CQC report explained · a residential care home
What the CQC found at Royal Care Home
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
What inspectors found, November 2023
Rated Requires Improvement; inspectors found kind care, but safety records, cleanliness, legal safeguards and quality checks were not reliable.
This was an unannounced focused inspection. Inspectors visited on 14 and 22 June 2023, spoke with people, a relative and staff, observed care, checked medicines and reviewed care, recruitment and management records.
The home was rated Requires Improvement overall. Safe and well-led were Requires Improvement, while caring was Good. Inspectors found inconsistent risk assessments and care records, poor cleanliness and maintenance, gaps in staff training, and weaknesses in how legal safeguards and quality checks were used.
People generally said they felt safe and were treated kindly and respectfully. However, the rating had remained Requires Improvement since the previous inspection, and the home was still in breach of regulations. The CQC said it would request an action plan and monitor progress.
Kind and respectful care
People described staff as kind. Inspectors observed respectful and dignified interactions, and staff knew people's preferences.
“People were treated with respect, compassion and kindness, they were given emotional support when needed.” from the report
Medicines managed safely
Inspectors found trained staff, suitable checks, accurate medicine records and safe arrangements for medicines given covertly or when needed.
“The registered manager and staff followed safe processes to ensure people's medicines were managed safely.” from the report
Positive staff culture
Staff were described as happy in their roles. People and staff said the manager was approachable and that staff meetings took place regularly.
“There was a positive staff culture at the service and staff were happy in their roles.” from the report
Inaccurate risk and care records
seriousRecords did not always guide staff safely. Inspectors found conflicting information about mobility, falls and fire evacuation, and equipment had been used without a risk assessment or safety instructions.
“Risks to people's health, safety and wellbeing had not been consistently assessed and managed.” from the report
Cleanliness and maintenance
seriousSeveral areas were unclean, including communal bathroom equipment and walking aids. Some paintwork was chipped and flooring was poorly fitted, making effective cleaning harder.
“We found concerns with regards to preventing and controlling infection. This placed people at risk of harm.” from the report
Mental capacity and CCTV safeguards
seriousThe home did not always follow best-interest processes. CCTV had been used without people being informed or their wishes being considered, and some restrictions were not covered by legal authorisations.
“The provider had not followed best interest principles with regards to the use of CCTV as a means of supervision.” from the report
Weak quality checks and training
seriousAudits had not found or resolved the problems identified by inspectors. Staff had not received training about learning disabilities and autism in line with current guidance.
“We found there was not a structured, systematic, effective approach to assess and monitor the service to identify shortfalls and drive improvements.” from the report
People not always involved in care plans
needs fixingPeople and families said they had not always seen or helped develop care plans. The CQC recommended that the provider improve how it involves people in care planning and reviews.
“People were not always consulted about their care plans.” from the report
- 01What has been changed to make mobility, falls and fire evacuation records accurate and consistent?
- 02How are cleanliness, equipment storage, flooring and cleaning checks now being monitored?
- 03How are Mental Capacity Act decisions, restrictions and CCTV use being recorded and reviewed?
- 04What training have staff completed on the equipment used in the home and on learning disabilities and autism?
- 05What actions are in the provider's improvement plan, and how will you show that audits are finding and fixing problems?
This was a focused inspection of Safe, Caring and Well-led only; the other key questions were not inspected and their previous ratings were used in calculating the overall rating. This explanation was written from the published report of 8 November 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, February 2022
Inspected but not rated; inspectors were assured that infection control, PPE, testing and visiting arrangements were being managed safely.
This was a targeted inspection on 27 January 2022. It focused on infection prevention and control during the COVID-19 pandemic, visiting arrangements and staffing pressures. The inspection was announced 24 hours in advance.
Inspectors found the home was clean and hygienic. They were assured that visitors, new admissions and people living in the home were protected from infection. Staff used PPE safely, testing was available and there were enough PPE supplies.
The home had dedicated staff to support safe admissions and help people keep in touch with relatives. It also had cleaning schedules, extra cleaning procedures and systems to support contact using phones and computers.
The home was inspected but not rated. This means the visit did not give an overall quality rating or a full set of ratings for the five inspection areas.
Infection control
The home had cleaning schedules, extra sanitising procedures and PPE stations. Inspectors found the home clean and hygienic.
“The home was clean and hygienic. Cleaning schedules were in place and PPE stations placed around the home.” from the report
PPE supplies and use
Staff were observed using PPE safely, and the home had enough supplies available.
“During our visit we observed the staff using Personal Protective Equipment, (PPE) safely.” from the report
Keeping families in touch
The home used phones and computer systems to help people stay in contact with relatives during the pandemic.
“Social media systems such as mobile phones and computer systems were used to facilitate contact between people and their relatives.” from the report
COVID-19 testing and vaccination
The home took part in regular COVID-19 testing for staff and residents. No staff were employed who had not been vaccinated as required at the time.
“The service participated in the regular COVID-19 testing programme for both staff and who lived at The Royal.” from the report
Inspectors raised no specific concerns in this report.
- 01How are COVID-19-related staffing pressures affecting staffing levels and people's care now?
- 02How do you currently manage visits and prevent infections from spreading?
- 03How often are staff and residents tested, and what happens if someone tests positive?
- 04How often are shared areas cleaned and how do you check that cleaning is completed?
- 05When was the service last given a full inspection and ratings for all five areas?
This was a targeted inspection of infection prevention and control, visiting arrangements and COVID-19-related staffing pressures; the service was inspected but not rated and the other areas were not assessed. This explanation was written from the published report of 10 February 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 Royal Care Home
4 rated inspections over 7 years: the service has slipped, from Good to Requires improvement.
- November 2023Requires improvementcurrent ratingSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- February 2022Inspected but not ratedSafe: Inspected but not rated
- April 2021Requires improvementSafe: Requires improvementWell-led: Requires improvement
- December 2020Inspected but not ratedSafe: Inspected but not rated
- August 2019Goodstayed GoodSafe: GoodCaring: GoodWell-led: Good
- January 2017GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2015
Registered with the Care Quality Commission on 18 December 2015.
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
85 live-in carers within about an hour of Lancashire
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 £980 to £1,260 a week. 78 can care for a couple. 11 years' experience on average.
“She understands the needs of an elderly person in the early stages of dementia and has treated my mother with great kindness and skill.”
“Thanks to Tracy, Dad was always immaculately dressed and clean, his meals were all home cooked and nutritionally well balanced and his home was always kept really clean and tidy.”
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.