Archived: Riverslie

Updated 24 November 2022

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. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

As part of this inspection we also 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 first day of the inspection was completed by two inspectors and the second day was completed by an inspector and an inspection manager.

Service and service type

Riverslie is a 'care home'. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

At the time of our inspection there was a registered manager in post.

Notice of inspection

Both days of the inspection were unannounced.

What we did before inspection

We reviewed information we had received about the service since it was newly registered. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We checked the inside and outside of the premises, equipment and infection prevention and control measures. We spoke with the manager, two nurses, the cook and three care staff.

We reviewed a range of records. This included health and safety and cleaning records, recruitment records for three staff, maintenance records and a variety of records relating to the governance of the service. We also reviewed the management of medicines.

We also reviewed information provided by other health and social care professionals who we worked in partnership with during the inspection.

After the inspection

CQC used their urgent powers to ensure that people remained safe from potential harm.

Updated 24 November 2022

About the service

Riverslie is a care home providing accommodation, personal and nursing care for up to 30 people; some of whom lived with dementia and physical disabilities. At the time of our inspection 22 people were living at the service.

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

Risk to the health, safety and welfare of people and others had not been assessed, monitored and managed, placing them at serious risk of harm. We found a catalogue of serious concerns relating to the safety of both the inside and outside of the premises, utilities, equipment and preventing, detecting and controlling the spread of infections.

The systems and processes for assessing the quality and safety of the service failed to identify things that had gone wrong and bring about improvement and learning.

The provider and registered manager neglected the environment people lived in placing them at risk of abuse.

People were not protected from the risk of the spread of infection. Many parts of the service and equipment in use were unclean. The clinical waste bin stored outside the building was not secured posing a risk to the public. Items of used personal protective equipment was disposed of in the rear garden. The laundry was extremely dirty and laundering facilities were inadequate. Soil pipes at the rear of the building were missing resulting in waste from bathrooms being flushed onto a pavement.

Assessments were not carried out on staff to make sure they were competent to safely manage people’s medicines. The last medication audit was incomplete and previous audits could not be located; therefore, we could not be assured people’s medicines were safely managed. There were concerns in relation to the management of people’s medicines including the administration, recording and the use of ‘as required’ (PRN) medicines.

People and others were placed at serious risk of harm because the provider and registered manager lacked oversight and scrutiny of the service. They failed to operate an effective system and take responsibility for assessing, monitoring and improving the quality and safety of the service and for mitigating the serious risks found during this inspection.

Recent checks carried out on the environment were ineffective, they failed to identify any of the serious concerns we found, despite many of them being visible and longstanding.

There were sufficient staff on duty to provide care and support to people and safe recruitment process were followed.

The Care Quality Commission (CQC) took action to address the serious concerns found on the first day of inspection. The provider was invited to complete and send an urgent action plan, setting out how they were addressing the concerns identified during our inspection, and how they intend to address other serious concerns identified by inspectors immediately. We received an action plan from the provider within the agreed timescale, however it failed to adequately mitigate the risks.

During the first day of inspection CQC shared the concerns with the relevant local authority due to the significant risks identified by inspectors. The local authority took immediate steps to remove all 22 people from the service on the first day of inspection.

CQC used their urgent powers to ensure that people remained safe from potential harm.

Rating at last inspection

The last rating for this service was good (published 4 January 2021).

At this inspection we found breaches of regulation 12 (Safe care and treatment) and regulation 17 (Good governance).

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

Why we inspected

CQC received information of concern about people’s safety. As a result, we undertook a focused inspection to review the key questions of safe and well-led only. Please see full details in the individual sections of this full report.

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 assurances that the service can respond to COVID-19 and other infection outbreaks effectively.

Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has changed from good to inadequate. This is based on the findings at this inspection.

Enforcement

We have identified serious breaches in relation to risk management, preventing and controlling infection and the governance and leadership of the service.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or varying the conditions of the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.