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Riverview Nursing Home Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 15 November 2018

The inspection was carried out on 5 and 12 September 2018 and was unannounced on both days.

Riverview is a care home. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Riverview accommodates up to 60 people in one adapted building. Accommodation is over four floors. At the time of our inspection there were 33 people living at the home.

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.

The last inspection took place in December 2017 and January 2018. The report was published in March 2018. At that time the service was rated inadequate and placed in Special Measures. Services that are in Special Measures are kept under review and inspected again within six months. We expect services to make significant improvements within this timeframe. During this inspection the service demonstrated to us that improvements have been made and is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is now out of Special Measures.

People told us they felt the service was safe. The registered manager understood their safeguarding responsibilities and staff knew how to recognise and report concerns about people’s safety and welfare. All the required checks were done before new staff started work. This helped to protect people from the risk of being cared for by staff unsuitable to work in a care setting.

There were enough staff on duty to keep people safe. Staff were trained and supported to carry out their roles.

Risks to people’s safety and welfare were assessed but the records did not always show who had carried out these assessments. Therefore, we could verify they had been done by a suitably trained person.

The home was clean. Inside it was well maintained and safe and improvements had been made to create a more dementia friendly living space for people. The outside patio area had uneven flags which potentially created a trip hazard.

People’s medicines were managed safely.

The service was working in line with the requirements of the Mental Capacity Act (2005) and acting in people’s best interests. However, this was not always clearly recorded.

People were offered a variety of food and drink which took account of their cultural and religious dietary needs and preferences. We recommended the service look at the timings of meals with the aim of supporting people to have their meals at regular intervals.

The service worked with other agencies to support people to meet their health care needs.

People told us staff were kind and caring and most of the interactions we observed were good. However, people’s dignity was not always respected. Improvements were needed to the way meal times were managed.

People’s care needs were assessed and care plans were in place to guide staff. People were supported to plan for their end of life care.

People had the opportunity to take part in a range of social activities. Doll and pet therapy was used to support people to engage with their environment and others.

Complaints were dealt with. The provider had systems and processes in place to assess and monitor the quality and safety of the services provided. They need to show they can sustain these improvements and continue to develop the service before we can be assured people will consistently experience safe and effective care which is responsive to their needs.

We found the provider remained in breach of one regulation. This related to their quality assurance and governance systems. You can see what acti

Inspection areas

Safe

Requires improvement

Updated 15 November 2018

The service was not consistently safe.

There were enough staff to keep people safe.

People told us they felt the service was safe. Staff knew how to recognise and report concerns about people’s safety and welfare.

Records did not always show risks to people’s safety had been assessed by a suitably trained person.

The home was clean. More needed to be done to make sure the grounds were safe for people to use unsupervised.

Effective

Requires improvement

Updated 15 November 2018

The service was not consistently effective.

The service was acting in people’s best interests but this was not always reflected in care records.

People were supported to have a varied diet which took account of their needs and preferences. We asked the service to review the timings of meals with the aim of achieving more regular intervals between meals.

Staff were trained and supported to meet people’s needs.

People were supported to meet their health care needs.

Caring

Requires improvement

Updated 15 November 2018

The service was not consistently caring.

People told us the staff were caring and kind.

Improvements had been made since the last inspection and we saw good interactions between staff and people who lived at the home. However, we also saw some practices which showed a lack of respect for people.

People's relatives were involved in decisions about care and treatment.

Responsive

Good

Updated 15 November 2018

The service was responsive.

Improvements had been made since our last inspection. Daily routines were more flexible and took account of people’s needs and preferences.

People’s care plans contained information about their care and support needs.

People were offered the opportunity to take part in a range of activities.

Complaints were dealt with appropriately.

Well-led

Requires improvement

Updated 15 November 2018

The service was not consistently well-led.

Improvements had been made since the last inspection. The provider needed to demonstrate they could sustain and develop these improvements to ensure people consistently experienced safe and effective care.

There were systems in place to monitor and assess the quality and safety of the services provided.

People were given the opportunity to share their views of the service.