Riverside House

Updated 8 February 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by 1 inspector and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Riverside House is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Riverside House is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was not a registered manager in post. The manager had managed Riverside House since September 2022 and had submitted an application to register. We are currently assessing this application.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from commissioners. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 6 people who used the service and observed people interacting with staff. We received feedback from 6 people's relatives and 3 professionals, about their experience of the care and support provided by the service.

We spoke with 8 staff including the nominated individual, manager, senior support worker and 5 support workers. The nominated individual (NI) is responsible for supervising the management of the service on behalf of the provider. We also received feedback from the provider's clinical lead and the behavioural support lead.

We reviewed a range of records. This included people's care records and records of incidents and accidents. A variety of records relating to the management of the service, including the service’s action plan and recent audits were reviewed.

Updated 8 February 2023

About the service

Riverside House is a residential care home providing accommodation and personal care for up to 12 people. The service provides support to people living with a learning disability or autistic spectrum disorder. At the time of our inspection there were 11 people using the service.

The service is a large adapted house with facilities over 4 floors. People have their own bedrooms and access to a variety of communal rooms and an enclosed garden.

People’s experience of using this service and what we found

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

Right Support: The service was a busy, larger than average, household where people enjoyed a good quality of life. People were regularly in and out of the service, interacting with others, making use of their personal space and communal resources as they wished. They participated in individual and/or group activities within the service, at the main ‘Stepping Stones’ site, or in their wider community. Work was ongoing to adapt the environment in line with people’s sensory needs and changing mobility.

Some people had lived at Riverside for many years, they were happy and settled in their home. People were supported to maintain relationships with others who were important to them through regular visits, phone and video calls and celebrating special occasions. This included visiting family members who lived some distance away.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Right Care: People’s activities were tailored to their interests, preferences and needs. A professional said, “Riverside are working hard to expand meaningful activities and are thinking of the individual’s specific needs, likes and dislikes and working with them directly to build on this.” We saw people were confident when interacting with staff, often leading interactions and joking with them. People spent time with others and engaged in activities when it suited them.

Each person had a named staff member [keyworker] who supported them with planning and decision-making. People were supported to access appropriate health and dental care; Medicines and incidents were reviewed regularly with external professionals to ensure any restrictions were in people's best interests. Legal authorisation had been sought as required when people were unable to consent to care. Staffing levels and staff training were reviewed in-line with activities and people’s needs.

Right Culture: People lived in an inclusive and caring environment where they were valued and relationships were based on mutual respect and kindness. The manager led by example, working openly and setting clear expectations for staff. People and staff were listened to and their ideas and suggestions were welcomed.

The staff we spoke with were compassionate and empathetic and understood people's needs and risks. Staff were very positive about working at Riverside and praised the manager for ongoing improvements in the service, a staff member described their achievements as, “remarkable”. Effective working relationships had been established with professionals and 5 out of 6 relatives said communication with Riverside was very good.

The provider was reviewing their governance and oversight arrangements to ensure they always had capacity to support services to make timely improvements when needed.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 12 November 2021) and there was 1 breach of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

At our last inspection we recommended the provider seek additional guidance in the principles of STOMP (stopping overmedication of people with a learning disability, autism or both). At this inspection we found the provider had acted upon this recommendation and STOMP (best practice) guidance had been followed.

Why we inspected

We carried out an unannounced inspection of this service on 24 and 29 September 2021. A breach of legal requirements was found. The provider completed an action plan after the last inspection to show what they would do and by when to improve person-centred care.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe, Responsive and Well Led which contain those requirements.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Riverside House on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.