The Care Quality Commission (CQC) has taken action to protect people living at Riseley House Care Home and rated it as inadequate, following an inspection in January.
Riseley House Care Home in Macclesfield is run by Laurel Bank Residential Care Home Limited. It provides personal care for older people, including people living with dementia, as well as people needing rehabilitation after being discharged from the local hospital before they go back home.
The inspection was prompted in part due to concerns received about the safety of the premises, and after enforcement action was issued by the fire service following a visit to the home.
Following the inspection, the overall rating has decreased from requires improvement to inadequate. The rating for how safe the home is has also declined from requires improvement to inadequate. Well-led has been rated again as inadequate.
The home has remained rated as requires improvement for how effective, caring, and responsive it is.
CQC has served two warning notices to the provider to make sure they are providing safe care and treatment to people living at the service, and have good governance systems in place.
The service has also been placed in special measures which means it will be kept under close review to make sure people are safe and there will be a re-inspection to check for significant improvements. If there are no improvements, CQC will not hesitate to take further action, even if that means taking steps to prevent the home from operating.
Karen Knapton, CQC deputy director of operations in the north said:
“When we inspected Riseley House Care Home, we were disappointed to find leaders still hadn’t addressed our previous areas of concern which placed people at a continued risk of harm.
“Leaders weren’t monitoring issues and risks effectively and didn’t always notify us quickly when incidents occurred. When people had recurrent falls, there was no evidence the provider had looked into the circumstances to see what lessons could be learned.
“Leaders also weren’t ensuring that the home environment was safe or that equipment was checked as regularly as it should be. We found several motion sensors and alert buttons were broken, which were in place to support people who were at high risk of falls. This issue had been previously highlighted by another agency, but the provider had not acted on these concerns, and this put people at risk of harm.
“Staff were doing their best to provide respectful and safe care but weren’t being supported to access all the training they needed to carry out their roles. At a previous inspection leaders told us they would take steps to ensure staff were suitably trained to support the people they cared for, but this had still not taken place.
“Care plans weren’t always updated when people’s needs changed. We found several people who had skin integrity risks hadn’t had their care plans updated, which meant staff lacked guidance on how to support them to reduce the risks of skin damage. Inspectors saw someone who was frequently distressed, but there was no guidance in their care plan on how staff should support them.
“In addition, people and their families weren’t always involved in planning their care. We found at a previous inspection that people’s care notes were focused on tasks rather than their wellbeing and interactions in the home, and this practice hadn’t changed. There was no evidence that people’s social and emotional needs were being met, or that they took part in any activities.
“We have told leaders where we expect to see rapid, widespread improvements and will continue to monitor the home closely to keep people safe during this time. We will return to check on their progress and won’t hesitate to take further action if people aren’t receiving the high level of care they deserve.”
Inspectors found:
- People weren’t supported to have maximum choice and control of their lives. Staff weren’t assessing people under the principles of the Mental Capacity Act, to see if they had the capacity to make decisions about their care, although the service had processes in place to do this. For example, there were motion sensors in several bedrooms but no evidence that this was in people’s best interests
- Staffing levels were inadequate to keep people safe. Staff told inspectors they didn’t feel listened to and there were limited opportunities for staff and people using the service to give feedback on the service. Inspectors noted that a staff survey had taken place since our last inspection, but no changes had been made following it
- Environment checks weren’t carried out when they should be. The lift had not been serviced and gas safety certification was out of date. We found leaders were unaware that they were responsible for these safety checks. However, the provider took action to address this after it was highlighted at inspection
- Medicines weren’t always managed safely, and records were incomplete. Inspectors found a controlled drug, was in an unlocked cupboard. People were prescribed flammable creams which were kept in their bedrooms, but there was no risk assessment to evaluate if this was safe, although the provider took steps to address this following the inspection
- The home’s layout and design didn’t support people who had dementia to navigate easily. The provider was advised at a previous inspection to update signage in the home so that people could identify where they were in the building and how to get to other areas, but this had not been acted on.
However:
- People using the service, as well as their relatives, shared positive feedback about the staff
- People were supported to access healthcare services and the home had good relationships with the local GP surgery, and worked with the local hospital to support people who were staying at the home for rehabilitation.