Archived: Riverview Community Support Service

Riverview Community Support Service currently provides personal care to people living in their own homes. The service is managed from offices close to the centre of Kendal. The agency provides domiciliary care to people living in the South Lakes and Furness districts of Cumbria. This service will be ceasing in the near future and the seven clients currently receiving a service have been given notice. It is anticipated that this service will cease by the end of October 2018. Leonard Cheshire will continue to provide a supported living service to a number of people living in Kendal. Supported living services involve a person living in their own home and receiving care and/or support in order to promote their independence. The care they receive is regulated by the Care Quality Commission, but the accommodation is not. People's care and housing are provided under separate contractual agreements. The Care Quality Commission [CQC] does not regulate premises used for supported living; this inspection looked at people's personal care and support.

At our last comprehensive inspection in October 2015 we rated the service as "Good". We however, made recommendations for improvements during this inspection. We noted that risk assessments lacked detail for staff on how to stay safe when dealing with some clients and their visitors. During this inspection, we also noted that all documents were not signed and dated and adequate attention was not paid to staff safety during their shift. Staff training records were not all up to date and in addition no registered manager was in post. As a consequence of these deficiencies people may be at risk of harm or of not receiving appropriate care.

The service does not currently have a registered manager in post. The previous registered manager left the service in March 2018. 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.

Riverview Community Support Service is currently being managed by a registered manager from another Leonard Cheshire Service who therefore has responsibility for two services. We were told a new manager had been appointed and was due to take up post on the 10 October 2018, however when we spoke to the staff they were unaware of this and felt this added to the feeling of unsettlement.

Some staff we spoke with said they felt anxious about the service provided and that morale was low. We observed staff trying to support people in a caring and patient way during the inspection; however, staff told us they felt unsupported and communication the management was poor.

The service was supporting some people with complex needs which had the potential to put staff at risk. Support plans and risk assessments lacked the detail required to ensure staff knew how to mitigate risks and keep themselves safe whilst supporting some people.

We have made a recommendation about this

Some staff files did not contain up to date training records however a separate record is maintained by the administrator that details all the training undertaken by individual staff members.

Support workers were carefully recruited. There was a recruitment procedure and staff records contained evidence that essential checks had been carried out prior to care workers starting work. There were enough support workers deployed to meet people's needs. Any shortfall in staff was covered by agency staff.

Medication was stored safely and staff said they had training in safe ways to support people to take their prescribed medication.

The service had a complaints procedure. People and their representatives knew who to complain to if they had concerns. The service had received a number of concerns from an anonymous source from who / where in recent months. They have been referred appropriately to local safeguarding teams and the management of the service had cooperated in the investigations.

Not all records and correspondence were signed and dated which made it difficult to establish what was current information.

The service responded in an open and transparent way when things went wrong, so that lessons could be learned and improvements made.

People were supported to eat and drink enough. People were actively involved in choosing what they ate and preparing their own meals. Risks to people with complex eating needs were understood by staff.

Staff worked with other external teams and services to ensure people received effective care, support and treatment. People had access to healthcare services, and received appropriate support with their on-going healthcare needs.

Staff provided care and support in a kind and compassionate way.

People told us they knew how to contact the agency if they needed to. Where people had raised concerns with the service, they told us these had been listened to and action had been taken in response to their comments.

Everyone we spoke with said they were able to refuse any part of their planned care if they wished.

Most of the people we spoke with told us they were happy with the care staff who visited them.

They told us,

'The staff are brilliant, I get on with them',

and said, 'The staff are very good, I look forward to them coming'.

Some people said that the quality of the service could vary, depending on which staff visited them. They told us, 'Some staff are excellent' but said, 'Some staff are better than others'. They said that, although they received the support they required, they had to give some staff a lot of guidance in order for their care to be provided as they wanted.

People told us:

'They are absolutely excellent',

'I don't know how I'd manage without my carers'

and said, 'I'd definitely recommend them to other people'.