Archived: Riverside View Care Home

The service was last inspected in June 2016. At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Riverside View Care Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The service can provide accommodation and personal care for up to 59 people across two floors. At the time of our inspection 50 people were living there.

There was a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. The registered manager was registered in March 2015.

People and their relatives said they felt safe living at the service. Steps were taken to reduce risks to people. Established and effective infection control processes were in place. Plans were in place to support people in emergency situations. People were safeguarded from abuse. People’s medicines were managed safely. The provider and registered manager monitored staffing levels to ensure enough were deployed to provide safe support. The provider’s recruitment processes minimised the risk of unsuitable staff being employed.

People’s support needs were assessed before they moved into the service to ensure effective and appropriate support was available to them. The service worked with a range of external healthcare professionals to support people’s health and wellbeing. Staff were supported with regular training, supervision and appraisal. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice. People were supported to manage their food and nutrition. The premises were adapted for the comfort and convenience of people living there.

People and relatives told us staff were caring and kind and spoke positively about the support they received. People were treated with dignity and respect. We saw numerous examples of kind and caring support being delivered. People were supported to maintain relationships and social networks of importance to them. Policies and procedures were in place to support people to access advocacy services.

People received person-centred support based on their assessed needs and preferences. People were supported to access activities they enjoyed. Clear procedures were in place for investigating and responding to complaints. At the time of our inspection nobody was receiving end of life care, but policies and procedures were in place to provide this where needed.

The registered manager had informed CQC of significant events in a timely way by submitting the required notifications. This meant we could check that appropriate action had been taken. Staff spoke positively about the culture, values and leadership provided by the registered manager. The registered manager and provider carried out a number of quality assurance audits to monitor and improve standards at the service. Feedback was sought from people, relatives and external professionals. The service was closely integrated into the local community, with relationships that benefited people living there.

Riverside View care home provides nursing and personal care for up to 59 people.

We last inspected the service on 14 July 2014 and found the service was compliant with regulations at that time.

There was a registered manager in post who was on duty at the time of the inspection. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

The premises were clean and well maintained. We saw that equipment was in place to maintain the health and safety of people and staff, and were checked both by the service and approved contractors when required.

We found that safe recruitment and selection procedures were in place and appropriate checks had been undertaken before staff began work. This included obtaining references from previous employers to show staff employed were safe to work with vulnerable people.

There were systems and processes in place to protect people from the risk of harm. The care staff understood the procedures they needed to follow to ensure that people were safe. They were able to describe the different ways that people might experience abuse and the right action to take if they were concerned that abuse had taken place.

Appropriate systems were in place for the management of medicines so that people received their medicines safely. Medicines were stored in a safe manner. We witnessed staff administering medicines in a safe and correct way. Staff ensured people were given time to take their medicines at their own pace.

There was a regular programme of staff supervision in place and records of these were detailed and showed the service worked with staff to identify their personal and professional development. We fed back to the registered manager that the quality of recording around supervisions and appraisals was good.

There were policies and procedures in place in relation to the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). The registered manager had the appropriate knowledge to know when an application should be made and how to submit one. The registered manager also ensured that capacity assessments were completed and ‘best interest’ decisions were made in line with the MCA code of practice. This meant people were safeguarded.

Staff had a good awareness of people’s dietary needs and staff also knew people’s food preferences well. People told us they enjoyed the food at Riverside View and we saw people were supported to have their nutritional needs met.

People told us they had good access to their GP, dentist and optician. Staff at the service had good links with healthcare services and people told us they were involved in decisions about their healthcare. This meant that people who used the service were supported to obtain the appropriate health and social care that they needed.

We observed that all staff and the registered manager were very caring in their interactions with people at the service. People clearly felt very comfortable with all staff members and there was a warm and caring atmosphere in the service and people were relaxed. We saw people being treated with dignity and respect and relatives and people told us that staff were kind and professional.

We saw people’s care plans were personalised and had been well assessed. Staff told us they referred to care plans regularly and they showed regular review that involved, when they were able, the person. We saw staff proactively managing people who became anxious or distressed in a caring manner.

The service encouraged people to maintain their independence and the activities co-ordinators ran a full programme of events which included accessing the community with people. We saw people popping in and out of the registered manager’s office to chat and spend time with them and it was evident that everyone knew the registered manager well and were comfortable to speak with them at any time.

The service had an accessible complaints procedure and people told us they knew how to raise a complaint if they needed to.

Any accidents and incidents were monitored by the registered manager and registered provider to ensure any trends were identified. This system helped to ensure that any patterns of accidents and incidents could be identified and action taken to reduce any identified risks.

The service had a comprehensive range of audits in place to check the quality and safety of the service and equipment at Riverside View and actions plans and lessons learnt were part of their on-going quality review of the service. We saw that immediate electronic feedback was used via the use of tablet computers, one situated in the reception area and others used with support from staff. This meant people were able to give immediate feedback on the quality of the service.

The management of the home had recently changed and the new manager had only been in post for one week. The manager told us she was being supported by the provider's other home managers in the area as well as by the regional manager. Staff spoke highly of their new manager and said they felt that positive changes were happening at the home.

We set out to answer our five questions; Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

Below is a summary of what we found. If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

Everyone we spoke with told us they felt safe and secure living at the home. Staff we spoke with understood the procedures which they needed to follow to ensure that people were safe.

Care plans and risk assessments were in place and updated on a regular basis and were based on people's individual needs and preferences.

Systems were in place to make sure that the new manager and staff learnt from events such as accidents and incidents, concerns, complaints, whistleblowing and investigations. This helped to reduce the risk of harm and ensured that lessons were learnt from mistakes.

Is the service effective?

Everyone had their needs assessed and had individual care records which set out their care needs.

It was clear from our observations and from speaking with staff that they had a good understanding of the care and support needs of people living at the home and that they knew people well. Assessments included dietary, social and leisure and emotional needs.

People spoke highly of the staff and said that they were happy with the care that had been delivered and their needs had been met.

People had access to a range of health care professionals some of which visited the home and all was documented in the care files.

Is the service caring?

People were supported by kind and attentive staff who showed patience and gave encouragement when supporting people, whilst helping them to remain independent.

People who used the service, their relatives and friends were asked for their views on the care and service provided. Where shortfalls or concerns were raised, these were addressed.

People told us that they were happy with the care and support provided to them.

Is the service responsive?

There was clear evidence contained within people's care plans to show how they worked with other health and social care professionals.

People told us that they knew how to make a complaint if they needed to.

Discussion with the new manager during the inspection confirmed that any concerns or complaints were taken seriously. We looked at the complaints record which confirmed that complaints had been investigated and in line with the complaints policy.

Is the service well-led?

The new manager had only been in post for one week but she told us she felt supported by her peers, the staff team and her regional manager. There were systems in place to assure the quality of the service provided. The way the service was run was regularly reviewed. Actions were put in place where needed in relation to medication and we were able to see that these actions had been addressed.

Staff were clear about their roles and responsibilities. Staff had a good understanding of the ethos of the home and were knowledgeable about people's needs. This helped to ensure that people received a good quality service at all times.

What people said:

People who were able to express their views told us they were happy with the care and support they received. People said of the staff; 'They are all good lasses' and 'The staff are lovely'. One person said; 'There is not a lot going on, I just sit here all day'. Comments about food were very positive by everyone we spoke with, people told us; 'The food is very good'.

Staff told us 'It's a nice home here, the care is good' and 'We are a good staff team'. One person said it would help the team if there was more training in palliative (end of life) care. We let the new manager know of this request. Two staff told us that they felt the staffing numbers at times were too low and they were very rushed and it meant if two people were supporting people to mobilise it left no-one else around to supervise other people. They were aware that more staff were on annual leave than normally allowed but we raised this issue with the regional manager who confirmed that minimum staffing levels of three care staff on both floors during the day had been adhered to recently.

We decided to visit the home at 6.15am to gain a wider view of the service provided. This was part of an out of normal hours pilot project being undertaken in the North East region. We spoke with eight people living at the home. Some people were not able to tell us directly what they thought about the service. However, during our visit we spent time observing how care staff supported people and this was positive and respectful. One lady told us 'It's lovely here, the food is great'.

The environment had been specially adapted by the use of colour coded doors, rummage boxes and memory stimulating design to help people find their way around and to feel comfortable in their surroundings. Care staff told us they had also received training in supporting people with dementia and that this was ongoing.

We saw the provider had a quality monitoring process in place to check the quality of the service, which included seeking the views of people and their relatives. Members of staff also told us the manager had effected positive change at the home and 'It's now a great place to work'.