues and had plans to improve them. The overall rating had improved from Requires Improvement at the previous inspection.
Safe medicines
People received medicines on time from trained nurses. Medicine storage was clean and well organised, with clear guidance for medicines given when needed.
“People received their medicine on time by staff trained to administer it.” from the report
Kind and respectful care
People were treated with kindness and their privacy was respected. Staff involved people in decisions and explained what they were doing.
“People were treated with kindness and involved in decisions about their care.” from the report
Food and healthcare
People were offered drinks and balanced meals, including support with eating and swallowing difficulties. Staff worked with doctors and other health professionals.
“People were supported to maintain a balanced diet and offered drinks throughout the day.” from the report
Improving leadership
The new manager had identified areas needing improvement and was using audits and action plans to address them. The previous concerns about leadership had been improved.
“At this inspection we found that the new manager had already identified the areas for future improvement and actions were already underway to progress those improvements.” from the report
Limited time for conversation
needs fixingStaff were often focused on completing tasks and did not always have enough time to talk or engage with people. One relative also reported that a person was sometimes not helped up until after 10am.
“Staff appeared to be task focussed and had limited time to spend chatting and engaging with people.” from the report
Activities were not consistent
needs fixingActivities took place, but inspectors did not see a continuous plan offering a range of meaningful activities. Some people spent time in a lounge with nothing else available.
“We did not see a continuous plan in place that offered people a range of things to do that were meaningful to them.” from the report
Call bell response
needs fixingCall bells sometimes escalated because they were not answered within a set time. The provider was reviewing staffing needs and whether the alarm system was effective.
“At times the alarm bell sounds escalated as they were not answered in a set time frame.” from the report
Care plan detail
minorSome care plans did not give enough detailed, person-centred information. The manager had started reviewing the paperwork.
“Some care plans lacked detailed person-centred information.” from the report
- 01What staffing changes have been made to give staff more time to talk with and engage people?
- 02How quickly are call bells answered now, and how is this monitored?
- 03What regular activities are currently offered, and how are they matched to each person's interests?
- 04How have care plans been updated to include more detailed, person-centred information?
- 05Have advance decision care plans for end-of-life care now been developed with people?
This was a planned, unannounced inspection covering all five key questions and the overall quality and safety of the service. This explanation was written from the published report of 30 April 2019 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, November 2017
Rated Requires Improvement; inspectors found kind and mostly safe care, but improvements were needed in decision-making, food choices and quality checks.
Inspectors visited the home without warning on 28 September 2017. They spoke with people, relatives and staff, observed care, checked seven care records and reviewed management records. This was the first inspection under the new provider.
People were generally kept safe. Staff understood safeguarding, medicines were managed safely, risks were assessed and there were enough staff to meet needs at the time of the visit. However, some people sometimes had to wait for help when two staff were needed.
Inspectors found kind and respectful care. People were involved in their care, received healthcare support, joined activities and could receive visitors freely. Complaints were investigated and relatives were involved in care reviews.
The overall rating was Requires Improvement. The Effective and Well-led areas were also Requires Improvement because mental capacity checks, culturally preferred meals and quality monitoring were not consistently good enough.
Safeguarding and risk management
Staff knew how to recognise and report abuse. Risks were assessed and care plans were followed.
“Risks to people's health and wellbeing were assessed and plans to manage them were followed.” from the report
Kind and respectful care
Inspectors saw caring relationships and staff who knew people well. Privacy and dignity were respected.
“Staff developed caring, respectful relationships with the people they supported.” from the report
Activities and personal interests
People were encouraged to continue hobbies and interests. Support was also offered to people who did not want to join group activities.
“People were encouraged to pursue interests and hobbies.” from the report
Healthcare support
Healthcare appointments were arranged when needed, and care plans were updated after professional advice.
“This meant that people were supported to maintain good health and to access healthcare services.” from the report
Mental capacity decisions
needs fixingCapacity assessments were not always recorded when decisions were made in people's best interests. This included decisions about medicines and cameras in the home.
“However, capacity assessments were not always in place where decisions had been made in people's best interest.” from the report
Choice of meals
needs fixingPeople were not always offered meals they chose, including food that was culturally important to them. Some people were also unaware that there was a second meal option.
“People were not always provided with their choice of meals.” from the report
Quality checks
needs fixingAudits and monitoring did not always identify problems or make sure they were corrected. Some checks were late or were not recorded clearly enough.
“Some of the audits and systems in place to monitor and drive improvements were not effective.” from the report
Medicines records
needs fixingMedicine administration records were not always signed. Although other checks suggested people received their medicines, the records did not reliably show this.
“The medicines administration records (MAR) were not always signed to evidence that people had received their medicines.” from the report
Environmental monitoring
needs fixingThe Legionella test was out of date. Portable electrical equipment was not fully logged, and a dusty fan had an unreadable testing sticker.
“For example, the test for Legionella was out of date and needed to be reviewed.” from the report
Camera policy and privacy information
needs fixingCameras had been installed, but there was no policy explaining their purpose or how recordings would be managed. Visitors were not told through visible signs that they were being recorded.
“They did not have a policy in place to guide them on this or to ensure that they were complying with the Data Protection Act 1998.” from the report
- 01What system is now used to assess capacity and record best-interest decisions, including decisions about medicines and cameras?
- 02How do you make sure residents receive their chosen meals and culturally important food?
- 03How are medicines administration records checked each day, and what happens when a signature is missing?
- 04How do you plan staffing when residents' needs change or when several people need two staff to support them?
- 05Have the Legionella checks, portable equipment records and camera policy now been brought up to date?
This was an unannounced first inspection under the new provider and covered all five CQC questions, including care, records, staffing, safety and management systems. This explanation was written from the published report of 7 November 2017 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 Rider House Care Centre
2 rated inspections over a year: the service has improved, from Requires improvement to Good.
- April 2019Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Good
- November 2017Requires improvementSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- September 2016
Registered with the Care Quality Commission on 16 September 2016.
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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