Archived: Riverside Nursing Home

Updated 18 January 2019

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 31 October 2018 and 1 November2018. The inspection was unannounced and was carried out by one adult social care inspector, one assistant 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 service. The expert by experience had experience of supporting older people.

Before the inspection we reviewed the information, we held about the service. This included notifications from the provider and by speaking with the local authority contracts and safeguarding teams.

We used information the provider sent us in the PIR. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make.

We spent time observing care in the communal areas and used the Short Observational

Framework for Inspections (SOFI), which is a way of observing care to help us understand the experience of people using the service who could not express their views to us.

We spent time looking at records, which included, six people's care records, five staff recruitment files and records relating to the management of the service, which included three Medication Administration Records [MAR] and quality assurance files, complaints and compliments files.

We spoke with 14 people who used the service, five relatives, two visitors, five care workers, the chef, the clinical lead, the registered manager and a house keeper. We contacted three health professionals by email but did not receive a response.

Updated 18 January 2019

People and staff told us they felt the staff team had been well led by the registered manager. The registered manager also known as matron had been in post for 14 years. They were supported by clinical leads, nurses, team leaders, seniors and care assistants.

The registered manager completed a number of audits relating to the monitoring of the service which included falls. They said,” We monitor falls really closely using half-hourly observations, light beams, alarm mats, and crash mats. If a person is at risk of falls, we often provide an ultra-low profiling bed. We carry out an accident audit and analysis to identify trends. These are comprehensive and examine all factors that might cause people to fall.”

The registered manager said, “I believe the trick is to get everyone involved and engaged in the management of the service. For example, we have monthly heads of department meetings, in which the health and safety champion and infection control champion are included. We start with health and safety and discuss all other issues that need to be addressed. This means that the management of the various teams is integrated and work together. This helps us to keep things running smoothly either when things become difficult or when I am not present. An action plan is created out of this meeting. At the next meeting, actions are followed up and any outstanding actions addressed.

Areas identified for improvement were responded to in a timely manner by the management of Riverside Nursing Home. Some issues identified required longer-term actions, however some were quickly addressed. For example, Do not disturb signs were purchased for people’s doors to ensure privacy whilst having their personal care.

Staff held specific responsibilities in regards health and safety, infection control and dignity. They told us, “I cannot guarantee that our staff will never commit errors. However, we as a management team, and I as the registered manager, do try to anticipate issues and also ensure that staff are aware of, and carry out good practice”. The registered manager was confident that “their extensive audits and monitoring of the service” would ensure any issues or concerns would be highlighted and addressed with immediate effect.

People their relatives, staff and professionals felt the service was well led. They all told us the management team were approachable, and they could talk to them at any time. One person said, “We always see the matron around, she is very approachable.” A relative told us, “The home is well run, they think of the resident first, they think outside the box”. “The matron is a good role model, they do so much.” “I definitely like it here, matron is one of the best, I feel safe and well looked after.”

The registered manager told us they received regular support from the provider, they told us, “I normally see them once a month, but would call if I needed any additional support. We have a good working relationship.” The provider sought input from external agencies and organisations to ensure improvements in service delivery. Residents meeting were held to enable people to have information shared and to share ideas.

Feedback from staff about the management team was positive. We were told that management were approachable, listened and took action where this was needed. The registered manager and management team were visible and helpful during our inspection. There was a shared focus on ensuring that people were treated with equality and dignity. The registered manager told us they were proud of their team, they told us, “There are staff incentives in place to recognise the valuable contribution staff make to the home. This includes rewarding staff that share good ideas that will benefit the residents”. “Staff have regular supervision and annual appraisal. We keep staff informed when we have meetings. If there is an issue of poor communication or poor practice we manage this with supervision”. Staff confirmed they had regular staff meeting and were able to contribute ideas.

The service worked in partnership with a range of external agencies to provide joined up care to people. They were in regular contact with the local authority safeguarding team from whom they sought advice and guidance if there were any potential safeguarding concerns. A professional told us that the home had worked well with them and had taken on board their suggestions and recommendations following a recent visit to the service.

The service played an important role within their local community. The service ran a local community group to support people who were living with the effects of a stroke. The registered manager told us, “Local people come along you don’t have to have had a stroke, just enjoy a social gathering. We have great links with our local hospital and GP surgeries, who get involved. Our residents love going to the club each week. Other initiatives included working with local schools to offer work experiences, and younger children coming to the service at festival times, to sing and socialise with people and their families.

There were development plans in place to drive changes and improvements at the service. The registered manager promoted an ethos of honesty, learned from mistakes and admitted when things had gone wrong. This reflected the requirements of the duty of candour. The duty of candour is a legal obligation to act in an open and transparent way in relation to care and treatment.

The registered manager demonstrated a good understanding of their role and responsibilities including when they needed to notify CQC, the local authority safeguarding team or the police of certain events or incidents.