Background to this inspection
Updated
11 November 2020
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 Care Act 2014. Due to the Covid-19 pandemic this inspection focused on three domains only. We targeted and focused on the domains of safe, effective and well-led. These were crucial to ensure people received care in a safe and effective way.
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
This inspection was completed by two inspectors and an assistant inspector. Site visits occurred on 28 and 29 September 2020, with the desk-based inspection being completed there after.
Service and service type
River View Care Centre 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 had a manager registered with the Care Quality Commission. 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.
Notice of inspection
We gave the service 48 hours’ notice of the inspection. This was because we wanted to ensure the service was able to accommodate our visit, amidst the Covid-19 pandemic. We provided the registered manager with a list of documents we would be seeking to look at during the inspection. Any information that could be provided electronically for review was to be sent.
What we did before inspection
We reviewed information we had received about the service since the last inspection. 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 spoke with two people who used the service about their experience of the care provided very briefly during the inspection. We spoke with five members of staff including the area director, registered manager, clinical manager, maintenance and the hospitality lead.
We reviewed a range of records. This included ten people’s care records and multiple medication records. We looked at six staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We worked through additional care files, risk assessments, audits and sought written feedback from relatives and staff. We received responses from two relatives and seven staff.
Updated
11 November 2020
About the service
River View Care Centre is a residential care home providing personal and nursing care to a maximum of 137 people. At the time of the inspection the service was supporting a total of 70 people.
The service provides facilities over three floors, and six units. Five of the units had recently undergone immense refurbishment. The units had been redecorated to meet the needs of people. For example, one unit had been specifically renovated to successfully support people living with dementia remain independent and able to access their room and communal areas freely. Each bedroom was individualised with en-suite facilities. An enclosed garden to the rear of the property was accessible from the ground floor. Relatives of people used this to visit their loved ones within the home.
People’s experience of using this service and what we found
The service had ensured people were kept as safe as possible by identifying, assessing and reviewing risks. Care plans were kept up to date, with actions identified on how to mitigate risk to people.
Medicines were safely managed and audited. Staff trained and assessed as competent administered medicines only.
Recruitment checks were completed for all staff employed at the service, to ensure they were safe to support and care for people. These were regularly audited to ensure compliance with the regulations.
The service had comprehensive infection and control plans in place to help ensure the service managed the pandemic. We saw robust policies and procedures in place. We spoke with the registered manager to ensure all actions were attainable. Where required amendments were made to ensure compliance with the provider’s internal policy. The service was very clean and free of malodour.
People were supported to eat and drink safely. Where required they had their food and fluid safely monitored. Records indicated staff closely maintained an overview of the nutrition and hydration checks. Where appropriate support from external professionals was sought within a timely manner.
Staff had a comprehensive understanding of the MCA. People were encouraged to make choices and retain as much control as possible over their lives and care.
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.
People were supported by a staff team that in turn was well supported by the registered manager and provider. Staff were compliant with all identified training, and had effective strategies of support with one to one chats and supervisions, team meetings and daily handovers.
The service had undergone extensive adaptations to the environment. These reflected and met the needs of people living at River View Care Centre.
The registered manager worked proactively to ensure an open door, transparent and inclusive method of working was attained at the service. This included staff, external professionals, people and relatives.
Feedback was sought and actioned to ensure care and practice was reflective of meeting the needs of people. People, professionals, relatives and staff were extremely complimentary of the registered manager and staff team.
The service was extensively audited. This meant the registered manager had retained a complete overview of the practice, safety and effectiveness of how the care home operated.
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 05 September 2019) and there were multiple breaches of regulation. The provider completed monthly action plans 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 12 (safe care and treatment), 14 (meeting nutritional and hydrational needs), 17 (good governance) and 19 (fit and proper persons employed). We did not focus on the domains of caring and responsive, however we found there to be sufficient improvement within regulation 9 (person centred care) and 10 (dignity and respect) for the service to no longer remain in breach. As the KLOEs related to these domains were not inspected against, we are unable to comment on the entire domains.
This service has been in Special Measures since the September 2018 inspection. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.
Why we inspected
This was a planned inspection based on the previous rating.
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 coronavirus and other infection outbreaks effectively.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.