Rivelin Care Home

Rivelin Care Home is a residential care home providing personal care to up to 40 people. The service provides support to older people, some of whom are living with dementia. At the time of our inspection there were 38 people using the service.

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

Quality monitoring systems were in place which helped to check various areas of the home.

People were happy with the care they received, they felt safe and well looked after.

People had support from staff who had been safely recruited. Staff received training in safeguarding and understood their role and responsibilities to protect people from abuse.

People and staff spoke positively about the management of the service. Staff receive guidance and support from management regularly and when required. The service had enough staff to keep people safe. We observed staff respecting people's privacy and dignity when providing care and support.

People were supported to take their medicines safely as prescribed.

Staff followed care plans and risk assessments which were in place for known risk, up to date, and regularly reviewed.

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 regularly asked their views on the service provided and action had been taken when suggestions were made.

People were supported to have access to healthcare services to monitor and maintain their health and well-being. People were encouraged to maintain a healthy diet, where people had specific dietary requirements, these were catered for.

The provider and staff worked in partnership with other health and social care agencies to deliver good outcomes for people and to ensure their needs were met and reviewed.

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

Rating at last inspection

The last rating for this service was good (published 31 August 2017).

Why we inspected

This inspection was prompted by a review of the information we held about this service and when the service was last inspected.

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.

This was a focused inspection and the report only covers our findings in relation to the Key Questions safe and well-led. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

Follow up

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

Rivelin Care Home is a care home providing personal care and accommodation to up to 40 people, some of whom may be living with dementia. When we inspected 30 people were living in the service.

We found the following examples of good practice

¿ Visitors were asked a set of screening questions and their temperatures taken to ascertain any risks and their details were kept for track and trace purposes. All visitors were supervised to ensure they followed infection control guidelines and wore appropriate Personal Protective Equipment (PPE).

¿ Measures had been put in place to support social distancing. Staff staggered their breaks and travelled to work separately in their own vehicles or taxis to reduce the use of public transport.

¿ People were supported to maintain contact with their families and friends through phone calls and video calls.

¿ The provider was fully aware of all current best practice guidance including the safe admission of people from hospital. The provider communicated updates to people, their families and staff when they happened.

¿ Designated stations for the use of PPE were situated around the service to enable staff to regularly change their PPE and reduce the risk of transmission. Staff were trained in the use and disposal of PPE and senior staff were appropriately trained to complete testing for Covid-19.

¿ People who used the service and staff were regularly tested and there were clear procedures in place to make sure people and staff self-isolated when necessary.

¿ The service was clean and tidy. Thorough cleaning schedules were in place and frequently touched areas such as handles, and rails were cleaned regularly throughout the day and night to reduce the risk of transmission.

¿ The provider had contingency plans in place which included the use of agency staff who only worked at the service to reduce the risk of transmission to and from other services.

Further information is in the detailed findings below.

Rivelin Care Home provides accommodation and personal care for older people, including people living with dementia related conditions. The home is situated in Cleethorpes, in North East Lincolnshire. There are various communal areas including a dining room and three lounges. All bedrooms are for single occupancy; some have en-suite facilities. Rivelin Care Home is close to the sea front and to local amenities. 36 people were residing at the home at the time of the inspection visit.

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.

At the last inspection carried out on 25 March 2015, the service was rated overall as good. We had rated the service as ‘Requires Improvement’ under the effective domain as some improvements were required to ensure the service complied with the Mental Capacity Act. At this inspection we found all improvements had been made.

At this inspection visit carried out in June 2017, we found the service the service met the fundamental standards. People and relatives spoke extremely positively about the quality of service provided. We found there was a warm, welcoming and vibrant atmosphere at the home.

There was a strong emphasis on promoting dignity in care. We found that dignity was at the centre of all care provision. Dignity champions had received additional training and skills in their specific areas. Skills were then shared within the staff team to create more positive outcomes for people who used the service. People who lived at the home were encouraged to think about dignity and how it affected them and feedback in meetings where improvements could be made. Dignity champion training had also been extended to relatives of people who lived at the home in order for them to contribute to how dignity was ensured at the home. We observed dignity being respected at all times during our inspection visit.

People who lived at the home and relatives praised the caring nature of staff and the owner of the home. Staff were constantly referred to as ‘kind’ and ‘caring.’ Relatives told us staff often went the extra mile. We observed positive interactions between people and staff which confirmed that care provision was of a high quality.

People and relatives praised the activities made available and told us there was plenty to do. The service adopted a person centred approach to the provision of activities to ensure people’s personal interests were pursued. There was a focus on developing and maintaining independence.

We saw there was an open and transparent culture within Rivelin. Prompts were set around the building reminding people of the importance of feeding back their experiences of care delivery People and relatives told us they were encouraged to raise any concerns and complaints. We saw evidence of this occurring. Relatives told us they were confident any concerns raised would be dealt with efficiently and professionally should they arise.

Care plans emphasised the importance of promoting independence and empowering people. There was a welcoming, homely atmosphere within the home where visitors were encouraged. Relatives compared the home to a family unit where people were happy and had a sense of belonging.

There was emphasis on creating positive health outcomes for people who used the service. Healthcare needs were proactively met. Relatives told us people’s wellbeing had improved since they started living at the home. They praised the ways in which people’s quality of life had increased.

Relatives praised the ways in which they were included at the home. They told us they were able to join in activities, attend meetings and were also empowered to have say in which the home was managed. They constantly likened the home to an extended family unit in which they were welcomed and cared for.

The service worked in partnership with other care professionals to meet needs. Health professionals we spoke with praised the standard of care provided and described the service as professional and reliable.

Leadership within the organisation was good. The registered manager had recently been recognised and awarded by the Clinical Commissioning Group for their management skills and the way in which they managed the home. Staff were positive about ways in which the service was managed and the support received from the management team. Staff praised the positive presence of the senior management team at the home and repeatedly described the management team as, “Excellent.” And, “On the ball.”

Staff described a positive working environment and told us teamwork was good. The service worked proactively with other organisations to ensure they were implementing and following best practice guidelines. Information was willingly shared with other providers to assist improvements within other services.

Procedures were in place to protect people from harm. Staff told us they had received training in this area and were able to describe abuse and their responsibilities for reporting this.

People told us they felt safe at the home. The registered manager assessed individual risk and developed risk assessments to minimise the potential risk of harm to people during the delivery of their care. Care records showed they were reviewed and any changes were recorded. Risk was suitably managed.

We received positive feedback about the quality of food at the home. There was a variety of food on offer and staff were accommodating to people’s individual needs and preferences. Meal times were relaxed. Nutritional and hydration needs were met through innovative and person centred ways.

People told us staffing levels met their needs. We observed staff were not rushed and had time to sit with people. The registered manager reviewed staffing levels to ensure there were suitable numbers of staff on shift to meet the needs of the people who lived at the home. We observed staff being deployed to ensure people were kept safe.

We reviewed staff records. Suitable recruitment checks were in place to ensure staff recruited possessed the correct characteristics and experiences for working with vulnerable people.

We looked around the building. We found it was hygienic and suitably maintained. We reviewed documentation relating to health and safety at the home and found suitable maintenance checks had been carried out.

We reviewed systems in place for managing medicines. We found that good practice guidelines were consistently implemented. Medicines were given as prescribed and stored and disposed of correctly. We looked at medication administration records of people who lived at the home and found them to be correct and up to date.

People and relatives told us staff had the required skills and knowledge to provide effective care. The registered manager maintained a training matrix so that training could be planned effectively. Staff praised the training on offer.

Care records were person centred and reflected the needs of people who lived at the home. We saw evidence these were reviewed on a regular basis or when people’s needs changed.

The registered manager used a variety of methods to assess and monitor the quality of care at the home. These included regular audits of medication, care plans and dignity. We saw evidence that findings from audits triggered change. Relatives told us the registered manager was committed to making improvements to enhance the quality of care.

Resident and relatives meetings took place on a regular basis. People and relatives told us suggestions to improve the service were taken seriously and acted upon. Relatives told us the registered provider valued feedback as a means to improve service delivery.

The registered manager was aware of their responsibilities in reporting to the Care Quality Commission. They understood the importance of continuous learning and development in order to ensure good quality care was consistently implemented and delivered.

Everyone told us they were treated with dignity and respect by staff. One person told us, "The staff know me well, they treat me very well." Another person said,'The staff are nice, they don't boss you about.'

We spent 30 minutes over the lunch time period watching people having their meal. We saw staff managed to support people efficiently and sensitively. We saw they interacted well with people and at an appropriate pace. People were offered choices about what they would like to eat and the atmosphere in the dining room was relaxed.

We looked around the premises and found people who used the service were protected against the risks of unsafe or unsuitable premises because of adequate maintenance. People spoken with told us they liked their home. One person said, 'My room is comfortable and very cosy, just how I like it.'

We found staff were recruited appropriately and checks were carried out before staff worked in the home.

People had opportunities to comment on the service through regular meetings and surveys. People told us they felt comfortable about making suggestions and talking about concerns.

We saw that the topic of dignity had been given high priority at the home and that most staff had undertaken training on dignity awareness. A notice board displayed information for staff on how to promote dignity and a dignity champion had been appointed. However, we were concerned about people not receiving appropriate support in the dining room and felt that this did not respect their dignity.

People told us that they felt safe living at the home and the discussions we had with staff evidenced that they had a good understanding of the principles of safeguarding vulnerable adults from abuse.

Staff received training to provide them with the knowledge and skills they needed to support the people who lived at the home. Staff told us that they were well supported by the manager.

We checked complaints information at the home and saw that any complaints made were investigated thoroughly and that appropriate corrective action had been taken.