CQC report explained · a residential care home
What the CQC found at Royley House Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found that medicines were managed safely, people received medicines as prescribed, staffing levels were sufficient and recruitment checks were completed. Safeguarding, risk management and infection control arrangements were also in place.
- Effective?
- Good
- This focused inspection did not assess Effective. The previous rating was used when calculating the overall rating.
- Caring?
- Good
- This focused inspection did not assess Caring. The previous rating was used when calculating the overall rating.
- Responsive?
- Good
- This focused inspection did not assess Responsive. The previous rating was used when calculating the overall rating.
- Well-led?
- Good
- Management had become more stable, and quality checks were being used effectively. Improvements to medicines and care documentation systems had been sustained and embedded in practice.
What inspectors found, December 2021
Rated Good; inspectors found safe care and improved management, although the visit did not reassess all five areas.
This was an unannounced focused inspection on 10 November, 17 November and 2 December 2021. Inspectors checked whether the home had made improvements after its previous inspection. They reviewed care, medicines, staff and management records, spoke with staff and contacted nine relatives.
The home was rated Good for Safe and Well-led. Medicines were managed safely, there were enough trained staff, recruitment checks were completed, and infection control arrangements were in place. The home was clean and well maintained.
Management had become more stable. Improvements to medicines systems, care records and quality checks had been sustained. The overall rating improved from Requires Improvement to Good, and the previous breaches were no longer in place.
This was not a full inspection of all five key questions. The ratings for Caring, Effective and Responsive were carried forward from the previous comprehensive inspection.
Safe medicines
Inspectors found that people received their medicines as prescribed and that staff understood the electronic medicines system. Staff administering medicines had training and competency checks.
“The electronic medicines management system in place was understood by staff and was effective in ensuring all aspects of medicines' management were safe.” from the report
Sufficient staffing
There were enough suitably trained staff to support people in line with their wishes and care plans. Recruitment checks included criminal record checks and references.
“There were enough suitably trained staff to support people in line with their wishes and care plans.” from the report
Improved leadership
The report says management had become more stable and that earlier improvements had been sustained. The home used audits to monitor quality.
“The improvements implemented following our last inspection had been sustained and further embedded in practice.” from the report
Good communication with relatives
Relatives were generally happy with how the home communicated with them and kept them informed. Inspectors also found links with health professionals to support people's health needs.
“Relatives were generally happy with the way the service communicated with them and kept them informed.” from the report
Satisfaction survey was not yet available
minorMost relatives said they had not received a satisfaction survey to give their views about the home. Management said a survey was being prepared and distributed.
“Most commented that they had not received a satisfaction survey to provide feedback or give their views on the home.” from the report
- 01Has the satisfaction survey now been completed, and what changes were made as a result of relatives' feedback?
- 02How do you check that staff remain competent when using the electronic medicines management system?
- 03How are falls monitored and what changes have been made as a result of the falls project?
- 04How will you maintain the improvements to care records, medicines records and quality audits?
- 05What were the ratings for Caring, Effective and Responsive at the previous comprehensive inspection?
This was a focused inspection of Safe and Well-led following earlier concerns; Caring, Effective and Responsive were not reassessed and their previous ratings were carried forward. This explanation was written from the published report of 17 December 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.
What inspectors found, August 2021
Rated Requires Improvement; inspectors found kind and effective care, but medicines management and oversight were still unsafe or inconsistent.
This was a focused inspection. Inspectors visited on 30 June 2021 and gathered evidence until 9 July. They reviewed care, risk and medicines records, staff files, audits and meeting notes. They spoke with people living at the home, relatives, staff, the manager, the provider and the chef.
People said they felt safe and staff were kind. There were enough staff, equipment was checked, infection control was good and healthcare needs were met. Training and supervision had improved, and the Effective rating rose from Requires Improvement to Good.
However, inspectors found serious gaps in medicines records and practice. Advice from healthcare professionals was not always followed, records for some medicines and creams were incomplete, and insulin was stored in a fridge outside the safe temperature range for three weeks.
The home was still rated Requires Improvement overall and for Safe and Well-led. It had been rated Requires Improvement at the previous inspection, and had received this rating for five consecutive inspections. The home remained in breach of two regulations.
People felt safe
People told inspectors they felt safe. Staff had safeguarding training, knew how to report concerns and there were enough staff to meet people's needs.
“People told us they felt safe living at Royley House care home.” from the report
Improved staff support
Staff training had improved since the previous inspection. Staff had completed training in areas previously identified as gaps, and regular supervision was taking place.
“Staff had completed a variety of on-line and face to face training.” from the report
Pleasant mealtimes
People were happy with the choice of food. Inspectors saw a sociable meal where staff offered encouragement and help when needed.
“The lunchtime meal we observed was a pleasant, social occasion.” from the report
Healthcare support
People had access to healthcare professionals when needed. Information from appointments and assessments was recorded in care records.
“People had access to a variety of medical and health related services and professionals, such as general practitioners, district nurses, speech and language therapists and dieticians.” from the report
Medicines were not always managed safely
seriousInspectors found that healthcare advice was not always followed, which meant three people were not given their medicines safely. There were also gaps in records for as-required medicines, thickeners and creams, and insulin was stored at an unsafe fridge temperature.
“The advice and directions of health care professionals was not always followed which meant that three people were not given their medicines safely.” from the report
Governance and records
seriousThe provider's checks had improved but had not made sure that good practice was consistent. Care charts contained gaps or inaccurate entries about thickeners, modified diets and repositioning.
“Closer oversight was needed of the way care charts were completed by staff, as we found inconsistencies and gaps in some records.” from the report
Fluid records and support
needs fixingAlthough fluid intake was monitored and recommended amounts were recorded, the amount of fluid offered varied greatly and rarely reached the recommended daily amount.
“However, we saw the amount of fluid offered to people each day fluctuated greatly and rarely approached the recommended daily amount.” from the report
- 01What specific changes have been made to ensure healthcare instructions and medicine directions are always followed?
- 02How are you checking that insulin is stored at a safe fridge temperature?
- 03How do you check that staff record thickeners, modified diets, creams and repositioning accurately?
- 04What has been done to make sure management is stable and improvements remain in place?
- 05How will you ensure people are offered the amount of fluid stated in their care plans?
This was a focused inspection of Safe, Effective and Well-led; the report says the other ratings from the previous comprehensive inspection were carried forward. This explanation was written from the published report of 7 August 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 Royley House Care Home
7 rated inspections over 5 years: the service has improved, from Requires improvement to Good.
- December 2021Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- August 2021Requires improvementstayed Requires improvementSafe: Requires improvementWell-led: Requires improvement
- February 2021Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementWell-led: Requires improvement
- November 2019Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementWell-led: Requires improvement
- October 2018Requires improvementstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- September 2017Requires improvementstayed Requires improvementSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- January 2017Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- November 2014
Report published without a new overall rating.
- November 2013
Report published without a new overall rating.
- December 2012
Report published without a new overall rating.
- August 2011
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 24 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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