CQC report explained · a nursing home
What the CQC found at Risby Hall Nursing Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Requires improvement
- Inspectors found missing daily checks and incorrect settings on five specialist pressure-relieving mattresses. They also found that one person's weight and food intake had not been recorded as required, although the manager acted quickly to address both issues.
- Effective?
- Good
- Staff had induction, training, supervision and support. People received suitable help with food, drink and healthcare, and consent and best-interest decisions were recorded.
- Caring?
- Good
- People and relatives said staff were kind, respectful and caring. Inspectors saw staff protecting privacy, encouraging independence and involving people in choices.
- Responsive?
- Good
- Care plans were personalised and activities were available, including music, outings and group events. Communication needs, complaints and end-of-life wishes were recorded and supported.
- Well-led?
- Good
- The new manager and deputy manager provided clear day-to-day leadership, and quality checks were in place. However, there was no CQC-registered manager at the time of the inspection.
What inspectors found, April 2020
Rated Good overall; inspectors found kind, effective care, but safety requires improvement because some pressure-relieving equipment and nutrition checks were not reliable.
This was an unannounced planned inspection on 28 January 2020. Two inspectors spoke with people, relatives, staff and visiting professionals. They observed care and checked care plans, medicines, recruitment, training and management records.
The home had enough staff who had been properly recruited and trained. People were treated with kindness and respect. Care was personalised, activities were available, complaints were handled through a clear process, and healthcare support was arranged when needed.
Safety was not always reliable. Daily checks of specialist pressure-relieving mattresses were missing, and five mattresses had incorrect settings. One person's weight and food intake were not recorded as required. The manager acted quickly when inspectors raised these issues. The home was rated Good overall, with Good ratings in Effective, Caring, Responsive and Well-led, and Requires Improvement for Safe.
Kind and respectful care
People were happy with the care and felt safe and well-treated. Staff supported people as individuals and respected their privacy, dignity and choices.
“People were happy living at Risby Hall Nursing Home and with the care they received.” from the report
Staffing and training
There were enough staff, with recruitment checks completed. New staff received induction, training and support before working alone.
“Newly employed staff members received an induction, training and they were supported through shadowing a more experienced staff member.” from the report
Personalised activities
People had individual and group activities, outings and opportunities for music and community involvement. Care plans reflected people's needs and preferences.
“People had choices of individual and group activities to participate in which also included excursions.” from the report
Good partnership working
The home worked with health and social care professionals, and people's changing healthcare needs were acted on promptly.
“The home had good working relationships with other agencies and health care professionals.” from the report
Pressure-relieving equipment
seriousDaily checks were not in place, and five mattresses had incorrect settings that staff had not noticed. This increased the risk of pressure ulcers, although the manager introduced checks immediately.
“Daily checks of specialist pressure relieving mattresses were not in place.” from the report
Nutrition records
seriousFor one person at very high risk of weight loss, weekly weights and food-intake records were not completed. The manager acted straight away after inspectors raised this.
“There was also no record of the person's food consumption recorded so that staff could monitor their intake.” from the report
No registered manager
needs fixingThe home did not have a manager registered with the CQC during the visit. A new manager was running the service and was applying for registration.
“At the time of inspection, the service did not have a registered manager in place.” from the report
- 01How often are specialist pressure-relieving mattresses now checked, and how are incorrect settings recorded and corrected?
- 02How do you monitor people's weight and food intake when they are at high or very high risk of weight loss?
- 03What is the current progress of the manager's CQC registration application?
- 04How are medicines checked after the minor discrepancy found during the inspection?
- 05What improvements have been made to the areas where inspectors found old tape and marks on the walls?
This was an unannounced planned inspection that assessed all five key questions and compared the results with the previous inspection in 2017. This explanation was written from the published report of 16 April 2020 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, June 2017
Risby Hall Nursing Home was rated Outstanding overall, with kind and personalised care, strong leadership and no current safety breaches identified.
Inspectors visited on 17 January 2017 without notice and returned on 7 February 2017 after asking for more evidence. They observed care, checked four care plans, reviewed medicines and other records, and spoke with people living there, visitors, staff and managers.
The home was rated Good for Safe, Effective and Responsive care. Inspectors found enough staff, safe medicines systems, suitable training, good health support, personalised care plans and a wide range of activities. They also found some minor shortfalls, including limited recorded observations during new staff induction and one staff interaction at mealtimes that was not attentive enough.
Care was rated Outstanding. Inspectors saw warm relationships, respect for dignity, strong family involvement and support for people's personal wishes, including end-of-life wishes. Well-led was also rated Outstanding because the management team involved people and families, monitored the service closely and kept looking for improvements.
The previous inspection in October 2014 rated the home Good overall and identified concerns about medicines. At this inspection, inspectors found that people received medicines as intended and that clearer checking and support systems were in place.
Kind, personal relationships
Staff knew people well and showed warmth, empathy and understanding. Inspectors saw care that improved people's wellbeing and helped them feel valued.
“We saw lots of laughter and tenderness.” from the report
Respect for dignity and choice
Staff asked permission, protected privacy during personal care and supported people to remain independent. Care plans included people's wishes, routines and life histories.
“We observed staff knocking on doors and waiting for people's permissions.” from the report
Strong family involvement
Families were welcomed, consulted about care and invited to meetings and activities. Support continued for families after a person's death.
“Relatives continued to remain involved even after loved ones had passed away.” from the report
Good staffing and medicines arrangements
There were enough staff who understood people's needs, with qualified nurses giving medicines. The home had checking systems for medicines, errors and storage.
“People received their medicines on time and the medicines round was divided up to ensure this happened.” from the report
Active improvement
The management team used feedback and audits to improve activities, dining and the environment. People and families were involved in wider decisions about the home.
“The management team were continuously looking at ways to improve their service and ensure people continued to have fulfilling lives without barriers.” from the report
Induction records
minorNew staff were shadowed and given a thorough induction, but inspectors found no recorded observations of their initial work. The manager agreed to introduce this.
“There were no recorded observations during staffs initial work based induction and this would be helpful in terms of assessing staffs performance in their first review.” from the report
Some staff knowledge
needs fixingInspectors found that some care staff had limited understanding of the Mental Capacity Act. Nurses provided direct support and advice.
“In some instances staffs knowledge was limited for example their understanding of the Mental Capacity Act.” from the report
Uneven mealtime attention
minorMost mealtime interactions were positive, but one staff member did not engage sufficiently with the person they were supporting. This was raised with the manager.
“Another staff member did not sufficiently engage with the person they were supporting.” from the report
Social engagement for one person
minorOne relative was unclear how staff socially engaged a person whose condition meant many activities were no longer suitable. The relative wanted more time for the person to be taken out.
“They wanted more time so they could be taken out as they said family were expected to do this.” from the report
- 01How do you record and assess new staff during their initial work-based induction?
- 02How do you make sure all care staff understand the Mental Capacity Act and best-interest decisions?
- 03How would you support my relative socially if they could no longer take part in group activities?
- 04How do you monitor staff interactions during mealtimes and respond if care is not attentive enough?
- 05What arrangements are in place for management cover when senior managers are absent or on leave?
This was an inspection of all five quality areas, with an unannounced visit followed by an announced return visit to review additional evidence. This explanation was written from the published report of 28 June 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. The report was longer than we could read in one go; the later sections may not be reflected.
Every inspection of Risby Hall Nursing Home
3 rated inspections over 5 years: the service has held its Good rating throughout.
- April 2020Goodcurrent ratingdown from OutstandingSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- June 2017Outstandingup from GoodSafe: GoodEffective: GoodCaring: OutstandingResponsive: GoodWell-led: Outstanding
- March 2015GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- September 2013
Report published without a new overall rating.
- March 2013
Report published without a new overall rating.
- July 2012
Report published without a new overall rating.
- February 2011
Registered with the Care Quality Commission on 9 February 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.
Weigh the report against the rest
Fees, photos and reviews from families
How to read CQC ratings and reports
What to check when you visit
23 live-in carers within about an hour of Suffolk
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £1,020 to £1,260 a week. 17 can care for a couple. 7 years' experience on average.
“Not only was she professional, polite and efficient but she bought a lovely smile and laughter to my parents home.”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.